Hello my name is Rob….
It’s been a big week for the health and care system nationally as NHS Improvement and NHS England, discuss the details of how the new 10 year plan for the NHS will be created. We will keep you updated. This plan is being designed to ensure that the extra resources announced for the NHS during NHS70 deliver a sustainable system with ambitious targets for improving the health of the public. Already we are seeing some welcome shifts in emphasis. Health inequalities, children, young people and learning disabilities are all given greater prominence. There is an essential recognition that staff are key to the future. In addition the plan will be created through engagement and joint leadership with people from the service. So far, so good.
There are challenges ahead. We have spent a lot of time ensuring our plan is led by local government, the NHS, commissioners, providers and communities. Local government and social care have not been party to the increased investments promised to the NHS and we await their settlement with interest. The power of supported self-care and self-management also needs to be emphasised, as it is in our planning and work in the Partnership. And delivery has to be secured in an era of Brexit, with subsequent impacts on staff supply, drugs and research.
What is clear is that the West Yorkshire and Harrogate Health and Care Partnership gives us the best chance for delivering ambitious improvements to outcomes for local people. By working across health, local government and local communities, we are delivering a bottom up alternative to traditional top down NHS change and genuinely focusing on the things that matter to people. And as Simon Stevens, Chief Executive for NHS England has made clear, these partnerships are here to stay – there is no plan B.
I think this is good news. We are seeing a maturity of debate and decision making amongst our leadership that has not existed previously. Organisational sovereignty and self-interest are giving way to collaboration and a focus on outcomes for local people. This is tough to deliver in the current context of organisational regulation and financial incentives. It needs a different style and type of leadership at all levels.
I was heartened that our investment in the Shadow System Leadership Executive Group is having such a big impact. At the end of last year, we were successful in securing funding from the NHS Leadership Academy to run this programme which is all about developing leaders of the future. Twenty colleagues took part from across the Partnership.
The Shadow Board was chaired by Dr Matt Walsh and co-chaired by Thea Stein. The outcomes of our first cohort went above and beyond any expectations we had. And on Tuesday we heard direct from colleagues on the programme about their commitment, drive and passion to make a personal and collective difference to leadership now and in the future. It was inspiring. I also think it’s fair to say they had a great Chair in Matt who reflected on the impact the shadow board had on his leadership and being his “best self”. One of his presentation illustrations is below.
In these times of change, we genuinely need to see the opportunity in front of us. As a self-determining partnership that wants more control over its resources and its future, we have a chance to make a profound difference for the staff we employ and the people we serve. I am more and more confident that we will succeed.
Have a good weekend
Rob
What else has been happening this week?
Joint Committee of the Clinical Commissioning Groups - Patient and Public Involvement Assurance Group (PPI)
PPI lay members fulfil an important role for CCGs in providing assurance that their statutory duties around involvement are met. The purpose of the WY&H CCG Lay Member Assurance Group, as agreed by the lay members, is to “assure the nine West Yorkshire and Harrogate CCG Governing Bodies through their respective governing body public lay members that authentic patient and public involvement is being planned, designed and delivered for the work plan of the Joint Committee”. The group met this week for the first time as shadow PPI assurance group. You can find previous notes of meetings on the website here.
The group has a critical role in providing assurance to the Joint Committee of CCGs. It is important that the group has the opportunity to review the work of relevant programmes before they are presented to the Joint Committee. The group discussed the work of the stroke care programme (please see the Clinical Forum update below).
The update was well received and there was a suggestion of a one page summary so that we can circulate it to people who have engaged in the work so they know what impact their feedback has had, for example. ‘we said, you did’ particularly in relation to preventing stroke, quality standards and preliminary discussions regarding the whole pathway (from prevention to end of life care) and service developments.
West Yorkshire and Harrogate 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.
Linda Driver, programme lead for stroke care gave an update on the work to date. In 2016/17 there were approximately 3,700 strokes in West Yorkshire and Harrogate. The Partnership’s ambition is to have fewer stroke across the area, more lives saved, reduced delays and improved recovery outcomes. A key part of our work is preventing ill health so people can live a long and healthy life. Work across West Yorkshire and Harrogate via the Clinical Forum and Joint Committee of the Clinical Commissioning Groups has highlighted the importance of stroke prevention, community rehabilitation and after care support delivered in our six local places (Bradford District and Craven; Calderdale, Harrogate, Leeds, Kirklees and Wakefield). This is especially important given that we have an ageing population and people are living longer with multiple long term conditions. We are rolling out best practice care for people with atrial fibrillation (AF) in every GP practice, with the aim of preventing over 190 strokes over the next three years. This includes detecting, diagnosing 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 available to save people’s lives. We are reducing other risk factors linked to stroke. For example the treatment of hypertension (high blood pressure) which has the potential to reduce a further 620 strokes within three years. Work is also taking place to re-establish the stroke clinical network and to seek views on the draft service specifications and standards covering hyper acute stroke care (first 72 hours of care) and care across the whole of the stroke pathway (including recovering from a stroke).
Karen Poole, West Yorkshire and Harrogate Health and Care Partnership Programme Lead for the local maternity system board (LMS), gave forum members an update on work to date. Karen explained the importance of continuity of care and the developments to date, which include the co-production of a plan with women and their partners and the work of maternity voices that involves women who have accessed maternity care from our six local places. Karen and other colleagues will be attending Health and Wellbeing Boards and scrutiny committees to keep people update over the coming months and will update forum members on these conversations in October 2018. You can read more information here in the recent blog from Anne-Marie Henshaw (one of three co-chairs for the LMS Board). You can also watch the film here which also sets out the work taking place.
Penny Woodhead, Chief Quality and Nursing Officer, Calderdale, Greater Huddersfield and North Kirklees Clinical Commissioning Group updated forum members on options appraisal for a ‘do once and share’ approach to quality and equality impact assessments (QEIA). Penny proposed that it is used initially by commissioners for the Elective Care and Standardisation of Commissioning Policies Programme. A standardised approach could potentially be applied to a wide range of Partnership work. Establishing a single approach which could be applied across all commissioners and providers would be a longer term piece of work. The proposals are the first step on a journey towards greater consistency.
Dr James Thomas updated the forum on the Elective Care and Standardisation of Commissioning Policies Programme. James gave an update on high level pathways for eye care and elective orthopaedics (bones and joints). There was a discussion about how we ensure we achieve clinical engagement in our six local places (Bradford District and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield), particularly in primary care, and the role of commissioners and clinical leaders in helping to achieve this.
Leadership Group meeting on Tuesday
The leadership group met on Tuesday. This includes leaders from across the Partnership, including hospitals, councils, clinical commissioning groups and voluntary sector. The meeting is chaired by Rob Webster, CEO lead for our Partnership.
First, Dr Ian Cameron, Director for Public Health, Leeds Council and Partnership Lead for Public Health updated us on the work of population health management. Put simply, population health management is a collection of best practice focused on improving care delivery whilst making it affordable.
To support Partnership’s like ours to go faster, NHS England has launched a Community of Practice for the work. The aim is to share good practice nationally around improving the health and well-being of people; enhancing experience of care and increasing productivity whilst making the most of data and intelligence. Our first West Yorkshire and Harrogate network meeting will take place in September and will focus on the work taking place locally. There are natural links to the work of primary care networks and colleagues from each of our places will be asked to get involved (Bradford District and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield).
We also heard from Dr Ros Tolcher, CEO for Harrogate Hospital who is also the Partnership’s workforce lead. Ros talked us through the workforce investment plan of nearly £1million funded from Health Education England and the Local Workforce Action Board (LWAB).
Following a process which combined structured conversations and investment ideas - schemes have been developed within each of our six local places, from partnership priority programmes and the LWAB work streams. The investment cuts across all sectors from upskilling staff and career opportunities in mental health, primary care, stroke (establishing a learning and development network); supporting young carers to consider careers in health and social care; mental health first aiders; preventing ill health (making every contact count) and primary care (psychologist and occupational therapist roles).There was also a conversation around the importance of apprenticeships in the health and care sector.
The creativity across our area has brought with it an opportunity to make the most of digital technology and you don’t need to look far to see some great examples. On Tuesday we also heard about the work of mhabitat from its founder Dr Victoria Betton. mhabitat specialises in the co-design of digital skills and inclusion, policy, strategy and evaluation – some of the great work they do includes MindWell, a mental health website. There are lots of great digital Apps available too including GP Apps and those which support people who have hearing loss and visual impairments.
WY&H Health and Care Partnership 2019/20 Planning Workshop
Colleagues from across the Partnership, including commissioners and care providers, attended a planning event organised by NHS England on Wednesday about the 2019/20 planning round. There was a discussion around developing a West Yorkshire and Harrogate Health and Care Partnership plan which would include how we work together; and a conversation around making best use of
business intelligence to support the work; and the potential for Aligned Incentive Contracts, which is all about commissioners and providers working more closer together.
What’s happening next week?
- West Yorkshire and Harrogate Local Maternity System Board meets on Monday.
- Kirklees Overview and Scrutiny Committee meet on Tuesday. A Partnership update will be given.
- West Yorkshire and Harrogate Programme leads meet on Wednesday.
What’s coming up?
- We are holding a ½ day engagement event for primary care colleagues on the 25 of September 2018 in Leeds from 9.30 to 12.30pm. The event is supported by NHS England and will aim to provide an opportunity for an open and honest conversation about the role of primary care in supporting improved quality outcomes for carers of vulnerable people. If you would like to book a place please contact joanne.rothery@wakefieldccg.nhs.uk
- NHS England are organising an event in October for people who are leading work on the integration of children’s and young people’s services across STPs and integrated care systems. The purpose of the event is to provide an opportunity for clinicians and non-clinicians to contribute to the long-term plan for the NHS. We have been asked for a small number of people to attend.