This week’s update is sent from Rob Webster, CEO Lead for West Yorkshire and Harrogate Health and Care Partnership and CEO of South West Yorkshire NHS Partnership Foundation Trust.

Hello my name is Rob...

I believe our Partnership is one of the most advanced health care systems in England – it has strong local leadership and ambitious plans to strengthen primary care and joined up health care for the benefit of local communities. You can see some excellent examples of this in the publication of ‘The positive difference our Partnership is making’ a series of case studies here. These case studies reflect the very real difference we are making.

This week, I attended the second in a series of events in Wakefield, bringing together the NHS, councils, charities and local people to discuss children’s mental health services. Representatives from the Youth Parliament were also in attendance. Tackling issues in Wakefield will require a whole system response and the updates on work agreed at the first session were heartening. For example, moving to a new model of care on providing better community support and clear links to beds across West Yorkshire and Harrogate has almost halved bed days for children and length of stay. This has freed up money to invest in local services in Wakefield. Another example was Wakefield Council and young carers setting plans for better identification and support for young carers locally. This is consistent with and can be supported by the resources playing out across West Yorkshire and Harrogate on our carers’ strategy.

Meeting the next day, the Mental Health Collaborative shared examples of where genuine progress is being made on improving care and where more needs to be done. In both instances, what was clear was the partnership at neighbourhood, place (Bradford District and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield) and at a West Yorkshire and Harrogate level is making a genuine difference in a tough climate on a wicked set of issues. We now need to keep going and have the support to do so.

Some of this will come through the new Long Term Plan. On 18th June the Prime Minister set out a funding settlement for the NHS in England for the next five years. This means an increase in the NHS England budget by £20.5bn in real terms by 2023-24. In return, the NHS has been asked to set out a long term plan for the future of the NHS by autumn, setting out our ambitions for improvement over the next decade and our plans to meet them over the five years of the funding settlement.

In the words of Chris Hopson, CEO for NHS Providers, the long term plan must not be “written behind the bike sheds”. It’s important that everyone has the opportunity to have their say on what kind of health service the country will need in 10 years’ time, and how we use the next five years of funding to move towards that.

NHS England received over 2,500 responses to their call for views from the public, NHS staff and stakeholders in September. This equated to over 3.5m people represented by responses received online. It was pleasing to know that our Partnership had a voice – with organisations and members of the public sharing their views. You can read our Partnership response here. 

The long term plan has various work streams, including preventing ill health; addressing inequalities; healthy child and maternal health; personalised care for people with long term health conditions; cancer; learning disabilities and mental health.  I was invited to get involved in the development of the learning disabilities and autism working group which is all about improving diagnosis, early intervention and personalised support for adults, children and young people. It’s a sobering and inspiring piece of work where there are high aspirations and significant ambitions. There are some shocking statistics at play – on life expectancy, early deaths from avoidable illness and bed utilisation. These are underpinned by experiences that can be very poor for some people and where, as one parent put it, “fundamental rights are often seen as privileges for people with autism and learning disabilities”. We can change this.

I have also been asked to contribute through my role as the CEO Lead for our Partnership on issues like structure and system reform. These are important considerations too.   We must have a system that recognises that key to the sustainability and success of any long term plan is our workforce; technology; research; innovation; stronger integrated health care systems and engagement based on the expertise and insights of staff, public and communities.

All the work done by these groups will help as policy proposals are refined and brought together over the next two months. Other engagement – both by working groups and central teams – will also carry on during this time, meaning that people will continue to have the opportunity to influence the final plan up to its publication, expected in November 2018. We will be doing our best to ensure that voices across our Partnership are heard.

From December to March 2019, staff, the public and other stakeholders will have the opportunity to help local health and care organisations determine what the plan means for their area, and how best the ambitions it sets out can be met.

Key to the development of both the long term plan and our Partnership ambitions will be recognition of the role of Local Government as equal partners. It is barn door obvious to me that we need a focus on the wider determinants of health and wellbeing.  Across West Yorkshire and Harrogate there are eight councils working together to bring the benefits and potential of local government into the heart of our Partnership. Councils in Bradford, Calderdale, Craven, Harrogate, Kirklees, Leeds, North Yorkshire and Wakefield are collaborating in the way they provide joined up social care; to ensure healthy environments; decent housing, inclusive growth that expands employment; reduces health inequalities and promotes opportunity for all. Ensuring the role of democratic leaders has maximum benefit for all residents and is a fundamental part of our approach.

We are establishing a new Partnership Board, which will be the primary governance forum for the Partnership, bringing in elected members, non-executives, and lay members into the decision making process. The first meeting is expected to take place in spring 2019.  The nomination of elected members will be determined by individual authorities, while recognising this would include the Chair of each Health and Wellbeing Board. The public voice will also be represented on the Board – something we try and ensure in all that we do.

The absence of a long term settlement combined with demographic and socio-economic pressures on social care budgets, as well as ongoing workforce issues means there are significant concerns about the sustainability of both health and social care services. For me, health and care goes hand in hand – you can’t have one without the other – not if we want to deliver quality services and improve people’s lives. Investment by our local authority partners in preventing ill health, the environment, housing quality and support services for people with a range of needs and conditions, has a direct link to health spending. For example, poor housing and the impact on health is one area we have pledged to tackle together; it costs the NHS £1.4bn a year but by reducing fuel poverty we could save £848m nationally – but more importantly improve people’s lives. 

Therefore as a Partnership we are very clear that the future sustainability of health and care is dependent on working together as one health care system. As one of the largest health care partnerships in England we need to use this to maximum benefit and shape the future of health care services together with communities.

As a Partnership we will need to consider the outputs of the long term plan in late autumn and the spending review 2019  capital settlement (in the spring). Involving people in these conversations is central to our communication approach and we will continue to engage people and provide updates throughout. This matter – who better to help, to support and to hold us to account than local people. Just ask the Youth Parliament in Wakefield.

Have a good weekend

Rob

What else has been happening this week?

Local Maternity System update

The Local Maternity System Programme (LMS) held its first workforce meeting last week to discuss   recruitment, retention and staff development – all key to the development of our West Yorkshire and Harrogate maternity plan.

The implementation group met this week. This includes heads of midwifery, chairs of the task and finish groups, for example maternity voices, and colleagues from higher education. The group discussed safer maternity care, choice and the development of community hubs.

The next programme board meets on the 12 November. This will be chaired by Anne-Marie Henshaw, Head of Midwifery, and Calderdale & Huddersfield Foundation Trust. We’d also like to take this opportunity to thank Suzanne Hinchliffe, for all her leadership and support as co-chair of the Local Maternity System Board, ahead of her stepping down from this role in December.

Urgent and Emergency Care Programme Board

Our Urgent and Emergency Programme Board met on Monday. The Board is chaired by Dr Adam Sheppard and includes colleagues from clinical commissioning groups, A&E Delivery Boards, hospitals, urgent care providers and our regulators i.e. NHS England. We heard from our partners in Leeds about the work they are doing to review outcomes for people who were medically fit for discharge and whether the right discharge and continuing care decisions were being made. The findings of the work have been developed into a plan; supported by a system wide leadership approach being implemented during winter. The Board also gave unanimous support to the ongoing development of an internal and community campaign around communities doing more for themselves and each other to prevent ill health and looking out for vulnerable neighbours. It’s important to note that a truly changed approach with the public will take investment from every partner. We have the opportunity to do something totally different and to see if it has a tangible impact. If we don’t try different things, demand will not reduce.

Communication and engagement network

Communication, engagement and equality colleagues from the West Yorkshire and Harrogate Health and Care Partnership network met on Tuesday in Huddersfield. This included those working in councils, hospitals, clinical commissioning groups, housing, and Public Health England, Healthwatch and community organisations. Colleagues discussed how the network works together in terms of understanding organisational pressures, shared learning, skills and good examples of work. This will in turn reduce duplication and costs whilst developing the role of the profession. There was also a presentation from Claire Troughton, from Public Health England, about the national and regional work taking place, such as One You, Heart Age and Change for Life. There is a raft of intelligence, insight and communication products available to use on their website here. The network meets again on the 17 January in Leeds. All communication, engagement, equality colleagues are welcome.

National Cancer Team Round Table Discussion

National Cancer Director Cally Palmer and National Cancer Programme Director David Fitzgerald visited White Rose House in Wakefield this week to meet with senior leaders from the West Yorkshire and Harrogate Cancer Alliance and the wider Health and Care Partnership.

The first part of the afternoon’s agenda focused on the work of the Cancer Alliance and how it engages with all stakeholders across its programme areas.  Presentations by Fiona Stephenson (Macmillan Head of Quality and Optimal Pathways); Rebecca Jowett (Programme Manager, Living with and Beyond Cancer) and Hazel Taylor (Programme Manager, Tackling Lung Cancer) were followed by a question and answer session.

The focus then widened to look at the Alliance in the context of the wider partnership. These discussions were chaired by Amanda Bloor, Accountable Officer, NHS Harrogate and Rural District CCG (commissioning lead for the Alliance) and also involved Rob Webster, CEO Lead for the Health and Care Partnership; Ian Holmes, our Programme Director;  Rob Harrison, Chief Operating Officer, Harrogate and District NHS Foundation Trust; Fiona Hibbits, Senior Delivery and Improvement Lead, NHS Improvement, and Mike Harvey, Assistant Director of Operations at Leeds Teaching Hospitals NHS Trust.

Topics covered included how West Yorkshire and Harrogate is developing as an Integrated Care System, its priorities, ways of working across the partnership and approach to mutual accountability between partners, also what this has meant for the way the Cancer Alliance functions, and its evolution from improvement programme to system leadership for cancer in West Yorkshire and Harrogate.

We as a Partnership were, of course, pushed quite strongly on recovery of our cancer waiting times performance and were able to describe the way in which colleagues in WYAAT are working together to support improved performance.

There was a particularly strong theme about the extent to which the Cancer Alliance is embedded and integrated in our whole system, which is unusual as most Cancer Alliances cover multiple footprints, and we were commended for the strength and depth of the governance arrangements that support this way of working. We extended to offer to continue the conversations with the National Cancer Programme to support effective delivery of the forthcoming five year planning in the context of the Partnership.

System Oversight and Assurance Group

The first meeting took place of the Partnership’s System Oversight and Assurance Group (SOAG) on Monday. This group has been established to take an overview of progress with our shared priority programmes, and to agree collective action to help tackle shared challenges. In this first meeting the group reviewed the WY&H stroke transformation programme; discussed how we can do more to improve waiting times for elective care; and agreed an approach to reviewing how well prepared our health and care systems are for the coming winter.

The West Yorkshire and Harrogate Area Partnership Group

This group meets today. It is made up of union representatives from across West Yorkshire and Harrogate and includes colleagues from Local Workforce Action Board, HR and NHS Employers. The meeting was chaired by Rob Webster, our CEO Partnership Lead. The agenda included supporting working carers; promoting careers in health and social care; hospitals working together and primary care. 

What’s happening next week?

  • West Yorkshire and Harrogate Stroke Programme meets on Wednesday. It is chaired by Dr Andy Withers
  • Partnership Directors of Finance meet on Wednesday.
  • West Yorkshire and Harrogate Health and Care Partnership Public Health Co- ordination Group meet on Thursday.
  • The Population Health Management group meet on Friday. This is all about improving people’s health by using data to plan and deliver care to achieve maximum impact.
  • Yorkshire Ambulance Service NHS Trust will host the first conference for the National Ambulance BME Forum at the NHS Leadership Academy in Leeds on Friday 19 October, during Black History Month (October).  Rod Barnes, Chief Executive, will welcome ambulance colleagues from across the country and Tasnim Ali, Chair of the National Ambulance BME Forum and Business Manager at YAS, will also present the BME journey so far. The main themes of the conference will include:
    • The case for compassionate leadership
    • Understanding and tackling micro-behaviours
    • Clinical impacts of racial inequality
    • Inclusion, innovation and transformation
  • The conference is designed to build upon the conversations that YAS are having in response to the Workforce Race Equality Standard and will also be a fantastic opportunity to meet and share best practice.