Posted on: 10 May 2019
Hello my name is... Sarah
The Voluntary, Community and Social Enterprise (VCSE) Sector is such a massive contributor to people’s health and wellbeing. From mental health support to reducing social isolation, not for profit organisations work passionately to deliver high quality services to everyone who comes through their doors. The VCSE sector complements health care in a way that only the VCSE sector can and is an integral part in prevention of the need for primary care services which I will talk about later.
Quality is such an important word in terms of service delivery; it is a word that can instil trust in the organisation’s work, impact and conduct. Developed in 2015 by Voluntary Action Calderdale and Calderdale Clinical Commissioning Group, Quality for Health was set up to support the VCSE sector to demonstrate the quality of their health and wellbeing services.
“One of the things that GPs often talked to us about was how could they be sure about the quality of services if they were to refer into voluntary or community sector organisations. We wanted to put something in place that gave that level of confidence to GPs to use the non-statutory sector.”
Watch this film from Penny Woodhead, Chief Quality and Nursing Officer, Calderdale, Greater Huddersfield and North Kirklees Clinical Commissioning Groups to find out more.
Today, we are proud to have Quality for Health ‘Approved Providers’ across the country and have a strong presence across the area, including Calderdale and Kirklees. Being a Quality for Health Approved Provider not only gives organisations a quality assurance standard, but also signifies their readiness to support local priorities and the NHS Long Term Plan priorities around social prescribing and working together with the VCSE, for example.
“We’re thrilled to receive the Quality for Health award because we see this as a great indicator to the people we work with, their families and carers that they can expect to have an excellent experience when they work with us. We also hope that this will allow professionals to feel confident about referring people to Better in Kirklees for the first time.” Tamsin Macdonald, Team Manager at Better in Kirklees social prescribing service. Please click here to see a video from Tamsin.
Quality for Health is not just a self-assessment. Tiered over 3 levels (smaller groups up to big organisations), Quality for Health demonstrates meeting the standard via evidence which is assessed and independently verified to gain accreditation. It also involves direct support to organisations, a quality improvement plan and access to online platforms and peer exchange.
To our approved providers, successfully completing the Quality for Health standard has not only verified the high quality of their work but has offered them opportunities to reflect on their current delivery and make improvements where need to provide the best service possible.
The ArchWay Project is a charity set up for the purpose of increasing the health and wellbeing of local communities especially those who have mental health issues. They use music, art and drama as vehicles to engage with these vulnerable people, teach new skills, build confidence and self-esteem and help people manage their mental health more effectively. The organisation concentrates on empowering people who feel disaffected or live on the fringes of society, many of their service users feel marginalised and they work with them building confidence in order that they may feel more able to re-connect with society. Recently renewing their Quality for Health Approved Provider status, Gary Flowitt, Chief Executive said: “What we found in the process of doing [Quality For Health] was that it made us look at ourselves. It made us look at our processes, our policies and procedures and it made us think about turning them into working documents instead of ticking boxes.” Please click here to see a video from Gary.
As strong advocates of the impact the VCSE sector has on the health and wellbeing landscape, I and the rest of the Quality for Health team really wanted to demonstrate how our approved providers improve local lives.
We were privileged to interview two people whose lives had been completely transformed thanks to the support of a Quality for Health Approved Provider, Alpha House Calderdale.
Alpha House Calderdale is a supported housing project with a Change of Lifestyle Training Programme. Alpha House is not a soft option and they only take people who are committed to staying off drugs/alcohol and recovering from addiction as well as working towards an independent and industrious lifestyle.
“This is the longest I’ve ever been clean from Heroin and Crack in 26 years and it’s thanks to Alpha House. I’m now not taking money from the taxpayer getting my methadone scripts which I were abusing, I weren’t taking, I were selling. I’m no longer a vein on society; I’m a valued member of society nowadays” said Craig who accessed support from Alpha House Calderdale. Please click here to see a video from Alpha House Calderdale.
Starting as a quality standard developed and piloted in Calderdale, Quality for Health is now gaining traction as a nationally recognised standard and it is hoped this will be taken up further across the West Yorkshire and Harrogate Partnership area with the support of local infrastructure organisations and their commissioning partners.
If you would like to find out more about Quality for Health, please visit www.qualityforhealth.org.uk or phone us on 01422 348777.
Have a lovely weekend,
Sarah
What else has been happening this week?
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. Members received an update on the development of the West Yorkshire and Harrogate Clinical Strategy from Robin Jeffery, West Yorkshire Association of Acute Trust, Clinical Lead; and Sammy Lambert, Business Manager for Harrogate District NHS Foundation Trust. The development of a clinical strategy is important to the work we do and a steering group has been established to take forward this work. It includes colleagues from our six local areas and all sectors (Bradford District and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield). It will support the work of the 52 primary care networks / communities across our area and joined up relationships between primary care, hospital services and mental health providers.
A number of key areas were agreed at the Clinical Forum and System Executive Leaders Group in February 2019 including the review of frailty services. Recent work has taken place to establish whether there is value in developing a joined up approach where good practice and learning can be shared across West Yorkshire and Harrogate. To enable this to happen a series of interviews with people who use frailty services and stakeholder workshops were held. There were a number of findings including the support people need to address loneliness and the help they may need to maintain their independence, for example one person interviewed hadn’t spoken to someone for two weeks – and that was the postman.
The work also identified that different assessment tools are used to assess frailty across the area. It’s important to note that although most people using frailty services are elderly – younger people do access these services. Health promotion and social prescribing are important areas of work that can help prevent frailty. Clinical Forum members agreed when they met on Tuesday 7 June that the approach to share good practice and learning around frailty services should be included in the Partnership’s five year plan - which will be published in the autumn.
The work also identified that different assessment tools are used to assess frailty across the area. It’s important to note that although most people using frailty services are elderly – younger people do access these services. Health promotion and social prescribing are important areas of work that can help prevent frailty. Clinical Forum members agreed that the approach to share good practice and learning around frailty services should be included in the Partnership’s five year plan - which will be published in the autumn.
A paper was presented by Dr James Thomas on Flash Glucose Monitoring and other colleagues working on the Improving Planned Care and Reducing Variation Programme. 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, with the potential to agree a single policy for all nine clinical commissioning groups. NHS England published guidance in April entitled “Flash Glucose Monitoring: National Arrangements for Funding of Relevant Diabetes Patients.” The criteria outlined in the document are similar but not identical to the current policies in place across West Yorkshire and Harrogate. The West Yorkshire and Harrogate Pharmacy Leadership Group is currently working with the diabetes specialists across West Yorkshire and Harrogate to consider a single policy in light of this national guidance.
Forum members recommended that the Flash Glucose Monitoring commissioning policy would come back to June’s meeting for wider clinical discussion before anything goes forward to the Joint Committee of CCGs with the potential for an amended policy.
Professor Sean Duffy, Clinical Chair for West Yorkshire and Harrogate Cancer Alliance, Dr Suzanne Kite and Charlotte Rock gave forum members an update on the work taking place to support people living with a palliative cancer diagnosis (end of life care). Palliative and end of life care referrals have increased significantly and there is difference in the level of support people receive across the area.
The Living with and Beyond Cancer (LWBC) programme team, which is part of the West Yorkshire and Harrogate Cancer Alliance, coordinated an engagement piece of work around palliative /end of life care to further understand the experiences of those living with a palliative diagnosis (who are not yet appropriate for support from specialist palliative care services)., carers and staff. Engagement findings highlighted that further improvements in accessing and navigating services, availability of support, and communications between patients, carers and staff were needed.
Any areas for improvement will be led locally (Bradford District and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield). However an overview from the Partnership for shared learning and good practice would be helpful. The Clinical Forum supported the proposal for the development of a community of practice / clinical network with identified clinical leadership for end of life care. This would help to ensure the recommendations are implemented locally.
West Yorkshire and Harrogate Joint Committee of Clinical Commissioning Groups (CCGs)
The Committee met in public on Tuesday – chaired by Marie Burnham, independent lay chair. You can view the webcast, agenda and papers here. The Committee considered a musculoskeletal (MSK) pathway (problems with muscles, bones and joints). The Improving Planned Care Programme is transforming local MSK services and making positive changes that focus on clinical evidence, and on the patient as an individual. We have developed a new MSK pathway that sets out the various steps in the care of people referred onto MSK services by their GP or other healthcare professional. This diagram gives an overview of those steps and sets out the different types of treatment and support services available within the pathway.
The development of this pathway considered feedback from public engagement carried out on behalf of the Partnership between April 2014 and November 2017 and involved clinicians, commissioners and service providers. At its public meeting on 7 May 2019, the Partnership’s Joint Committee agreed to adopt the pathway in the nine Clinical Commissioning Groups across West Yorkshire and Harrogate. There’s more information about the new MSK pathway on the Partnership’s website here.
Following the Joint Committee’s recommendation to appoint Yorkshire Ambulance Service as the provider of the new Integrated Urgent Care service, the Committee heard the service had gone live on 1st April 2019. The main changes included an increase in clinical advice and direct booking - and greater collaboration and integration with local services.
The Committee also reviewed its draft annual report for 2018/19 (this will be published soon).
To summarise the Joint Committee approved the draft Joint Committee Annual Report; agreed proposals for developing the work of the Committee in 2019/20 and noted the vacancy for one of the Joint Committee CCG lay members and the proposal to seek expressions of interest for the role.
West Yorkshire and Harrogate Association of Acute Trusts (WYAAT - hospitals working together)
The WYAAT Programme Executive (the six Chief Executives of the acute trusts in West Yorkshire and Harrogate) met on Tuesday 7 May. The Chief Executives discussed the recently agreed system financial control total and the financial risks in the WY&H system, including in Harrogate and Airedale. Angela Wilkinson, the HDFT HR Director, joined the meeting representing the WYAAT HD Directors to discuss consultant retention and pensions. This is an important issue for all trusts, and is being looked at nationally. Dr Robin Jeffrey, the WYAAT Clinical Lead, presented the work he is leading to develop a clinical strategy for WY&H. The CEOs were impressed with the 24 “Service Profiles” that have been developed, noting that they will be helpful in shaping trust strategies within the overall WY&H context. Finally the CEOs also discussed the NHS Long Term Plan, particularly the development of primary care networks and how trusts can best engage with and support them locally. They agreed to have a series of briefings on each place over the next few months.
Leadership Executive Group
The Executive Group met on Tuesday. This includes leaders from all partner sectors, including councils, hospitals, clinical commissioning groups, Healthwatch and community organisations. It is chaired by Rob Webster, CEO Lead for the Partnership.
Working in our six local places to plan for a sustainable future is the only way we can further improve care for people and with this in view Helen Hirst, Chief Officer for Bradford District and Craven CCGs, who is also the CEO lead for West Yorkshire and Harrogate Organisational Development and Matt Graham, Programme Director for West Yorkshire Association of Acute Trusts (hospitals working together) introduced an update on how far the Partnership has come in the last 18 months to break down barriers and organisational silos.
The session included looking at where we could do better together. Helen explained how areas are already working well in local partnerships to improve on many aspects of health and care, including mental health where commissioners and providers work together to plan services which meet national requirements and importantly local people’s need. Matt explained that we have come a long way in a short time to overcome leadership differences, and to develop arrangements for joint decision-making. You can see an example of this in the way our hospitals work together around workforce recruitment, training and shared procurement.
Professor Sir Chris Ham and Dr Nicola Walsh from the King’s Fund joined the session as part of the ongoing support we receive from the King’s Fund to develop our Partnership. We used the time to further develop a conversation about how we lead the development of our forthcoming five year plan to ensure we continue to focus on the right things, for example primary and community care, preventing ill health, inequalities and improving quality and outcomes for adults and children – all of which align to the NHS Long Term Plan.
Rob gave leaders an update on the recent meeting with NHS England and NHS Improvement on progress and challenges. This included progress on smoking prevalence which has fallen from 18.5% to 17.3%. This equates to over 22,000 smokers; a 9% reduction in alcohol related admissions; the work of the diabetes prevention programme which has exceeded targets. We continue to roll out the atrial fibrillation programme with 34 GP practices recruited to further identify people most at risk of stroke. We have estimated that 123 strokes have been prevented since the programme began. West Yorkshire and Harrogate Healthy Hearts programme has now been shared across the area and the tackling lung cancer programme has been implemented in Bradford, Wakefield and Kirklees.
Anthony Kealy (Locality Director –West Yorkshire and Harrogate; NHS England and NHS Improvement – North East and Yorkshire) updated leaders on the NHS operational plans for 2019/20 which have now largely been completed across the Partnership. They include details on quality, finance, delivery, performance and workforce. Our Partnership System Oversight and Assurance Group will review the delivery of plans throughout the year, identifying risks and prioritising support where needed. A whole partnership System Operating Plan has also been produced. This will provide the detail for year one in our five year plan, which will be published at the end of October.
Ian Holmes, our Partnership Director, also gave an update on the development of the Partnership’s five year plan including timescales. This included a proposal shared by Karen Poole, Maternity Programme Lead to include a new priority around children, young people and families. Dr Ian Cameron led a discussion on health inequalities. As the majority of these areas of work are led locally, key to any future conversations will be where the wider Partnership can add value.
The approach to develop the plan will be discussed at the first meeting in public of the Partnership Board in 4 June 2019 and with stakeholders over the summer. The deadline for submitting our plan to NHS England and NHS Improvement is the end of October 2019.
In parallel engagement activity continues. To date over 1,300 people across the area have completed the NHS Long Term Plan surveys. This work has been coordinated by Healthwatch and Partnership engagement leads. There were two surveys - one on long term conditions and another on personalisation and digital. A series of focus groups aimed at groups of people, including those with mental health concerns, deaf and hard of hearing have also taken place covering personalisation, digitalisation and local place conversations. A focus group also took place with the Cancer Alliance public panel. This work ended on 3 May 2019. Findings will be shared in a report submitted to NHS England, National Healthwatch and our Partnership in June 2019.
There was also a discussion on workforce funding led by Mike Curtis and Kate Holiday from Health Education England. Part of Health Education England’s budget is set aside for ‘workforce development’, to support the transformation and development of the current workforce. The newly formed delivery group is made up of education and training leads from all hospital and mental health providers, with representation from primary care, social care, hospice, local authority, other care providers and the five local universities (including the Open University). The group has undertaken a training needs analysis to look at the allocation of the budget. In West Yorkshire and Harrogate, a number of education contracts and programmes remain for another 12 months. The allocation of the workforce budget will be discussed at the Partnership Board meeting in public in June.
West Yorkshire and Harrogate Health and Care Partnership Public Health Co-ordination Group
The Public Health Coordination Group met on Wednesday. The meeting was chaired by Dr Ian Cameron, Director of Public Health for Leeds City Council. Emm Irving, from the core team, gave an update on the preventing ill health workshop held in April and the prevention plan.
Colleagues have also been working towards the following priorities:
- Development and implementation of the four key work streams: tobacco harm; alcohol harm; obesity – to reduce diabetes; health and care workforce.
- Co-ordination of the public health input into the West Yorkshire and Harrogate priority programmes.
- Development and strengthening of links and co-ordination of the prevention work taking place across the area in our six local places (Bradford District and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield) and contribution to the overall Partnership.
Discussions are taking place across the Partnership on the future relationships between preventing ill health, health inequalities; wider determinants of health and population health management, for example poverty, housing and health.
Better Care Together: Gloucestershire Care Services NHS Trust & 2Gether NHS Foundation Trust
Rob Webster, our CEO Lead for the Partnership attended a conference this week in Gloucester which is bringing together Gloucestershire Care Services NHS Trust and 2gether NHS Foundation Trust to develop a new organisation. Rob talked about the role of leadership and joined up health and care in the 21 Century. In particular he talked about the work of partnerships and also the importance of kindness, emotions and human relationship which are often the blind sport in public policy (to coin a phrase from Julia Unwin, Carnegie Fellow) and how people come first and not structures.
West Yorkshire and Harrogate Cancer Alliance
The West Yorkshire and Harrogate Cancer Alliance Board held its bi-monthly meeting on Wednesday. Here’s a summary of some of the key discussions:
Members received a summary of cancer waiting times performance and an update on proposals for a system-wide collaborative performance improvement programme. Partners across WYH are continuing to invest effort individually and collectively to recover performance against the 62 day cancer standard pathway but sustained upward improvement continues to be challenging. Last month, WYAAT Chief Executives gave an explicit commitment to deliver as a system against the 62 day standard, and to accelerate a system-wide whole pathway approach through the development of an improvement collaborative approach - focusing initially on prostate and lung pathways and engaging with clinical teams, patients and system leaders . The Alliance PMO team will lead and co-ordinate this work, including a stakeholder event on 5th July and concept testing of the proposed cancer hub. Discussions have taken place with WYH stakeholders and other Alliances who have developed similar hub approaches. The aim of the hub is ‘to provide a framework that enables WYH to operate as an effective health system, enabling patients to receive optimal and timely referral and care to deliver best outcomes, irrespective of where they live’. More specifically, this would allow system capacity, including diagnostics, treatment and workforce to be used optimally and flexibly to meet population and system demands. Initially the Cancer Alliance will take an incremental approach to developing the hub, focusing on cancer waiting times performance across pathways which involve transfers between providers. For more information, contact Fiona Stephenson, Macmillan Head of Quality and Optimal Pathways, Fiona.
The findings of Alliance stakeholder engagement to understand current service and support provision for patients with treatable but not curable cancer, and not yet in the last weeks or months of life, were presented. Significant variation and unmet needs were identified, with themes identified around access to and navigating services, availability of appropriate support, a lack of information, education and communications. These were consistent across patients, carers and professionals, and many of the issues are not specific to cancer, but also other conditions. A number of the report’s recommendations will be progressed through existing projects within the Living With and Beyond cancer workstream, but others need a broader, system-led approach with the potential development of high level metrics to be monitored through the Partnership (System Oversight Assurance Group), rather than a single disease programme. Findings of the report have also been presented to the Partnership’s Clinical Forum to secure senior, clinical and local endorsement across all six places and identify the system support needed. It was also agreed that a community of practice or clinical network should be established for end of life care to ensure the report’s recommendations are taken forward locally. For more information, contact LWBC Project Manager Becky Jowett, rebecca.
Members received a progress report against the Cancer Alliance communications and engagement strategy, which was approved by the Board in November 2016 and is now to be reviewed and refreshed. Lay Board Members Mike Frazer updated on the success of recent cancer-focused sessions at the Bradford Patient Network of PPG members and potential to roll out to other CCG areas and wider communities. Fellow Lay Member Paul Vose described his work in connecting those already engaged with cancer and his new role on the national Patient and Public Voice Forum. A revised draft strategy will be presented to the next Board meeting in July. For more information, contact Tracy Holmes, Communications and Engagement Lead, tracy.
The challenges of collating local data to demonstrate the impact of Living With and Beyond Cancer interventions – primarily access to the Recovery Package - were discussed. Given this is not part of any single mandated dataset, collection tends to be manual and therefore potentially less accurate than other performance data. Articulating progress therefore more difficult. It was agreed further discussions should be held with WYAAT colleagues about how this might be given greater priority at local level.
Developing clinical engagement with neighbouring Cancer Alliances will form part of the WYH delivery plan for 2019/2020. A suite of optimal pathway groups for common and interim cancers is being formed across WYH. For less common cancers, the proposal is collaboration across the whole of Yorkshire and the Humber to enable broader clinical conversations and also the sharing of project and administration support.
Governance of the ICS’ work around Tobacco Control is to return to the Prevention at Scale programme. However, the Alliance will retain strong links with work around tobacco control, particularly through its Tackling Lung Cancer workstream.
Amanda Procter, Lead Cancer Nurse at Bradford Teaching Hospitals NHS Trust, attended her last Board meeting, as she will shortly take up a new post as Centre Head at the newly-built Maggie’s Centre in Leeds. Amanda was thanked for her hard work and contribution to the work of the Cancer Alliance.
Phase 2 of the ‘Looking out for our neighbours’ campaign
It’s wonderful to hear about the positive difference the campaign is making across the area. Many people feel lonely at some point in their lives, whether this is due to bereavement, divorce or other life changing events and without the support of family, friendships and neighbours it can be very difficult to overcome – so the help a community supporter gives is making a huge positive difference. Working together with our communities (who are already doing this in many cases) to highlight the causes and effects of loneliness and social isolation has been amazing. We now have over 350 organisations and community champions supporting the ‘Looking out for our neighbours’ campaign across West Yorkshire and Harrogate. Take a look at the latest newsletter here. We are launching the 2nd part of the campaign on 13 May (mental health awareness week), where we will be asking others to share their positive experiences. A new campaign pack will be circulated to campaign supporters from 10th May to help this next campaign phase. Many thanks once again for being part of this very important social movement.
West Yorkshire and Harrogate Healthy Hearts
The Healthy Hearts programme is a three-year local NHS initiative that aims to reduce the number of cardiovascular incidents, such as heart attacks and strokes by 10% right across West Yorkshire and Harrogate. We believe this will mean 420 hearts attacks and 620 strokes will be prevented, saving the local NHS more than £12 million.
In phase two of our programme, which is due to launch in the autumn, we’ll be concentrating on cholesterol levels. Cholesterol is a fatty substance, also known as lipids, that’s mainly created by our own livers, though it’s also found in some of the foods we eat, and it’s vital for maintaining a healthy body. Simply put there are two types of cholesterol – good cholesterol (high-density lipoprotein, or HDL – and bad cholesterol (low-density lipoprotein, or LDL). If the level of bad cholesterol in your blood is too high it can increase the risk of heart disease, including heart attack and stroke.
To combat this GPs will very often prescribe statins for patients who have high levels of bad cholesterol. Statins are a group of medicines that can help lower the level of bad cholesterol by reducing the amount produced by the liver.
In phase two of Healthy Hearts, we’re equipping local GPs with new coding, which allow them to search their own patient databases more effectively, helping them to discover patients who have high levels of bad cholesterol or who may be at risk of a future heart attack or stroke. People can then be offered treatment to help bring down the level of bad cholesterol in their blood.