Hello my name is Tim…
I’m delighted to have the chance to take on the role of Chair for the new Partnership Board. Improving health and care for those we serve is a priority to us all. The Partnership covers six places and six local Health and Well-being Boards including Bradford, Calderdale, Leeds, Kirklees, Wakefield and North Yorkshire. We are all agreed that only by working together with the NHS and local communities can we provide better joined up health and care to the benefit of local people.
When we agreed to take the next step in working together by setting up the Partnership Board, we set out our shared principles, including our continuing commitment to an NHS free at the point of delivery, fully accessible to all and world class in its care. There are some excellent examples of this already taking place across West Yorkshire and Harrogate, in all areas.
Creating the Partnership Board is also a clear message of the importance of democratic accountability in our changing health and care system. It ensures decisions are rooted in an understanding of each place across West Yorkshire and Harrogate and are focused on getting the help to people who need it. We are very pleased that this is equally recognised and valued by our health partners.
As democratically elected councillors – ensuring our role as equal partners around the decision-making table is an important step forward and one I, amongst others, welcome.
The factors that determine whether someone leads a long and healthy life are not just about health and social care services. They include decent housing, access to green space, good education and the kind of inclusive growth that expands employment. Together we can, reduce health inequalities and promotes opportunity for all – whilst helping the poorest fastest. These important factors will be discussed at the Board and are at the heart of our shared priorities as local councils.
In West Yorkshire and Harrogate there are around 50 local neighbourhoods, where GP practices, community and social care services, are working to join up health and care services for populations of 30,000-50,000 people.
For example, in Calderdale where I am Leader for the Council and Chair of the Health and Wellbeing Board we are working together to join up health and care in many ways. We have done this by focussing upon improving ways of working and by empowering colleagues across our different services, organisations and sectors to work together to come up with new approaches and new ideas about how to improve the quality of care we deliver. This focus on people and bottom up solutions is better than a simplistic approach to performance management of targets (or number of people we support).
We are involving NHS, council colleagues, community organisations and local housing staff to ensure that people’s needs are flagged up early enough to enable the right arrangements to be made. We believe that improvements can only be delivered through a combination of leadership, teamwork, data and intelligence, appropriate governance and by the creation of a movement for change with local people. We want to see everyone involved in making this change, and that they are doing it because they want everyone in Calderdale to have the best health and wellbeing possible, rather than because a centrally driven target says so.
The focus for these local and West Yorkshire and Harrogate partnerships is increasingly moving away from simply treating ill health to preventing it - tackling the wider determinants of health, such as housing, employment, social inclusion and the physical environment i.e. green spaces. All important areas of work close to local authorities and the Partnership’s heart.
Key to this is tackling deep rooted financial problems or recruitment and workforce challenges by bringing together all of our resources locally and working with communities to support self-care and staying healthy.
You don’t need to look far to see the pressures facing councils, either in your neighbourhoods and communities or via conversations with families and friends who work for local government.
The recent Local Government Association: Moving the conversation on: LGA budget submission 2018 sets this out quite clearly. What we all have in common, whether you work for a council, NHS organisation or community organisation – or indeed – any other public sector organisation, for example police or fire service – is the aspiration and ambition to deliver good quality services that make a positive difference to people’s lives.
During the current unprecedented times the country is facing, local government is providing local stability and the leadership needed to support national government as it seeks to negotiate the best deal for all our local communities. We will continue to advocate nationally for a fair funding settlement for both health and care – and in particular that the social care funding crisis is resolved. We have welcomed the support of the Partnership’s leadership in supporting this important case for change.
Locally, we will continue to work with our partners to ensure that all of the public money available to us is spent wisely and invested fairly.
We recognise our responsibility to play an active part in both shaping and delivering health and care across West Yorkshire and Harrogate. This makes it essential that we are represented at a strategic level where decisions are taken, ensuring the voice of local political leadership is heard and above all representative of our local communities.
We are therefore pleased to have achieved agreement that the West Yorkshire and Harrogate Partnership will in future be overseen by a representative board of partner organisations that will include elected members – in a way that puts elected members and community voices at the heart of our local health and care system. We want to see these conversations driven from the Town Hall more than at a distance from Whitehall.
This is why I’m delighted to have been nominated by my council leader peers to Chair the West Yorkshire and Harrogate Health and Care Partnership Board. The new Partnership Board will strengthen joint working arrangements and break down organisational barriers to further improve health and care for the 2.6 million people living across our area. Put simply - a shared ambition and commitment to improve health care.
The Partnership Board will bring together health and social care organisations, including the voluntary sector and other care providers across the area to give people the best start in life with support to stay healthy and live longer. The importance of joining up services for people at a local level in the six local areas means all decisions on services are made as locally and as close to people as possible.
The role of the Board is to further facilitate the work at both a local and West Yorkshire and Harrogate level. It will be the primary governance forum for the Partnership, bringing in elected members, non-executives, and lay members into the decision making process.
There will be no change in the legal powers or duties of all organisations involved that are represented on the Board - it will oversee a closer and more collaborative way of working towards the Partnership’s shared goals; for example preventing ill health, breaking down barriers between physical and mental health, cancer, urgent care and tackling health inequalities which exist across the area.
The first meeting in public is expected to take place in June 2019. The Partnership Board will meet four times a year and will be held in public. The public voice will also be represented on the Board – something the Partnership aims to ensure in everything it does.
As a council leader, I am clear that joined up health care should be delivered by stable public services and third sector organisations. This represents the best value for money in use of public funds. Our ability to influence this will be maximised by being actively involved in shaping how all parts of the system work through the West Yorkshire and Harrogate Partnership Board.
The role of local authorities is key to delivering a truly joined up approach to many of the areas we know are priorities for the people who live here – and I’m very much looking forward to being more involved in our Partnership’s work.
Thank you and have a good weekend.
What else has been happening this week?
The Joint Committee of Clinical Commissioning Groups (CCGs)
The Committee met on Tuesday – chaired by Marie Burnham, independent lay chair. The meeting was held in public and you can view the webcast, agenda and papers here. The Committee has delegated powers from the CCGs to make collective decisions around specific work programmes, for example cancer, mental health, urgent care and stroke. Although the Committee supports the wider Health and Care Partnership, it does not represent all of our partners.
A report was presented to the Joint Committee on improving stroke outcomes, which included recommendations and next steps. You can read the report here.
The Joint Committee approved the recommendations to have four hyper acute stroke units as the ‘optimal’ service delivery model for sustainable and ‘fit for the future’ hyper acute stroke care. Hyper acute stroke units provide specialist care up to 72 hrs following a person having a stroke.
Members also approved the recommendation that all commissioners utilise the agreed hyper acute stroke service specification when commissioning hyper acute care services.
They acknowledged that local plans to take people with suspected stroke in Harrogate to a specialist hyper acute stroke service in either Leeds Teaching Hospital or York Teaching Hospital would be led locally by Harrogate partners. The plans would maintain a rehabilitation service for stroke patients at Harrogate District Hospital, to which they can be transferred after receiving hyper acute stroke care in Leeds or York.
They also supported that there is no requirement to further engage or consult across the whole of West Yorkshire (taking into account the views of local people and the Joint Health Overview and Scrutiny Committee) in line with the NHS England service change assurance process.
It was agreed that a sustainable stroke clinical network be established across West Yorkshire and Harrogate and that work would be undertaken to improve quality and outcomes across the whole of the stroke pathway. This would support the aspiration to adopt a standardised ‘whole pathway’ stroke service specification across West Yorkshire and Harrogate as soon as possible. We will be writing to key stakeholders and members of the public who have been involved in the work to provide a further update.
A progress update was also given on West Yorkshire and Harrogate Healthy Hearts project to reduce cardio-vascular disease. Much of the work to date has been to establish leadership, governance and project management. The next quarter will see the completion of the planning and the start of delivery, including engagement with patients on their care. You can find out more here.
West Yorkshire and Harrogate Clinical Forum
The Clinical Forum met on Tuesday. The meeting was chaired by Dr Andy Withers and included GPs, hospital medical directors, lead nurses and colleagues from Yorkshire Ambulance, community pharmacy and the Academic Health Science Network. Members received an update from Dr James Thomas on the improving planned care and reducing variation programme (the differences in policies across the area). James is the clinical lead for the programme. This included asking members for their views on the development of the musculoskeletal pathway (which includes joints and bones), and information on the development process for clinical threshold and prescribing policies. There was also an update on the eye care work stream.
Members also discussed the work of the West Yorkshire Association of Acute Trusts (hospitals working together). They received an update on the aims and key principles for the collaboration between the trusts and the role within the Partnership. WYAAT’s vision is to create a region-wide efficient and sustainable healthcare system that embraces the latest thinking and best practice so the hospitals consistently deliver the highest quality of care and the best possible outcomes for everyone.
Fiona Day, Consultant in Public Health Medicine at Leeds City Council will be joining the Clinical Forum from December 2018. There will also be two allied health professionals joining the Forum at the end of the year too.
System Leadership Executive Group
The executive group met on Tuesday afternoon. The group includes representatives from all our sectors, including councils, hospitals, clinical commissioning groups, Healthwatch and voluntary organisations. The meeting was chaired by Rob Webster our CEO Partnership Lead.
The shadow leadership group met on Monday. This includes colleagues from across the Partnership. They reviewed the papers discussed at the meeting on Tuesday. Thea Stein, CEO for Leeds Community Health Care Trust, chaired the shadow leadership session and colleague’s comments were included throughout the meeting.
There was a discussion around proposals on the approach that will be taken across West Yorkshire and Harrogate Partnership to develop NHS operational plans for 2019/20 and to prepare for the development of a five-year strategic plan for the Partnership as a whole were discussed. The agenda also included a conversation on how we work together to improve resilience of the care home market. This agenda item was led by Richard Webb, Director of Health and Adult Social Care, North Yorkshire County Council and Michelle Turner, Director of Nursing, NHS Bradford District and Craven Clinical Commissioning Groups. Richard and Michelle talked about the importance of working together to improve resilience of the care home market. It was interesting to note that more people work in the independent care sector than in the NHS. Stabilising the care home market is an important issue we need to address together, for example tackling the shortage of nurses, building investment, staff pay, and affording good quality care. Richard agreed to bring a group of people together to initially take forward the work.
Dr Andy Withers, Chair of the Clinical Forum, updated colleagues on the national clinical leaders session which was held last week. This included an overview on multi-disciplinary leadership and good practice in joined up health and care. Donna Hall, CEO of Wigan Council gave an overview on the Wigan Deal work, which includes a number of themes including workforce developments. Professor Don Berwick also presented at the session. He emphasised the importance of making the most of digital technology at the point of a person’s care whilst ensuring people’s voices are at the heart of everything we do. Julian Hartley, CEO at Leeds Teaching Hospitals NHS Trust attended the same session and updated colleagues on the development of the long term plan including the importance of the interface with social care. The Health and Social Care Secretary Matt Hancock’s announcement this week on ‘prevention is better than cure’ was welcomed by leaders at the meeting.
Julian is also Chair of West Yorkshire Association of Acute Trusts (WYAAT – hospitals working together). He updated leaders on the work of the Committee in Common which is an agreement for the six hospital trusts (Airedale District Hospital NHS Foundation Trust; Bradford Teaching Hospitals NHS Foundation Trust; Calderdale & Huddersfield NHS Foundation Trust; Harrogate & District NHS Foundation Trust; Leeds Teaching Hospitals NHS Trust and Mid Yorkshire Hospitals NHS Trust) to work together on a number of key areas of work. This led to a conversation around the importance of networks rather than organisations.
Dr Ian Cameron, Director of Public Health for Leeds City Council and West Yorkshire and Harrogate Director Lead for the Public Health Coordination Group gave an overview on the work of population health management. This is all about improving the health of population groups and making the most of data to improve the care delivered to people. There is an opportunity to share learning and receive funding.
Our Partnership work to strengthen the joint working arrangements between our organisations took another important step forward at the meeting with agreement by the System Leadership Executive that Cllr Tim Swift, Leader of Calderdale Council and Chair of Calderdale Health and Wellbeing Board will be incoming Chair of our new Partnership Board for the first two years. A deputy chair from the NHS organisations within the Partnership will now be identified. Rob Webster will continue to be the CEO Lead for our Partnership.
The creation of the Partnership Board is consistent with the development of our Memorandum of Understanding (MoU). This has been an iterative process with good engagement everywhere. The draft MoU is published on our website here with confirmation of full formal sign off by all partnership boards by the month end. The draft terms of reference for the Board are here. These will be reviewed by the Board when it meets for the first time in June 2019.
The Board will ensure that the work discussed there meets the ambitions set out in ‘Our Next Steps to Better Health and Care for Everyone’ whilst informing the development of the long term plan.
The importance of joining up care for people at a local level in the six local areas of Bradford District and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield is at the heart of local and West Yorkshire and Harrogate plans. This will continue to be the focus of most of our work and is enshrined in our MoU. Our work together will be strengthened through greater democratic accountability. The eight councils involved in the Partnership (Bradford, Calderdale, Craven, Harrogate, Kirklees, Leeds, North Yorkshire and Wakefield) are equal partners around the top table.
Mental health
On Thursday a number of colleagues from primary care, mental health, councils and voluntary and community organisations met with the NHS England’s mental health team and the National Collaborating Centre for Mental Health to input into the development of the new primary and community mental health framework. This also provided an opportunity for colleagues to connect and share work that is going on each of our six local places (Bradford District and Craven; Calderdale, Harogate, Leeds, Kirklees and Wakefield).
What’s happening next week?
- The Mental Health Programme Board meets on Monday.
- The Public, Patient Involvement Assurance Group for the Joint Committee meets on Monday.
- West Yorkshire and Harrogate Local Maternity System Board meets on Monday.
- Communication and engagement colleagues from across the 44 national partnerships will meet on Tuesday.
- The six local area planners (Bradford District and Craven; Calderdale, Harrogate, Leeds, Kirklees and Wakefield) will meet on Tuesday.
- Programme leads for the West Yorkshire and Harrogate priorities meet on Thursday.
Telling our Partnership Story
- Additional case studies about the ‘Positive Difference our Partnership is Making’ have been added to our website here.