Posted on: 25 October 2019
This week’s leadership message comes from Rod Barnes, CEO for Yorkshire Ambulance Service and our Partnership CEO Lead for the Urgent and Emergency Programme Board and Dr Adam Sheppard, Clinical Chair for Wakefield Clinical Commissioning Group. Adam is also the Clinical Chair for the Urgent and Emergency Programme Board.
Hello everyone.
Over the past 12 months we had a real focus on the ‘urgent care’ elements of urgent and emergency care (UEC). Transformation funding was used to accelerate our work on joining this up across partners, including the technology needed to underpin the urgent care system.
We now have a system which has the ability for our NHS 111 service to directly book people with urgent care needs into services such as GP out-of-hours, local extended access GP services and urgent treatment centres.
The additional effort we put into this area of work meant that we went well beyond the national target for 30% of the calls directly booked into receiving services, with the latest figures showing that by the end of September 51.2% of people were directly booked into different services other than A&E for their onwards care.
As our work on this has come to an end, our six local places (Bradford District and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield) are now working towards all GP practices being directly bookable from NHS 111 by 31st March 2020.
We also had the launch of the ‘Looking out for our neighbours’ campaign in March 2019 where 46,000 people across West Yorkshire & Harrogate delivered acts of kindness by looking out for their neighbours. Phase 2 of the campaign is launching next month. It has a focus on messages that encourage staying warm and well in winter and looking out for older neighbours.
However, there is much more to do as demand is continuing to increase in urgent care and emergency care. Recent feedback from our partners and stakeholders has given a clear steer that the programme needs greater co-production regarding priorities and outcomes.
This includes a particular shift in our collective ambition to transform the urgent and emergency care system across the total pathway of care. There are a wide range of services involved in the pathway, ranging from urgent care undertaken by GP practices (including out of hours services) and community pharmacies to urgent treatment centres and emergency departments, all underpinned by our NHS 111 and 999 services.
The Healthwatch Report for the NHS Long Term Plan published in June 2019 identified there are too many entry points into the unplanned care system which causes confusion for staff and communities. The majority of unplanned care services offer walk in options, yet this offer differs across our six local places. There is inconsistency in messaging and we need to get better at communicating what is available to whom and when.
So our first set of conversations around co-producing the next phase of the programme is taking place with the five A&E Delivery Boards, initially via their chairs to understand and agree how collectively we can tackle the ‘wicked’ issues together but also to get better at sharing the good practice already out there across West Yorkshire and Harrogate.
We have outlined our collective ambitions within the Partnership’s Five Year Plan. Moving forward our priority areas of work include improving access to unplanned health and care services; using technology to allow different parts of the system to speak to each other; and ensuring our A&E departments are optimised to provide the best possible outcomes for our people. A priority to us all.
Have a good weekend, Rod and Adam
What else has been happening this week?
Mental Health, Learning Disabilities and Autism Collaborative Board
The Programme Board met last Friday. Chaired by Sara Munro, CEO Lead for the Collaborative Board and CEO for Leeds and York Partnership NHS Foundation Trust, the programme is made up of colleagues from the NHS, council and community sector. There was a series of updates including the plans across West Yorkshire and Harrogate to meet the Mental Health Investment Standard and to conduct further detailed work on the NHS Long term Plan trajectories. There was also a discussion on the core performance relating to Improving Access to Psychological Therapies (IAPT) (there is a workshop on 24 October); children and young people access and recruitment challenges.
The Board also agreed to support the direction of travel for dementia projects in West Yorkshire and Harrogate, with a wider Partnership leadership session in early November. Consideration is being given around a potential targeted suicide prevention campaign and the Board were supportive of the initial proposal.
The progress of the Mental Health Acute Hospital Team and Urgent and Emergency Care work streams were covered with the view they would work together under a single leadership team with the specific priorities for the revised work stream being discussed at the Board in November.
On Tuesday, Non-Executive Directors (NEDs) and Governors from our NHS mental health providers came together to hear about the overall work of the West Yorkshire and Harrogate Health and Care Partnership and its role in mental health, learning disability and autism. They also heard updates from those leading some of the significant transformation work that is being delivered by the provider collaborative, including the assessment treatment units for people with learning disabilities and children, forensic services and young people mental health care. All of which is reflected in our draft Mental Health, Learning Disability and Autism Collaborative Strategy, due to be finalised in November. NEDs and Governors spent some focused time considering what they have read in the strategy document, provided feedback and considered the role of co-production in communication and engagement and the expertise they bring.
System Oversight Assurance Group
The Partnership’s System Oversight and Assurance Group (SOAG) met on Tuesday. This group takes an overview of progress with our shared priority programmes, and seeks to agree collective action to help tackle shared challenges. This month’s meeting was different from the usual format. Richard Barker the NHS regional director for the North East and Yorkshire, and a number of his senior director team attended for a quarterly focus meeting to discuss the progress that our Partnership is making. Quarterly focus meetings have previously taken place as separate meetings, and this is the first time that we have incorporated it into our SOAG arrangements. The meeting considered a range of issues including progress with the Five Year Strategy and planning, the continuing development of the Partnership, and system performance.
The group also received updates on the programmes for mental health, learning disability and autism; primary and community care; improving population health; workforce and harnessing the power of communities.
Five Year Partnership Plan
Colleagues from across the Partnership met on Monday to talk about the development of the Five Year Plan. This included an update on the latest version, and the public summary which aims to set out what makes our six local places (Bradford District and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield) unique, and the shared ambitions which we all share to improve the lives of the 2.7million people across West Yorkshire and Harrogate. We hope to publish the draft plan and the summary on our website with the Partnership Board papers the week before members meet on the 3 December in Bradford.
Commitment to Carers Programme
NHS England’s Commitment to Carers Learning and Development Workshop took place last week. Colleagues brought together representatives from across the country who are leading on great work to support unpaid carers. This included Carers Trust who led on working carers, the issues facing young carers and innovative work developed by the Economic Foundation on how national sites can present compelling financial return on investment when developing proposals.
West Yorkshire and Harrogate’s very own Heather McKnight won the prized ‘Do I look like I care cup’. This is the second year running we have been awarded this for our collective innovative work across the area. The conference has been invaluable in supporting our programme and learning from others.
Personalised care for people with a learning disability
An important part of our Partnership’s Personalised Care Programme is to co-produce what good personalised care looks like for people with a learning disability. Jayne Heley from NHS England and the Improvement Personalised Care Group is providing leadership and support working with Primary Care Networks and coproducing the next steps with people with a learning disability. This will cover four areas of work:
- Social prescribing and testing what ‘good looks like’
- Supporting the quality and uptake of annual health checks so that physical health checks for at least 75% of people aged over 14 years can be offered
- Exploring shared decision making.
- Digital personalised approaches are also being explored.
If you are interested to know more, please contact Jayne.
Regional Health and Growth Roundtable
On Monday, our Partnership and West Yorkshire Combined Authority jointly hosted a Roundtable for senior leaders working across health and care, inclusive growth and the development of our region’s Local Industrial Strategy. You can read it here. It is the long- term, evidence-based plan to strengthen local economic growth, reduce inequalities and sets out the actions we will take to improve skills, productivity and the earning power of individuals and the region as a whole. Monday’s roundtable was to explore where those ambitions connect to our Partnership’s ambitions and identify those areas where we want to commit to act on together. There was clear commitment to align our efforts on skills and employment, inclusive growth, transport and active travel, health tech and inward investment as well as the appetite to think radically about how we approach issues of climate, the ageing society, research and development on the determinants of health and how we can become a world leader in the ways we work with communities. We look forward to taking these discussions forward in the coming months and years, including at the West Yorkshire and Harrogate Health and Care Partnership Board on 3 December and at the YHealth for Growth conference on 9 December, or you can follow the ongoing discussions on twitter by looking out for #YHealth4Growth
Yorkshire & Humber Care Record delivering population health management capability for the region
Yorkshire & Humber Care Record is making strong progress in advancing the population health management capability for the region to help better understand the needs of the people and improve the services provided. It is another step closer in achieving the technology solution to enable secure data sharing to enhance information and intelligence needed to plan and deliver services to help improve care. This will help better meet the needs of people within a given group and area, reducing health inequalities and improving health and well-being with increased cost efficiency. Yorkshire & Humber Care Record team is improving the way data is shared with safety and security as the key priority within the new technologies being implemented. The team is also advancing workforce skills by training staff from across the region at an academy, which will enable the benefits of population health management to be delivered across the region. The latest bulletin is here.
West Yorkshire and Harrogate Local Maternity System
Maternity Support Workers - An integral part of the maternity workforce
The Health Education England Workforce Strategy ‘Transforming the Maternity Workforce’ outlined how the UK healthcare system would deliver the Five Year Forward View for maternity. The importance of Maternity Support Workers in supporting midwives, maternity teams and mothers and their babies and their key role in supporting implementation of continuity of carer models and increasing opportunities for women to have births outside of hospital settings was recognised. The report pledged to ‘professionalise’ the Maternity Support Worker role, to develop new training routes into midwifery and make it easier for support workers to develop and become registered midwives.
National work activities are supporting the Health Education England strategy. These include the launch of a Maternity Support Worker Competency, Education and Career Development Framework in February 2019, the implementation of a higher level Maternity Support Workers role and a review of apprentice standards against revised NMC published curricula (expected April 2020).
The framework provides a national agreement on the expected minimum level of knowledge, skills, values and behaviours necessary for Maternity Support Workers. The review of roles and apprentice standards has potential to widen access to pre-registration midwifery education.
Our Partnership is committed to up-skill and train Band 3 Maternity Support Workers through the development of a standardised job description and role profile, the introduction of standardised competencies and the development of a training offer with use of apprenticeship pathways to enable Maternity Support Workers to meet the agreed competencies. Whilst the overall aim is to reduce variation and provide clarity in roles and responsibilities, it will mean that Maternity Support Workers will be able to access a career ladder through local training and development options, and move more easily between organisations, expanding the contribution they can make to care, and supporting recruitment and retention.
Road shows are being held in November and December, providing an opportunity for anyone who works in maternity services (including those in supporting roles) to learn about the local ambitions for Maternity Support Workers and the work of the Partnership’s Local Maternity System. Contact Jessica.
We Work For You podcast - Episode 2 - Eye Health
As part of the Improving Planned Care Programme, project teams are currently developing plans for service improvements related to age- related macular degeneration, diabetic retinopathy, glaucoma, cataracts and children’s eye services. These improvements may be in the form of a shared clinical pathway, a new use of technology or a workforce initiative for example, but all will reflect clinical evidence, best practice and patient insight. In episode 2 of our 'We Work For You' podcast, Steve Clark, Chair of the West Yorkshire Eye Health Network, talks about some of these eye conditions in more detail. Steve, who is also an experienced optometrist, explains what the symptoms of certain major eye conditions are and how those conditions can be treated. In conversation with Christine Hughes, the Planned Care Programme’s Communications and Engagement manager, he also talks about a little known consequence of sight loss for many people ‘Charles Bonnet Syndrome’ and how we can keep our eyes healthy to reduce the risk of developing a major eye condition that could affect our sight. The episode also features eye care service users Terry, Deanna, Sam, Adeel and Hajra who are all members of the Kirklees Visual Impairment Network (KVIN). They talk openly about the impact of sight loss and share their experiences of living with a major eye condition. You can listen to the episode here.