Posted on: 7 June 2019
Hello, my name is Sara and I’m the proud Chief Executive of Leeds and York Partnership NHS Foundation Trust. We provide first class mental health and learning disabilities services to people in Leeds, across the Yorkshire region and nationally too. When I have blogged for the ICS previously it has focused on the work we are doing as a collaborative to improve services for people with mental illness and learning disabilities. This week I am blogging about another system leadership role I am really passionate and proud of.
I’m also the ‘senior responsible officer’ for the health and care workforce in Leeds. That means I’m leading the efforts of all our health and care partners in the city to support the development of our workforce – essential to help Leeds realise its ambition to be the best city for health and wellbeing.
We aim to do this by creating a joined up approach for the 57,000 people currently employed across health and care services, to learn and work together as if they are one city-wide team. If our plans are successful that figure will grow to over 60,000 in the next few years.
The main driving force behind us achieving our ambition is the recently-launched Leeds Health and Care Academy – a project from Leeds Academic Health Partnership (LAHP). A core team is in place working on both our strategic workforce priorities for the city and the establishment of the Academy and this is led by Sheree Axon who joined us last year from NHS England where her substantive post is Director of Change and Programme Delivery.
Sheree is working closely with Jenny Lewis (Director of HR & OD at Leeds Teaching Hospitals), Cath Roff (Director, Adults and Health at Leeds City Council) and Jo-Anne Wass (Chief Operating Officer at the LAHP).
The Academy is, we believe, a completely unique partnership bringing together health, local authority, further and higher education, and the third and independent sectors. We see it as vital to help us through the step changes needed to tackle the national and local workforce challenges, and to benefit from all the opportunities a joined-up approach brings with it. This all fits nicely with the interim NHS People Plan published on 3 June, which gives our ICS a stronger mandate to lead on workforce matters because the majority of our solutions will be found locally.
Where best to launch the Academy? Washington DC of course!
As one of only two UK members of the Association of Academic Health Centers International, the LAHP was invited to showcase the Academy at its Global Issues Forum in Washington DC on 6 May.
I was privileged to present in Washington alongside Jenny Lewis, who is also the executive lead and host for the Academy. In front of us were clinical and operational directors, academics and system leaders from around the world.
As the Academy is thought to be unprecedented in scope, ambition and scale, it was a great story for the city of Leeds and its ambitions for health and wellbeing. We set the scene with this fabulous video...
The presentation from Jenny and I was very well-received. I really like the way we’ve defined our workforce transformation offer and segmented the workforce into a mixture of affiliates, associates, members, fellows and friends.
Some of the questions and comments we received from delegates really brought home how unique the Academy is. For example, people wanted to know more about:
- Our offer to volunteers
- Social care being an integral partner, and
- Growing our own through community engagement
This sense of working together to grow our own came across strongly and we also reflected the importance of working together across the West Yorkshire and Harrogate partnership, both to learn but also ensure we best utilise some of our more specialist and scarce experts.
Many of the discussions and presentations over the three days explored the importance of addressing the social factors of ill-health from a wider system perspective, and the opportunities with health and academia to contribute to this was a very strong theme.
We heard examples of hospitals in other countries that had invested in housing for the homeless who otherwise were frequent attenders of the emergency department. The integration of physical and mental health was another strong theme globally.
Cultural diversity, migrant health and supporting disadvantage groups who have the worse health outcomes also featured heavily, along with supporting innovation and outward facing research initiatives that generate learning back for organisations. All this resonates very strongly with what we are discussing and tackling here in West Yorkshire and Harrogate.
Progress so far and exciting times ahead
The Academy’s current focus is on building firm foundations for the future. It will then move into the transformational stage – looking to harness the many innovative opportunities for learning and development from research and technology. Our university and college partners will play a key role in helping the Academy create and deliver new services, turning world-leading academic research and innovation into a reality for the workforce.
We’ve got four key themes that are driving current work:
- Attracting our future workforce
- Improving working lives
- Improving systems, and
- Improving partnerships
Whilst the Academy only ‘went live’ in April this year, it’s already supporting a lot. For example:
- Training mental health first aiders from within partner organisations to increase and enhance support for all staff,
- The first 22 Academy ambassadors have been recruited from among health and care practitioners, who are visiting local schools, colleges and communities to promote careers in health and care,
- It’s also sharing a development programme to help those in leadership roles begin to focus more on the city as a whole and to think and plan for the ‘system’ rather than just their own organisations.
And, for the 3,000 or so people who join the Leeds health and care sector every year, the Academy is supporting the spread of a citywide induction. Whichever role or organisation someone is joining, they will understand from the start that they are part of a ‘one workforce’ culture and approach.
I will soon be meeting with Brendan Brown, Helen Hirst and the Local Workforce Action Board to talk about how we better connect on our Leeds work on strategic workforce priorities and the work of the Academy, to the work of the West Yorkshire and Harrogate Health and Care Partnership. We want to ensure that our plans support the development of the West Yorkshire Health and Care Five Year Strategy. These are exciting times for us all in health and care!
Have a nice weekend,
Sara
What else has been happening this week?
Looking out for our neighbours campaign
'Looking out for our neighbours’, the campaign to combat loneliness and isolation across the area, is proud to support The Jo Cox Foundation’s ‘Great Get Together’ taking place from 21 – 23 June. Throughout June the campaign delivers one simple message ‘Get together with your neighbours’. Whether it’s simply saying hello, having a cup of tea or doing something for your neighbour, the Great Get Together is the perfect reason to connect with those in your neighbourhood. Download your new summer resource pack here and please continue to spread this important message. We’re also looking for examples of what difference the campaign has made to the work in our communities – please share any updates you may have by contacting karen.coleman2@wakefieldccg.nhs.uk.
West Yorkshire and Harrogate Health and Care Partnership’s Partnership Board
Our Partnership Board met for the first time in public on Tuesday at Leeds Civic Hall. The Partnership Board further strengthens joint working arrangements between all organisations involved, including the NHS, councils, care providers, Healthwatch, community and voluntary groups. Together, the Partnership improves health and care for the 2.6 million people living across the area.
The Board is an important group for the Partnership, bringing elected members, non-executives and public lay members into the decision making process. Over 70 representatives make up the Board. You can view the list of members here.
Chaired by Cllr Tim Swift MBE, Leader of Calderdale Council and Chair of Calderdale Health and Wellbeing Board, the first meeting discussed the Board’s terms of reference; allocation of transformation funding and the development of the Partnership’s five year plan which will be published in winter. It also included an overview of our Partnership approach, as well as an update from Board members from the six places which make up West Yorkshire and Harrogate (Bradford District and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield). Propositions for future programmes of work around children, young people and families; and health inequalities were also outlined. A paper was also presented by Healthwatch on our approach to public questions at future meetings in public.
First things first: Helen Hunter, the Board’s Healthwatch representative, summarised the work carried out from our six Healthwatch colleagues in West Yorkshire and Harrogate regarding how public questions could be raised and responded to at our Partnership Board. The summary included good practice at Council and NHS meetings. Add picture of Helen
It’s useful to note that this is not the only way that the Partnership does engagement – we want to keep that broad, diverse and appropriate to each decision we make. The paper was about public involvement in Partnership Board meetings. A lot of engagement takes place in our six local places (Bradford District and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield). You can view the latest engagement and consultation mapping document, published in March, here. This highlights work over the past few years. You can also find out more about West Yorkshire and Harrogate programme engagement work here.
The Partnership Board is committed to transparency and accountability. We want to give people every opportunity to ask questions at our meetings.
The recommendations from the Healthwatch paper were agreed by Partnership Board members. This included allowing people to put forward questions before the meeting, and also in the meeting where they related to agenda items. We will post all questions and answers on our website within 10 days.
Wherever possible we will ensure a person’s story, or details of engagement relating to the agenda item are included. It’s important that we review how these very helpful recommendations are working to make sure that we are meeting the needs of people wanting to ask questions and receive responses. We will review the approach at the Partnership Board meeting in public in March 2020.
Outside of the meeting, people may have questions that they would like to put forward to the Partnership and its members. We will respond to these also within 10 working days and where appropriate promote other opportunities to get involved with the work of the Partnership. There is more information on our website here about public involvement in our programmes of work.
Board members also received an update from Rob Webster, our CEO Partnership Lead on our Partnership approach which is all about supporting people locally. We only work at a West Yorkshire and Harrogate level where it passes three tests: it is a scale issue (for example specialist care from excellence centres, such as hospitals); sharing and spreading good practice and where it is a wicked issue - for example child obesity. All of our six local places have good practice examples. This is one area where the Partnership can add value by sharing and spreading learning. Our approach is set out in our publication ‘Next steps to better health and care for everyone’.
With this in mind we heard from various leaders in Bradford District and Craven (Cllr Susan Hinchcliffe); Calderdale (Robin Tuddenham and Dr Matt Walsh), Harrogate and Rural District (Amanda Bloor), Kirklees (Cllr Viv Kendrick), Leeds (Cllr Rebecca Charlwood) and Wakefield (Anna Hartley). Each place described the work they are doing in place to join-up services and improve outcomes for people. There were a number of strong themes that emerged including preventing ill health, tackling health inequalities, making best use of digital technology and working in partnership with communities and voluntary community organisations (VCS).
Ian Holmes, Director for the Partnership introduced the agenda item to formally approve the Partnership’s memorandum of understanding (MoU). It was agreed that the VCS should have representation as a full member of the Board and that the role of co-opted members should be strengthened. With these additions in view the MoU was agreed by Board members.
Karen Poole (West Yorkshire and Harrogate Local Maternity System Programme Lead) and Sue Rumbold (Chief Officer, Children's Services Leeds) presented a paper on children, young people and families with a proposal to include it as a programme priority for West Yorkshire and Harrogate. This will also align the Partnership more firmly to the NHS Long Term Plan ambitions.
Dr Ian Cameron, Director for Public Health, Leeds Council) discussed a proposition for improving health and tackling inequalities at a West Yorkshire and Harrogate level where there is added value.
It was agreed by the Board that there are opportunities to work with Department of Health and Social Care regarding mental health support in schools; palliative care; obesity and that a development board to agree priorities and work streams would be established. It’s important that priorities are agreed across the Partnership, including via local Health and Wellbeing Boards whilst ensuring the voice of the child is included throughout.
There is a strong commitment from partners to prioritise preventing ill health. Key to this is tackling variation across the area; and our workforce having the skills, capacity to take on prevention targets for example climate change, social growth, housing and health. Local economy and employment is key and it’s important we evaluate what difference we make together.
There is a strong connection to the two proposals presented. Both propositions were welcomed with the intention of more clarity around themes being brought back to the Partnership Board for wider discussion in September with clear metrics. The Board will then take a view on prioritisation of themes to improve health inequalities, reduce variation, and manage the money. It’s also important that we map out the good work taking place across the area, for example obesity. Other concerns raised included access to dentists.
Both propositions will be discussed with local Health and Wellbeing Boards – with a formal proposal being presented to the Board in September. Working locally with Health and Wellbeing Boards is essential. The Partnership Board was asked to note the progress made in the development of the five year plan which will be published towards the end of the year.
The final item was a proposal to spend the £8.75 million transformation funding. Jonathan Webb, Finance Director for the Partnership introduced the paper which sets out the principles, approach and proposed prioritisation for Integrated Care System (ICS) transformation funding that will be allocated to the West Yorkshire and Harrogate Health and Care Partnership (also known as an ICS) in 2019/10. This was an important discussion about public money and how we choose to prioritise. Further discussions will take place at Health and Wellbeing Boards across West Yorkshire and Harrogate to ensure involvement and engagement on future transformational funding moving forward. There was an agreement to prioritise funds to move forward the children and young people’s proposals. This will form part of the Health and Wellbeing Board discussions with feedback from our six local places and through the executive group in July.
Cllr Swift said:
"Working alongside communities, the Partnership Board aims to give people the best start in life with support to stay healthy and live longer. Many factors determine whether someone leads a long and healthy life, including good housing, access to green space, and building an inclusive economy that creates more good jobs, reduces health inequalities and promotes opportunity for all. These important factors are at the heart of the Partnership and I’m looking forward to working alongside other Board members to ensure we discuss these issues fully whilst providing the best support possible for those we serve. This is a priority to us all and one I welcome."
View the Board’s papers, or watch a film recording of the meeting here. The next meeting in public will be on Tuesday 3 September 2019.
West Yorkshire and Harrogate Clinical Forum
The Clinical Forum met on Tuesday. The meeting is chaired by Dr Andy Withers and includes medical directors, GPs, pharmacists, allied health professionals, and lead nurses. Catherine Thompson, Programme Director for Improving Planned Care and Reducing Variation discussed the Flash Glucose Monitoring Commissioning Policy (options) for review and recommendation. We are currently working with diabetes specialists in West Yorkshire and Harrogate to update our policies on flash glucose monitoring, following the publication of new guidance from NHS England, and to consider a single policy for all nine clinical commissioning groups. Read more here. The Clinical Forum discussed the guidance and will make a recommendation to the Improving Planned Care and Reducing Variation Programme Board and to the West Yorkshire and Harrogate Joint Committee of Clinical Commissioning Groups.
Maureen Drake, Assistant Director of Allied Health Professionals (AHPs), Patient Experience and Engagement, Leeds Community Healthcare NHS Trust and Catherine Gregson, Head of Therapies and Rehabilitation Airedale NHS Foundation Trust led a discussion with clinical forum on the opportunities for AHPs to provide leadership and support to the WY&H Health and Care Partnership
Allied health professionals (AHPs) are the third largest workforce in the NHS. Collectively the Partnership employs approximately 4241.2 WTE registered and unregistered AHP staff. AHPs into Action, published in 2017 set out priorities and commitments for AHPs and the impacts that could be achieved through this. The NHS Long Term Plan acknowledges the impact this framework has on developing plans. Their skills are central to the delivery of sustainable services; they work across all life stages and within all sectors; and they have a long history of multi-professional team working. The Clinical Forum endorsed the creation of a Partnership AHP Council; with a request that each of our six local places (Bradford District and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield) identify representatives for the AHP council covering all organisations.
Future work involves scoping where the Partnership adds additional value above the work taking place in our six local places and how this links currently to the development of the five year plan – for example hospital avoidance. Colleagues work on the ethos they are ‘better together’. AHPs are key to delivering the outcomes of the NHS Long Term Plan and are keen to support the Partnership work by mapping where AHPs could help with priority programmes, for example sharing good practice and close working relationships with the clinical forum and a AHP Council would help with this, working out where they could field colleagues to support Partnership priority work. The clinical forum were very supportive of their work with AHPs to develop a council and to make connections with programme leads proactively and linking to their local AHP leads.
There was also an update on the proposed approach to develop our five year plan, including the scoping and development of new priorities relating to children young people and families and improving health and tackling inequalities. The NHS Long Term Plan is a framework to support the development of this and there is flexibility for us to tailor our response to local needs and priorities. We continue to focus on working together to improve health outcomes locally – working better together at every level and putting the person at the centre of all we do.
The Mid Yorkshire NHS Hospitals Trust are one of 14 Trusts in a national pilot for a new way to measure performance in A&E and David Melia (Chief Nurse at Mid Yorks) update Clinical Forum members on progress to date.
West Yorkshire and Harrogate Joint Committee of Clinical Commissioning Groups (CCGs) development session
The Joint Committee of the Clinical Commissioning Group development session took place on Tuesday 4 June, chaired by Marie Burnham, independent lay chair. The following was discussed:
Members considered a report on a flash glucose monitoring commissioning policy for adoption across West Yorkshire and Harrogate. Flash glucose monitors are hand held devices for checking blood glucose levels, replacing the need to prick a finger. Some national funding has been made available to support implementation from 1 April 2019. The report was discussed at Clinical Forum immediately before the Joint Committee development session and the Committee considered the recommendations from the Forum. The Joint Committee supported the commissioning policy and two amendments to it recommended by the Clinical Forum.
The Improving Planned Care and Reducing Variation Programme would develop a formal flash glucose monitoring proposal to be brought back to the Joint Committee meeting in public on July for further consideration and agreement.
Implementing the decisions of the Joint Committee
Members considered a report on strengthening the arrangements for ensuring that Joint Committee decisions are implemented effectively and consistently across all our places.
Members noted that the implementation challenges differed significantly between each programme and that a ‘one size fits all’ approach was not appropriate. Members agreed a way forward which included clarifying the Joint Committee’s work plan and responsibilities in relation to each programme and building in to the work plan a more systematic focus on implementation, based around progress on key outcomes.
West Yorkshire Association of Acute Trusts (WYAAT – hospitals working together)
The WYAAT Chief Executives met at their monthly Programme Executive meeting on Tuesday. In addition to reviewing the progress of the WYAAT Programmes, they discussed the West Yorkshire and Harrogate Capital and Estates Programme, the West Yorkshire Vascular Service (WYVaS) and cancer performance and improvement.
Owen Williams, Senior Responsbile Officer for the Capital and Estates Programme, briefed the CEOs on the role of the Capital and Estates Board in overseeing capital spending, developing the West Yorkshire and Harrogate Estates Strategy and in accessing future capital funding. He highlighted the importance of places and sectors being strongly represented on the board. Neeraj Bhasin (West Yorkshire Vascular Services Regional Clinical Director), Claire Vickers (WYVaS Head of Nursing) and Jane Lang (WYVaS General Manager) briefed the group on the development of a single vascular service for West Yorkshire.
Neeraj highlighted the benefits to patients and staff of the single service approach and the group discussed the operating model and planned public consultation. Martin Barkley, CEO for Mid Yorkshire Hospital Trust, provided the first of six monthly place briefings in which he described health and care integration in Wakefield and North Kirklees. Finally Carol Ferguson, West Yorkshire and Harrogate Cancer Alliance Programme Director, updated the CEOs on cancer performance across the area and the development of the improvement collaborative (which will be launched at an event on 5 July).
West Yorkshire and Harrogate Health and Care Partnership Public Health Co-ordination Group
Chaired by Dr Ian Cameron, Director of Public Health for Leeds City Council, colleagues came together on Wednesday to discuss the work in our six local places and where good practice could be shared and learned wider. There was also a discussion on the work of children and young people; preventing ill health and the wider determinants of health, for example housing and poverty. Discussions are taking place to look at health inequalities and definition to include age banding, boundaries and population groups. Those with learning disabilities, autism, carers, accessing maternity, social factors and people in rural areas are to also be considered. Primary networks have been having great influence. Tackling health inequalities is key to the work of the group and how this links to important work taking place locally and the ambitions of the Partnership Board.