Posted on: 28 June 2019
Hello, my name is Robin,
I have had the privilege to be the Clinical Lead for West Yorkshire Association of Acute Trusts (hospitals working together) since January 2018, having practiced as a consultant nephrologist (which means I specialise in kidney health and kidney disease) in Bradford for 25 years.
The clinical role for WYAAT is new and involves providing clinical leadership for the hospital programmes and taking a strategic and innovative view of clinical services. It is also all about promoting engagement and collaboration with clinical teams; and forging links within West Yorkshire and Harrogate Health and Care Partnership.
Our Partnership works because of the broad engagement across the whole of the system.
In my role it has been hugely helpful to connect with my colleagues who are part of the West Yorkshire and Harrogate Clinical Forum as well as those working on priority programmes , including primary care and communities, improving planned care, preventing ill health, mental health and the Cancer Alliance.
We all know that health and social care in the UK is under increasing pressure. If you have read the NHS Five Year Forward View you will know that it identified the triple challenge of better health, transformed quality of care delivery and sustainable finances. It is clear that we need to do things differently as a Partnership, and where appropriate, take a systems view. This is where I hope to add value.
For some of our acute hospital services there are immediate sustainability challenges which are of high priority to WYAAT and the wider Partnership.
So for example in dermatology (skin, nails, and hair conditions), gastro-enterology (stomach and intestines) and ophthalmology (eyes) there is agreement that programmes will work together to address the key concerns. We are also keen to take a pro-active approach across other major services to consider new models of care delivery so that together we make the most of our workforce and provide the best care possible to people.
The WYAAT programmes are driving real change in support service too - including radiology (medical imaging), pathology (study of causes and effects of disease or injury) and pharmacy. The benefits are significant in terms of efficiency and new working patterns. Our new vascular service will also provide sustainability and an equitable offer to people. Read my colleague Neeraj’s blog to find out more.
In elective orthopaedics (bones and joints), clinical teams from all acute hospitals and colleagues from the Partnership’s Improving Planned Care Programme, are working together to share learning, standardise practice and introduce new pathways. We are also looking at significant savings from buying products and services together - doing this will give us stronger buying power, whilst making sure we get best value for money and the best options available for people.
During 2018, WYAAT facilitated three workshops for clinical teams across the breadth of medicine and surgery, with representation from primary care, . Teams considered the present profile of services across West Yorkshire and Harrogate, with the challenges of workforce, capacity and demand; quality and efficiency.
The workshop delegates also looked at how services might look in the future. Our Partnership rightly stresses the importance of our local places (Bradford District and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield). However these meetings gave clinicians an insight into working together in the ICS and considering those circumstances in which a systems approach across a broader footprint would sustain services and drive transformation.
Another key principle of WYAAT is the formation of clinical networks. The networks aim to drive cultural change, placing clinical teams in the setting of the wider system alongside other colleagues from across Partnership organisations.
The networks give us the opportunity to be at the heart of change and development. They are a very important vehicle in a systems response to ‘getting it right first time’ (GIRFT). GIRFT is all about shared learning and good practice. It is also about driving forward standardisation (so everyone receives an equal service no matter where they live) and reducing difference in people’s experience of care.
Our clinical networks teams are also scoping new and innovative models of care and further developing the interface with primary care networks / communities.
So far, we have put in place networks in ophthalmology, vascular services, oral and maxillofacial (surgery of the face, mouth, and jaws), cardiology (heart diseases) and urology. Dermatology and gastro-enterology networks will follow later this year.
In May this year, the WYAAT colleagues brought together representatives of the quality and risk departments of our six acute trusts (which make up WYAAT) to consider how learning from Never Events and Serious Incidents could be shared more widely.
It was clear to see the appetite for a regular forum, supported by our medical directors, in which problems and solutions are communicated and discussed openly. This way of working importantly has the potential to deliver clear benefits for patient safety.
In the evolution of our ICS, an important step is the development of a clinical strategy which would complement and inform other key areas such as the capital and estates, and financial strategies .
As discussed in ‘Our Next Steps to Better Health and Care for Everyone’ we are building on the importance of bringing physical, social and mental health all together and seeing the whole person as one rather than in different parts dependant on their health condition or illness. Key to this is reviewing and refreshing our plans, where needed, to ensure they sit firmly alongside the NHS Long Term Plan.
Our Partnership’s executive group agreed to create a clinical strategy steering group which includes senior representatives of our six local places, sectors and priority programmes.
This new group proposed a direction of travel and some key themes for further work. One was to undertake clinical service profiling across 26 of our main specialties. For each, an assessment was made of the present service configuration, including the end to end pathway, starting with preventing ill health and self-management, to primary and community care and then hospital and specialist care. The work considered future models of care delivery and options for moving care into the communities and out-patients transformation. This information has been brought together into a series of ‘service profiles on a page’. It will serve as a compendium of services which can be used by all facets of the ICS in planning transformation and possible re-configuration.
Another proposal was to explore key areas that tested true integration of services in our local areas and to share good practice and learning across West Yorkshire and Harrogate. Frailty and children and young people were chosen as areas which require many parts of the system to be working well together to provide best possible health outcomes. For each, a large number of stakeholders were interviewed, including carers and people who have accessed care and support. The process used life-like case stories, covering a range of care scenarios. This was followed up with well attended feedback events and the opinions and learning shared will inform the development of the Five Year Strategy, due to be published at the end of the year.
The last 18 months has seen significant progress for the Partnership. In WYAAT there is a strong sense of our common destiny and a move to greater clarity of the care we provide. . The key to transformation will be to work ever closer with our partners in social and mental health and grasp the opportunities of the interface with the new Primary Care Networks.
Thank you for reading my blog.
Have a good weekend,
Robin
What else has been happening this week?
NHS Long Term Plan Implementation Framework
NHS England published the NHS Long Term Plan Implementation Framework this week. You can read it here. It has been produced to support the development of Partnership five year plans (also known as integrated care systems). It was also discussed at the NHS England and NHS Improvement Board meeting on Thursday. You can read the papers from the meeting here.
The Yorkshire and Humber Care Record
The Yorkshire and Humber Care Record team has met with each health partnership digital team – Humber, Coast and Vale; South Yorkshire and Bassetlaw, and West Yorkshire and Harrogate - to discuss plans for future roll out. The results from these meetings are being collated and prioritised over the next few weeks with each regional lead to form an 18 month plan. We will keep you updated on progress.
The technology used to join up the systems across the region has been demonstrated to NHS England to evidence our funding milestones. Colleagues are reporting we are on target.
The initial pilot sites across the regions are moving forward from proof of concept status into sharing live patient information. The benefits have been identified and baseline measurements taken for each site; these will measured once each site is operational.
Planning is underway to add more organisations to the pilots, so far colleagues have met with Harrogate and York. Others are being scheduled.
We also announced the procurement for the population health management capability – please click here for further information. Please do keep an eye on the website for updates.
Shadow System Leadership Executive Programme
We are seeking nominations from partner organisation to take part in the 2019-20 Shadow System Leadership Executive programme. Last year we had our first cohort of the programme, which was hugely successful. It has made a significant impact on the decision making of the Partnership. There are three high level objectives: to develop our system leaders of the future; to increase the sphere of influence and understanding of the Partnership; and to add value and challenge within the leadership topics of conversation. The 2019-20 programme will start in October. Please contact sherry.king@nhs.net for more information. The closing date is 5 July.
Housing and health
Our Partnership recognises the impact that poor housing has on people’s health and wellbeing. Our ambition is to address this across West Yorkshire and Harrogate. We’ve started to understand more the impact of housing on health care and where housing issues are present and the effect this has on people’s health. On Tuesday, Jacqui Gedman, CEO for Kirklees Council, and CEO Lead for Housing and Health for the Partnership; Jo Webster, Chief Officer for Wakefield Clinical Commissioning Group and member of Wakefield Council’s executive team and Sarah Roxby from WDH presented at the Housing Conference 2019 in Manchester. They highlighted the work taking place to improve housing and health across the area.
West Yorkshire and Harrogate Health and Care Partnership - Career workshops for young carers
The first in a series of career health and care insights events to support young carers was held by the Partnership in Huddersfield on Tuesday. The events, called ‘Couldn’t Care Less’, aim to show young carers how their skills can be transferred into exciting and varied roles in the health and care sector, supported by role models from across local business and the NHS. There are around 260,000 carers living across West Yorkshire and Harrogate in Bradford, Airedale and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield.
This number includes thousands of young carers taking on a caring role from as early as six years old. Often they are caring for parents who have long-term health conditions, mental health difficulties or experience alcohol and substance use and misuse.
A survey by Carers Trust found that 26% of young carers have been bullied at school because of their role - with 1 in 20 missing school as a result.
In partnership with the Local Workforce Action Board, we have developed the programme to encourage more young people to consider the 350 different careers and opportunities available in the sector. The event was supported by health and care professionals, including a paramedic, emergency nurse consultant, physician associate; operating department practitioners and other roles in social care, digital/IT, communications and mental health nursing.
The work is also supported by Barnardo’s, Calderdale Young Carers Service and Ahead Partnership, an organisation that specialises in working with employers, educators and healthcare providers to engage, inspire and motivate young people around skills, career options and future employment.
The event featured employability workshops, career tester activities and discussion with key health care leaders.
For information
- NHS England: One in three people in England – 21 million – are set to further benefit from improved health and care, with the announcement of three new integrated care systems (ICSs). The North East and North Cumbria will become the country’s largest ICS, serving more than three million people alone. South East London becomes the first ICS in the capital, while Buckinghamshire, Oxfordshire and Berkshire West make up the third new area where different health and care organisations work together to plan and join up services. The NHS Long Term Plan set the ambition for every part of the country to become an integrated care system by 2021. To help turn the ambition into reality, a new publication explores the arrangements needed to build strong health and care systems. Access the document and find out more about the new ICSs.
- The first NHS gambling clinic for children will open this year as part of a new network of services for addicts being rolled out as part of the NHS Long Term Plan. Up to 14 new NHS clinics are being opened, starting with the NHS Northern Gambling Service in Leeds this summer, followed by Manchester and Sunderland. The National Problem Gambling Clinic in London will also offer specialist help for children and young people aged 13 to 25 as part of an expansion which will also ramp up treatment for adults. Find out more.