Hello my name is Mel…
As a Director for Children and Young People Services I was pleased to be asked to write this week’s blog for West Yorkshire and Harrogate Health and Care Partnership.
This was for a number of reasons: one being that children and young people feature heavily in the NHS Long Term Plan and two, as equal partners of the Partnership I thought it helpful to give an alternative perspective on the world of health and care, i.e. supporting and working with vulnerable children and families; and thirdly I wanted to take the opportunity to tell you about the positive difference we are making in Kirklees with our partners in delivering our ambitions for the future.
The latter first…
It’s no secret (nor should it be) that in 2016 Kirklees Council received an inspection report that led to a government intervention. Working in children and young people’s front line care is a challenging and highly pressurised area of work and I believe this was reflected in the report findings.
I’m pleased to say that children's services in Kirklees are now continuing to improve. So much so that the hard work we are doing and the significant progress we are making was recognised by inspectors from the education and children's watchdog Ofsted in their latest visit in December 2018. Not only does it endorse we are heading in the right direction but, most importantly, we are managing to improve systems and processes to help ensure children and young people are kept safe – a priority to us all. However, it’s important to note we still have a way to go – we won’t be taking our foot off the gas.
Ensuring that our workforce has the right skills, knowledge and experience to work alongside people who may challenge us on so many levels is an important part of any model of care and support. There is no room for mistakes or inappropriate action.
Like our colleagues in health and the Police, effective workforce development takes account not only of worker skills, knowledge and expertise but how they are recruited, retained, supervised, supported and how worker behaviour is monitored and reviewed.
Children’s Services is often associated with high stress, staff sickness levels and social worker recruitment challenges. We have been addressing these concerns, which often have a negative impact on continuity of care for children and young people as well as the lives of staff. I’m pleased to say that our work is also having a really positive impact.
Our outcomes underpin every aspect of the work within our Children and Young People Services. Like any other of our West Yorkshire and Harrogate council partners we want children and young people to be safe wherever they are; confident and successful learners who can achieve personal success as they grow into adulthood.
A key part of the work we do is supporting families to be resilient, so they develop positive relationships and their children have good futures. Often called ‘ early help and prevention’, a key part of our work is around working with children, young people and families to know what it means to be healthy and adopt lifestyles that promote this.
Improvements in Kirklees are gathering pace and there is now increasing focus on quality as well as ensuring that statutory compliance is met.
You can see real examples in the work we are doing around children and young people growing up in poverty and higher than average childhood obesity levels. The Kirklees Integrated Healthy Child Programme covers a range of support for children and young people’s health and wellbeing from health improvement and prevention, to support and interventions for children and young people who have existing or emerging mental health problems, as well as transition between services. The partnership, which is working under the banner of ‘Thriving Kirklees’, is made up of Locala Community Partnerships, South West Yorkshire Partnership NHS Foundation Trust, Northorpe Hall, Home-Start and Yorkshire Children’s Centre.
It covers 11 areas of health provision for children and young people aged between 0 and 19 years (or up to 25 years for disabled children) and their families including: health visiting and family nurse partnership, school nursing, child and adolescent mental health services (CAMHS), single point of access (SPA) for 0 – 19 services, children’s weight management service, assessment and diagnosis of autistic spectrum conditions and support for those with learning disabilities.
Another example can be seen in our work with the Police and our communities around child sexual exploitation. We are acutely aware of the issue of child sexual exploitation (CSE) within our communities and are working tirelessly to stop the organised and deliberate exploitation of children through the work of Kirklees Safeguarding Children Board and beyond. CSE is a national concern and we know that any young person can become a victim and that the crime affects both girls and boys, from any background and of any ethnicity. We also note the devastating effects that CSE can have on an individual, their health outcomes and life chances – and this is why working with our communities has never been more important. Strengthened processes and effective management oversight is ensuring robust decision-making.
The State of the Nation’s Foster Care report prepared by charity The Fostering Network has warned of a “looming crisis” in foster care due to a lack of government funding and support. In Kirklees we are working hard to recruit more carers and to keep the ones we have. You can help us by talking about the value of fostering in your families, community and in your workplace and signposting anyone wishing to foster to councils recruitment line.
On a final note – because I could go on and there is much to say… the government's 10-year vision for the NHS sets out key pledges to improve support for children and young people with mental health problems, including investing in crisis and community-based interventions – whilst this is of course welcomed we also need to see the same level of investment and commitment to children and young people services. It will come of no surprise to you that spending on children and young people’s services has been reduced nationally, and that funding for early help and prevention is often seen as the poor relative – when in reality we need funding to support families sooner rather than later. Neither is it ‘new news’ that the cost of care is escalating.
We’ve come a long way together since 2016 to improve the care and support we give to some of our most vulnerable children and young people living across Kirklees – and we’re determined to remain focused and on track – our children and young people deserve nothing less.
Working with the Partnership and my peer Directors for Children and Young People Services, including the Association of Director for Children Social Services gives us a great opportunity to share and spread learning whilst importantly improving the lives of young people through pooling knowledge and expertise – I for one embrace this wholeheartedly.
Have a good weekend
Mel
>>>
‘Looking out for our neighbours’
‘Looking out for our neighbours’ is a West Yorkshire and Harrogate Health and Care Partnership social marketing campaign that aims to prevent loneliness and its associated health risks by encouraging communities to look out for vulnerable people, thus reducing demand on health and care services through early help and preventing ill health. Since November 2018, we've been gaining insight from communities and co-creating the campaign design with them. The campaign will launch from March 15 2019. We're really excited to launch a campaign across the whole of our area that aims to inspire people to engage in simple activities that will positively impact on the wellbeing of their neighbours. Communication colleagues are aware – please share this message with any other organisations who may want to get involved. They can pledge their support here. You can also read more here.
What else has been happening this week?
West Yorkshire and Harrogate Local Maternity System Board
The West Yorkshire and Harrogate Local Maternity System (LMS) held their Board meeting on February 15th 2019. The Board heard that the West Yorkshire and Harrogate LMS Plan is currently been reviewed in response to the publication of the Long Term plan (LTP). Presentations were given on neonatal care and maternal medicine networks - both included in the LTP.
From a neonatal perspective the Board learnt that ‘The Better Newborn Care’ report will be published soon. It will include improving survival, safety and the quality of outcomes for babies. Our LMS and Neonatal Operational Delivery Network will continue to work closely to implement the required work.
Dr Sarah Winfield spoke about Maternal Medicine Networks and the work she is undertaking with the national team. The Board noted the opportunity for the area to be one of only three Maternal Medicine Network pilots in the country. It was agreed the next steps are to establish a task and finish group to develop a business case for local implementation.
An update on the prevention work was shared. A Before, During and After Pregnancy Steering Group has been established and there will also be a number of task and finish groups taking forward the identified priorities. The Board supported a model for governance that fits with the current LMS structure but also incorporates governance at local authority place level.
The Board also heard about the work of the LMS guidelines group which has developed a process for LMS-wide guideline approval. Work has started on two guidelines to test the process. This will be reviewed and agreement sought from the LMS Board and then circulated to West Yorkshire Association of Acute Trusts (hospitals working together) for information and approval.
Delivering the continuity of carer ambition remains a challenge across the LMS and our hospital trusts continue to engage with staff and MVPs to design local models. The Board noted the hard work of all involved in this work.
Improving planned care and reducing variation
We have a new public lay member for the improving planned care programme. Pam Essler has recently joined the programme’s Clinical Thresholds Working Group to represent the patient’s perspective on planned care. As the lay member for patient and public engagement at Airedale, Wharfedale and Craven Clinical Commissioning Group, Pam has a great deal of expertise and experience to offer. She is also a trustee of a number of local health and social care-related charities. Pam is keen to make sure that patients are the focus of any development in planned care. The Clinical Thresholds Working Group is currently providing clinical input and a steer for the hips, knees and shoulders pathway before it goes to Programme Board for consideration on 19 March 2019.
Update on our work around the Evidence-Based Interventions (EBI) Programme
The Improving Planned Care programme’s Director Catherine Thompson and Clinical Lead Dr James Thomas joined the 12 other EBI demonstrator communities at a launch event in London on 11 February. The event created a great opportunity to test ideas with other integrated care systems and to work together to tackle problems and influence the national conversation. Gaining support for the new EBI policy from the public, and just as importantly from clinicians, will be central to its successful implementation. This behaviour change will be brought about through effective communication of the key message that ‘the policy is evidence-based and therefore the right thing to do’. Implementation of the EBI policy will reduce unnecessary medical procedures and prevent avoidable harm to patients. It will also free up clinical time by only offering interventions on the NHS that are proven to work and appropriate. The first phase of the programme targets 17 such interventions and it is expected that a list of further interventions that are either ineffective, or have been replaced by a safer and less invasive alternative, will be issued around Easter time.
First contact practitioners development and implementation workshop
The Improving Planned Care programme collaborated with the Chartered Society of Physiotherapists to deliver a First Contact Practitioner development and implementation workshop for providers and commissioners across West Yorkshire and Harrogate on 14 February. With posts already established in Leeds and Harrogate, delegates were able to share learning across the system, problem solve key barriers to implementation and plan strategically for workforce development to ensure we are able to establish further posts across the region.
WYAAT hospitals working together update
The West Yorkshire Association of Acute Trusts (WYAAT) brings together the six NHS trusts (Airedale NHS Foundation Trust, Bradford Teaching Hospitals NHS Foundation Trust, Calderdale and Huddersfield NHS Foundation Trust, Harrogate and District NHS Foundation Trust, Leeds Teaching Hospitals NHS Trust, Mid Yorkshire Hospitals NHS Trust), which deliver acute hospital services across West Yorkshire and Harrogate. The purpose of the association is for the hospitals to work together on behalf of patients to deliver more joined up, high quality, and cost-effective care.
Pathology
Pathology services are one of the areas of focus as part of West Yorkshire Association of Acute Trusts’ (WYAAT) wider work to look at how we can improve services for both patients and staff across the area. Agreement has been reached to establish a West Yorkshire and Harrogate pathology network, which will enable us to address the challenges that pathology is currently facing, and invest in developing services and staff. The network will build on the informal collaboration already in place to work together to provide services rather than as individual trusts. The next step is to undertake further discussion across the six acute trusts in WYAAT to map out possible approaches and recommendations for preferred models. We will keep you updated as this work progresses.
Hyper Acute Stroke Services (care people receive in the first 72 hrs)
Evidence shows that people who receive care in hyper acute stroke units which see a minimum of 600 new admissions per year have better outcomes, even if the initial travel time is increased. The Hyper Acute Stroke Unit at Harrogate District Hospital does not meet this threshold, nor is it ever likely to. With this in mind, Harrogate and District NHS Foundation Trust is working closely with Harrogate and Rural District CCG, Leeds Teaching Hospitals NHS Trust, York Teaching Hospital NHS Foundation Trust and the Yorkshire Ambulance Service to transfer hyper acute stroke services from Harrogate District Hospital to hospitals in Leeds and York. For more information, contact paul.widdowfield@hdft.nhs.uk.
Scan4Safety
The Scan4Safety programme uses barcode technology to help improve patient safety and care. The idea is that patients can be scanned via a barcoded wrist band, which links into other systems such as the electronic patient record, and barcoded locations across hospital sites, enabling much better tracking of patients. The same technology will also provide greater efficiency in the supply chain by ensuring all products, medicines, etc. are recorded and accounted for, making equipment more easily trackable, for example in the event of a product recall, and simplifying processes to release time for patient care. The technology is already being trialled at Leeds Teaching Hospitals NHS Trust, which is one of six demonstrator sites across the country. The trusts have received £15m to build on the success of the Leeds demonstrator and roll out across all the WYAAT trusts.
Getting it Right First Time programme
Getting it Right First Time (GIRFT) is a national programme delivered in partnership with the Royal National Orthopaedic Hospital NHS Trust and NHS Improvement. It aims to improve the quality of care by tackling unwarranted variation in services and encouraging the sharing of best practice between trusts. WYAAT and GIRFT have worked together in a number of areas, such as orthopaedics and ophthalmology, to support these aims across the whole of West Yorkshire and Harrogate. Recognising the maturity and strength of their collaboration, GIRFT asked the six WYAAT trusts to provide a case study of how we work together, what we aim to achieve and the programmes of work we are focused on, as part of a larger report on collaboration and system leadership in the NHS. We expect the report will be published at the end of February.
Working as part of the wider Partnership
The WYAAT trusts’ communications leads are working together as part of the wider Partnership to support engagement around the NHS Long Term Plan and towards the launch of the “Look after your neighbours” campaign.
Digital and social media
The new WYAAT website launched last month to share our achievements – you can view it here. We will continue to develop content over the coming months. WYAAT has also launched its twitter account @WYAAT_Hospitals with the hashtag #hospitalsworkingtogether. Follow us and find out more about all the work going on.
Northern Region Cancer Alliances collaborate on involvement and co-production
‘Patients and co-production’ is one of a number of primary and secondary drivers for the development of a regional change programme for cancer outcomes, identified by the leadership of all seven Northern Cancer Alliances. The programme will facilitate improvement activity that does not fall under the current focus on early diagnosis, living with and beyond cancer and performance standards. Alison Featherstone, Manager of the Northern Cancer Alliance, is the champion for this activity. She will oversee the delivery of the co-production work programme, including a framework for coproduction to be developed jointly across the region, which includes the Northern; Lancashire and South Cumbria; Humber, Coast and Vale; Greater Manchester; Cheshire and Merseyside; South Yorkshire, Bassetlaw, North Derbyshire and Hardwick, as well as the West Yorkshire and Harrogate Cancer Alliance. Funding has been secured from the NHS England regional team to support the work.
The overall objective of the work is to upskill individual engagement leads within each Alliance and to support development of the capacity and capability of the whole cancer system to deliver effective patient/public involvement. This involvement/coproduction work will contribute to and align with the patient and public engagement support offer from the national cancer team, led by Kaz Obuka. Elements of the programme include:
- Community of practice sessions for Alliance engagement leads
- A masterclass/training for engagement leads in the principles of effecting large-scale change in the context of patient/public involvement across the cancer system
- A system-wide large scale change stakeholder event, with each Cancer Alliance inviting key people from the cancer system to develop a collaborative approach across their individual Alliances
- Teleconference coaching sessions for engagement leads post-event.
The stakeholder event will be held in Leeds on 22nd March 2019, with limited places available to each Cancer Alliance. For further information, contact WYH Cancer Alliance by emailing tracy.holmes@wakefieldccg.nhs.uk
What’s happening next week?
- West Yorkshire and Harrogate Urgent and Emergency Care Programme Board meet on Monday.
- West Yorkshire and Harrogate Health and Care Partnership ‘Our Journey towards Personalised Care’ event takes place on Monday.
- West Yorkshire and Harrogate System Oversight and Assurance Group meet on Thursday.
ENDS