Hello my name is Matt…

For many people hospitals are what they first think of when they think of the National Health Service, so in the week when the NHS turns 70, we wanted to take the opportunity to shine a spotlight on how our hospitals in West Yorkshire and Harrogate are working together to ensure they will continue to provide outstanding care and support to everyone who needs it 24 hours a day, 365 days a year - and for the next 70 years.

There are six acute hospital trusts in West Yorkshire and Harrogate which run all the main hospitals in the area:

  • Airedale NHS Foundation Trust - Airedale General Hospital
  • Bradford Teaching Hospitals NHS Foundation Trust - Bradford Royal Infirmary and St Luke’s Hospital
  • Calderdale and Huddersfield NHS Foundation Trust - Huddersfield Royal Infirmary and Calderdale Royal Hospital
  • Harrogate and District NHS Foundation Trust - Harrogate and District Hospital
  • Leeds Teaching Hospitals NHS Trust - Leeds General Infirmary and St James’ University Hospital
  • Mid Yorkshire Hospitals NHS Trust - Pinderfields General Hospital, Dewsbury Hospital and Pontefract Hospital

These hospitals have come together to form the West Yorkshire Association of Acute Trusts (WYAAT) because they believe that the health and care challenges and opportunities facing our area cannot be solved by each hospital working alone.  We have committed to working together in partnership to improve services for the 2.6million people we serve and to ensure everyone, no matter where they live, have access to the same standards of care and treatment.

I am lucky enough to be the WYAAT Programme Director with the privilege of working with all six trusts to help them collaborate.  Since setting up WYAAT in early 2017 we have been working hard on a range of programmes which will address some of the challenges facing our hospitals and make improvements to our services.  There has been great collaboration between teams from all trusts and a huge commitment of time and effort from chief executives, clinicians and staff.  Our philosophy is that WYAAT is the combination of the trusts, not a separate organisation; WYAAT does not deliver programmes for the trusts, the trusts deliver them together supported by my small (but perfectly formed!) WYAAT programme management office team.

Our approach is already delivering results and the programmes are making excellent progress:

We are setting up a shared supply system for medicines which will not only save money and increase efficiency, but will increase quality by releasing pharmacists and nurses time to look after patients and increase safety by standardising medicines across all our hospitals.

We are rolling out a new IT system to enable clinicians to share images, such as X-Rays and other scans.  Harrogate went live with this system at the weekend and other trusts will follow over the next year and a half.  In parallel, and building on this system, our clinicians and managers are working together to standardise the processes and systems in radiology - at a workshop on 3 July clinicians and managers came together to agree the priorities for this work.  Because of the progress we are making we were awarded a further £6m in March for additional IT systems to enable clinicians to work even closer together.

In pathology we have already agreed to centralise immunology services at Leeds Teaching Hospitals (LTHT) and in microbiology we are working together to address staff shortages in some trusts.  In March we were allocated £2m to expand the National Pathology Exchange system and we have put together a joint bid for funding to implement a common pathology information system across West Yorkshire and Harrogate.  On 26 June pathologists, scientists and managers came together to discuss ways to improve how pathology is delivered in West Yorkshire and Harrogate with the intention of developing a full plan by the autumn.

In April the trusts all decided that vascular services (diseases of the blood vessels, arteries, veins and circulatory system), both surgery and interventional radiology, should be delivered as a single “West Yorkshire Vascular Service”.  A single service will bring together the incredible expertise and resources from all the trusts.  The opportunities for sub-specialisation, research and education, to work differently and experience a wider range of cases, will improve quality for patients, increase efficiency and make West Yorkshire a more attractive place to work.

In October 2017, we welcomed Professor Tim Briggs  to West Yorkshire and Harrogate for the first ever whole system “Getting It Right First Time” (GIRFT) workshop which was attended by over 100 surgeons from the trusts.  Out of this workshop we have established a clinically led standardisation programme for elective orthopaedics which will ensure any patient, anywhere in West Yorkshire and Harrogate receives the same, high standard of care

Recently we have established an additional programme to roll out “Scan4Safety” across the trusts.  LTHT has been a demonstrator site for this system which improves quality, safety and efficiency by using barcodes to ensure right patient, right place, right product and we have been awarded £15m to extend it across all the WYAAT trusts.

And these are just some of the highlights - we are also working together to make it easier for staff to work in any of our hospitals, to share IT systems, to reduce the cost of our supplies (we achieved over £1m savings through working together to on procure simple clinical supplies in 2017/18) and in a number of other areas.  There’s a lot happening!

Collaborating at this scale and in the current NHS system is really hard - it takes real commitment from everyone. So I hope by reading this week’s blog you will be as excited as I am about the way our hospital trusts are truly working together as partners and about what they are achieving together for the benefit of people living in West Yorkshire and Harrogate.  Together we can ensure our hospitals will still be delivering the best care on the NHS’ 100th Birthday!

Have a good weekend

Matt

 

What else has been happening this week?

Shadow Leadership Group

The shadow leadership group met on Monday. The meeting was chaired by Thea Stein, CEO for Leeds Community Health Partnership. The group is made up of aspiring future leaders from across our partnership. Feedback from the meeting was shared with the leadership executive group – there were some excellent reflections around the potential for peer reviews and transformation funding bids.  As part of the discussion for each item Thea provided a concise summary of shadow SLE discussions at the Leadership Executive Group meeting after the papers were introduced in the afternoon (please see below). The group will continue to meet for the rest of the year. A 2nd cohort is being planned for next year.

Clinical Forum

The Clinical Forum met on Tuesday. The meeting is chaired by Dr Andy Withers and includes GPs, medical directors from hospitals, lead nurses and colleagues from the Yorkshire Ambulance Service and NHS England.

Forum members received an update on the Local Health Care Record Exemplar bid, which was announced last week. Governance arrangements will be established to work across the three STPs involved and the group will be chaired by Rob Webster, our Partnership CEO Lead.

There was a conversation about population health management. NHS England are looking to develop a support offer for partnerships to develop capability in this area quickly. Emily Parry-Harris (public health consultant in Kirklees and shadow leadership group member) attended a national event on Wednesday on behalf of West Yorkshire and Harrogate Health and Care Partnership. Following this we are looking to establish a network to share good practice across our six local areas (Bradford District and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield).

Dr Ian Cameron (Director for Public Health, Leeds City Council and Chair of the Partnership’s Public Health Coordination Group) and Corinne Harvey (Public Health England) gave a presentation on preventing ill health and tackling health inequalities across our area. The work of the Public Health Coordination Group is currently focused on three areas of work:

  • Smoking: overall reduction in prevalence; Tobacco Advisory Board
  • Obesity: National Diabetes Prevention Programme; whole systems approach
  • Alcohol: reduction in related hospital admissions; population level approaches.

Ian and Corinne explained that if we are to improve people’s health then we also need to tackle the wider determinants of health (poverty, air quality, housing, and employment). We also need to secure the right level of investment so we can maximise local place plans.  Ian also talked about creating the right opportunities for more clinical engagement across the area to ensure this is embedded into the work of public health colleagues.

West Yorkshire and Harrogate Joint Committee of Clinical Commissioning Groups

The Joint Committee held a development session on Tuesday. Marie Burnham is the independent lay chair.

The Committee’s work plan includes mental health and this was discussed at the meeting.

NHS mental health providers in West Yorkshire have set up new shared governance arrangements. This builds on the close partnership working that has taken place over the past year.  Known as the West Yorkshire Mental Health Services Collaborative, the organisations have been working together to improve mental health services for local communities. This is part of the wider West Yorkshire and Harrogate Health and Care Partnership and its focus on mental health as a key priority area.

The mental health collaborative includes:

  • Bradford District Care NHS Foundation Trust
  • Leeds and York Partnership NHS Foundation Trust (LYPFT)
  • Leeds Community Healthcare NHS Trust
  • South West Yorkshire Partnership NHS Foundation Trust (SWYPFT)

Sara Munro, CEO for Leeds and York NHS Partnership Foundation Trust and Partnership CEO Lead for Mental Health; Helen Hirst CEO for Bradford District and Craven CCGs and Commissioning Lead  for Mental Health, Programme Director Emma Fraser and Amanda Bloor, CEO for Harrogate and Rural District CCG gave an update on the work taking place across West Yorkshire and Harrogate.

This includes a new adults and community eating disorder service across the area, keeping people closer to home when in crisis and plans to reduce variation in the care people receive.

Helen explained that collaborative working by providers had recently prevented 20 people being placed out of area for in-patient hospital care.  Emma also gave an update on other programme work, including funding received for perinatal services in Leeds and Harrogate and employment support in Bradford. A key aim of the mental health programme is to avoid out of area placements and provide more care closer to home. Sharing learning and good practice is essential. For example Tees, Esk and Wear Valley NHS Trust are piloting closer working with housing providers. The learning from this will be shared across the Partnership.

Anthony Kealy, NHS England Locality Director, discussed the support needed from national organisations to deliver on our priorities and strengthen our capacity as part of becoming an integrated care system. Local place-based development is a key priority for support.

Leadership Executive Group

The leadership executive group met on Tuesday. The meeting is chaired by Rob Webster, our Partnership CEO Lead. 

Rob gave an update on the national STP leaders meeting last week.  Dr Andy Withers (Chair of the Clinical Forum) and Joanne Crewe (Director of Quality and Governance Executive Nurse for Harrogate and Rural District CCG) attended this session as clinical leaders alongside colleagues from other STP areas.

The group discussed proposals for the development of a new approach to peer review / challenge. As we work towards becoming more of a self-governing Integrated Care System we will increasingly take collective responsibility for system improvement and performance. It is essential that our approach has the right focus on improvement, challenge and learning, and we have recently been exploring the role of peer review / challenge to create this focus.

Over recent weeks we have worked with the Local Government Association, NHS Providers and the NHS Confederation who have been commissioned by NHS England to develop an integrated system approach to peer challenge.

‘Peer review / challenge’ is a well-established process used in local government as a proven tool for improvement. Any peer review process would be a voluntary undertaking aimed at bringing partners together in a safe space to consider new and better ways of working together in and across our six local places.  Clinical leadership, different levels of staff and the public voice throughout is extremely important. 

Working with young people groups

We are exploring how we engage with young people so they can contribute to the work of the Partnership. We are keen to hear their ideas on how we can ensure the voice of young people are included in the future of health and care services. To support this work we are having conversations with youth forums / young people groups which already exist across West Yorkshire and Harrogate. The intention is to make the most of these important channels without duplicating the existing good work already taking place.

Local Government Association Conference

The LGA conference took place in Birmingham this week; the conference provided plenty of opportunities for local government colleagues to engage in a range of sessions on how good practice can deliver the best local public services for our communities.  It included policy discussions on subjects ranging from housing, local government finance, health and social care, Brexit, devolution, children’s services, education and schools, and transformation.

What’s happening next week?

  • The 2nd co-production meeting for the public involvement assurance group will take place on Tuesday. This work will include young people representation.
  • Our local area leads meet on Tuesday.
  • A meeting will take place on Wednesday with the Jo Cox Foundation ‘More in Common’ to discuss how we work together following the success of the Great Get Together. There is also the opportunity to work closer together on the loneliness agenda.
  • The West Yorkshire and Harrogate programme leads meet on Thursday.
  • The State of Carers Conference takes place on Friday.