Hello my name is Amanda

I have worked in the NHS for more years than I care to remember! During this time I have had a wide variety of clinical and non-clinical roles within a number of individual organisations and iterations of NHS structures in both Newcastle and Yorkshire. During this time I have also personally, and through my family, experienced the impact of the health and care services when they are great, and also when they don’t operate as we would hope.

These experiences are what drive all of us to do things better.

There are a number of buzzwords and catchy slogans that the NHS uses to describe how we want things to be. I am sure you can all think of many. Fundamentally though, whatever our individual roles across our Health and Care Partnership, we all come to work with genuine intent to deliver meaningful improvements in both clinical outcomes and people’s experience.

Within the context of growing demand for services, workforce recruitment and retention challenges, and financial constraints, delivering our ambitions is undeniably challenging. This only makes it more essential that we are prepared to do things differently. We know that the system we are working in doesn’t always respond well to change. It is up to us to be creative, collaborative and ambitious by identifying and nurturing opportunities to create the conditions in which to drive and deliver the change that we all know is needed.

We are doing this with the Cancer Alliance Board.

The Alliance has the ambition of becoming a mutually accountable system to drive and oversee the West Yorkshire and Harrogate work to improve outcomes and experience for cancer patients at a local level. The Alliance’s ambition is to deliver services around the patient rather than focusing on organisational or geographical boundaries. The Alliance also seeks to reduce unacceptable variations in treatment and outcomes across West Yorkshire and Harrogate and gain maximum patient benefit for every pound spent.

To help us achieve these goals we have developed a set of outcome measures (the Cancer Outcomes Assessment Framework) which will tangibly demonstrate the impact we are having and act as a tool which supports meaningful conversations about ambition and progress.

We have also designed a delivery framework to enable us to work in this collaborative, system-wide, way. This is different and new, it moves from an old style performance management structure where we all work in silos, to a genuine focus on delivering improved outcomes through mutual accountability. This new approach will empower local places and services to work differently together to deliver improvements.

Much is being demanded of Cancer Alliances nationally, including collective accountability around delivering performance standards and to drive the required improvements in cancer care delivery on behalf of the Partnership. Within our Alliance we have responded to these demands by developing and testing mutual accountability that we believe will be a prototype that the wider Health and Care Partnership can use as we pursue our ambition of becoming an integrated care system.

The Alliance will strive to develop a sense of community on cancer; sharing collective ambitions that we all recognise; adopting an open and transparent approach about performance and progress; offering constructive challenge where improvements can be made, and then sharing good practice and expertise to make us all the very best we can be. Working together will build confidence in how we develop transformational models and share our learning, making us better able to deliver both at scale and pace.

The stronger our cancer community, the better equipped we will be at delivering on our strategic policies such as reducing prevalence, diagnosing and making more cancers curable and living as full a life as possible after a cancer diagnosis. This will help us deliver better health and care outcomes at local level, for individual patients, across the Alliance.

By working in a new way, with a refreshed focus, the Alliance is committed to improving patient outcomes and experience. These goals are no different to the ambition we all have in whichever area of the health and care sector we work in or lead. It is what we would want for everyone, ourselves, our families and our friends. This is why it is so important that we challenge ourselves to think and behave differently in how we collectively push to deliver this improvement.

In my ‘day job’ I am the accountable officer for Harrogate and Rural District CCG, and I want to give a snapshot of the work we are doing across North Yorkshire to deliver better, more integrated Mental Health and Learning Disability services with our main provider Tees Esk and Wear Valleys NHS Foundation Trust (TEWV). There are significant challenges facing these services. Not just an historic low level of investment as a legacy of a financially challenged area, but also significant workforce availability and geographical challenges. We know that working in the same way will not deliver the improvements that we want for our population.

TEWV and the CCG with our colleagues in North Yorkshire County Council have formed a strategic Partnership Board for Mental Health and Learning Disability. We are moving away from a traditional commissioner and provider relationship to a transparent partnership approach, using our collective expertise to focus on what matters. Where and how we invest to reduce unwarranted variation in outcomes across North Yorkshire; how we transform services by harnessing digital and technology developments and how we focus on a greater range of accessible locally based services. The Partnership Board will be collectively responsible for managing the budgets, service improvement, operational performance delivery and risk management.A key principle is that any efficiency realised through this approach will be reinvested back into local services.

It is early days in this new way of working, but we had to change and a comment of ‘this feels really positive and really different’ fills me with hope that our approach will lead to real improvements locally in services across North Yorkshire.

Over the past 18 months I’ve noticed a significant shift in the commitment to and strength of partnership working – both in North Yorkshire and across the WY&H partnership.The challenges we face are significant – I firmly believe that a new way of partnership, system-wide, working should be an ambition across all of our health and care work. This approach has the potential to unlock efficiencies and truly deliver a patient-centred health and care service. I welcome the opportunity to lead the way with this new approach through both the work of the Cancer Alliance and in my Accountable officer role.

Enjoy the Bank Holiday weekend; I think the weather is going to be kind for a change…


What else has been happening this week?

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.

Dr Adam Sheppard, Chair of the Urgent and Emergency Care Programme Board and Nigel Gray from WY&H Partnership gave members an update on work, which includes A&E, dentistry and mental health. There was a focus on meeting people’s needs in a timely way, care as close to home as possible and centres with the right expertise. Priorities include NHS 111 and integrated urgent care. There was a discussion around what support people receive that don’t need to be at A&E. Colleagues from across the area including GPs and lead nurses will be asked to support the NHS 111 procurement evaluation. This went out to procurement last week.

Tony Jamieson from the Academic Health Science Network gave an overview on the innovation and improvement priorities, including those which are nationally led.We are looking to build a closer, more structured partnership with the AHSN so that people in WY&H can routinely benefit from the roll out of evidence based interventions.These include transfer of care around medicines (supporting people leaving hospitals to take their medicines when home); diverting people away from A&E (App for people to see where they can get local help and how long the wait times are in walk in centres etc.); polypharmacy (focus on review of multiple medications by a person - most common in the elderly); escape pain (services as close to home as possible for people with osteoarthritis). The opportunities are endless and the Clinical Forum is keen to influence the work moving forward.

There was also a discussion around joined up primary health care and how we bridge the conversation between the WY&H and local places (Bradford District and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield).

West Yorkshire and Harrogate Joint Committee of the Nine CCGS

The WY&H Joint Committee met on Tuesday; chaired by Marie Burnham who is our Independent Lay Chair. The committee is made up of clinical chairs and CEOs from the clinical commissioning groups (CCGs).

Dr Youssef Beaini and Sue Baughan updated members on the opportunities presented by NHS England RightCare data around the top priorities to address health inequalities. This includes CVD (heart disease), diabetes and the potential to prevent the number of stroke and heart attacks every year; including those people with high blood pressure, diabetes and high cholesterol. The number of people who could be identified and supported is very powerful; for example targeting people where statins (statins are prescribed to lower the level of cholesterol in the blood) could make a huge difference. There was an overview on Leeds and Bradford’s Healthy Hearts and how various community engagement methods are important to reaching those most at risk. A report will be submitted to the Joint Committee held in public in June regarding the next steps.

Tony Jamieson from the Academic Health Science Network gave an update on the work to prevent strokes. In particular, using the best evidence of how we treat atrial fibrillation across West Yorkshire and Harrogate (atrial fibrillation causes a fast and erratic heartbeat which is a major factor of stroke.) This work is about detecting and treating people who are at risk of stroke so that around 9 in 10 people with atrial fibrillation are managed by GPs with the best local treatments, saving lives and delivering efficiencies too. Linda Driver (Stroke Programme Lead) gave an update on the recent sessions with people who have experienced stroke, their carers and community organisations. A report from these sessions will be published soon.

Professor Sean Duffy (Clinical Lead for the WY&H Cancer Alliance), Amanda Bloor (Commissioning Lead) and Carol Ferguson (Programme Director), gave an overview of the Cancer Alliance work and progress. Please see this week’s leader message above for more information.

Stephen Gregg, the Governance Lead for the Joint Committee explained that an annual report is being produced. This is being shared with members for comments and will be published when complete.

You can find out more about the Joint Committee here.

West Yorkshire and Harrogate System Leadership Executive Group

The executive group also met on Tuesday; chaired by our Partnership CEO Lead, Rob Webster. The executive group has a representative from all our partner sectors, including councils, hospitals, CCGs and voluntary organisations. The group welcomed Emily Lawson, National Director – Transformation and Corporate Operations at NHS England who joined the meeting as part of a wider visit to the Yorkshire and Humber region.

The Shadow System Leadership Executive Group met for the first time on Monday, chaired by Matt Walsh. Matt provided a summary of the discussions and explained how positive the meeting had been.

Mike Curtis, Yorkshire and Humber Local Workforce Action Boards discussed funding to transform care and implement workforce plans identified by our six local places (Bradford District and Craven; Calderdale, Harrogate, Leeds, Kirklees and Wakefield). Mike will work with local leads to work up a proposal for the next meeting.

There was a discussion around establishing a partnership board which would meet in public. This potentially would include a CEO chair and elected member and lay representation from partner organisations and appropriate senior representation from national bodies. It would provide formal oversight and accountability for all partnership business. Conversations continue and we will keep you updated.

There was also an update on the Yorkshire and Humber proposal to NHS England to become a Local Health and Care Record Exemplar [LHCRE]. This initiative has sign-up from WY&H, South Yorkshire and Bassetlaw and Humber, Coast and Vale. This represents a significant piece of partnership work over the last three months across the whole region. It has included NHS technologists, clinicians, senior leaders, patient representatives, local authorities, universities and technology suppliers. We will hear in the next few weeks if this has been successful.

Leadership group

Leaders from across the WY&H and wider have been invited to meet with the Prime Minster to talk about their work, including the wider determinants of health, council partnerships and the health care sector in general.

Tony Jamieson also updated the wider leadership on the work of the network and getting to the depths of innovation and spreading the knowledge across the country. The Yorkshire and Humber Academic Partnership Network works across three health and care partnerships; Humber, Coast and Vale; South Yorkshire and Bassettlaw; and WY&H.

Jo-Anne Wass, Chief Operating Officer at Leeds Academic Health Partnership (LAHP), came along to update people about its work, as an example of how one part of the STP is addressing innovation at local level. As a collaborative partnership between three Leeds universities, all of Leeds’ NHS organisations and Leeds City Council, the LAHP aims to match the research and educational expertise of the universities with the challenges facing the Leeds’ health and care system. Watch this short film to find out more about the LAHP’s strategy, which focuses on how, given that people are living longer, but not necessarily healthier lives, we must innovate to find transformative, sustainable solutions.

Jo highlighted the huge opportunities for the Leeds City Region to build on its strength in health technology innovation (often referred to as ‘medtech’) and the need to work together with the world-leading medtech industry sector in the region to achieve this. Forecasts show that by establishing strategic partnerships with the medtech sector, the health and care system across Leeds City Region could benefit by £1 billion per year by 2025.

We also said hello to Kim Leadbeater and Ian Hepplewhite from the Jo Cox foundation. Kim (Jo Cox's sister) and Ian came along to explain the work of ‘More in Common’. Kim talked about Jo in her role as campaigner, activist, humanitarian to MP and the amazing legacy she has left behind.

‘More in Common’ is all about building strong communities and is not about politics. People

coming together across the country to form a national movement which builds resilient communities and focuses on things that we have in common and not what divides us.

Kim also talked about the work of public health which includes building stronger communities and how a recent report by the Kings Fund which is all about the role of communities in improving health is receiving increasing, and long overdue, attention in health policy and practice. You can read it here. Jo’s passion to tackle loneliness also led to a report being launched in December 2017.

‘More in Common’ has three strands to the work: developing and strengthening communities; community based events, partnership and networking. The national campaign the Great Get Together launched on the first anniversary of Jo’s death. This year it will take place between the 22 to 24 June.

There are many ways we can get involved as a partnership from holding events in hospitals, to care homes, sports and schools. There is also the opportunity to do some shared work with carers, mental health groups – the list is endless and many of those in the room had ideas to take away with them.

Anyone can get involved – by either attending an event or organising one. To get your free pack, to register an event or to find out more, visit www.greatgettogether.org/partner-resources.

What’s coming up next week?

  • Our local place planners meet on Tuesday.
  • On Wednesday the Yorkshire and Humber Care Record, Communications Workshop takes place
  • On Thursday the WY&H programme leads meet.