Kersten, as well as being Chief Executive of Bradford Council, also Chairs Bradford Integration and Transformation Board, which brings together partners across the area to drive transformation and change in health and social care to the benefit of local people. Helen is the ‘place based lead’ on the partnership for Bradford District and Craven and the Commissioning Lead for the WY&H Partnership Mental Health Programme.Helen is also Chief Officer for the three Clinical Commissioning Groups in Bradford District and Craven.

Big shout out to Bradford District and Craven

Hello and welcome to our first blog for West Yorkshire and Harrogate (WY&H) Health and Care Partnership.

First, we want to take this opportunity to give a big shout out for Bradford District and Craven.

The UK’s youngest city, globally connected and home to a highly entrepreneurial culture, Bradford is jam-packed with potential, talent and opportunity.Recently named by Barclays as the best place to start a business, its growing £10 billion economy is characterised by a manufacturing sector spearheaded by advanced engineering, digital innovation and a leading technology university.

Over half a million people call Bradford District home; more than a third of which are from black and minority ethnic backgrounds, and between us we speak 86 languages.A longstanding history of traditions and innovation, the list of Bradford ‘firsts’ is as diverse as its people, for example the first to introduce school meals, first UNESCO City of Film, first to pioneer chemotherapy treatments - the list is endless.

We welcome over 13 million visitors every year. From the industrial wonders of Bingley’s five Rise Locks and Salts Mill to the Bronte sisters, and Hockney; from the world famous landscape of Ilkley Moor and the Dales. We have amazing restaurants and we believe our area offers something for everyone.

In terms of health and social care we have much to be proud of in pursuit of our ambition of keeping people ‘happy, healthy at home’. We are bucking the trends with some of our stats on delayed transfers of care, A&E attendance, prevention and early intervention, out of area mental health placements (none in the past three years) and non-elective admissions.

However, we have huge challenges in terms of health inequalities and the impact these have on people, for example cancer, heart disease, lung disease and liver disease are frightening.

These inequalities and mortality rates have provided the focus for some of our major areas of work, such as Bradford Beating Diabetes and Bradford’s Healthy Hearts, the latter now being promoted as national good practice by NHS RightCare.

Through Bradford Beating Diabetes we set ourselves a target to identify people who had diabetes and didn’t know it.We found over 1,000 people within the first year and since the start of the programme, prevalence has increased from 5% to 10%.This isn’t more people getting diabetes – this is people who already have, but weren’t aware, and were therefore not receiving the right treatment.We have of course, importantly, focused on preventing diabetes and have targeted over 27,000 people with interventions.

In Bradford Districts Clinical Commissioning Groups, Bradford’s Healthy Hearts has already prevented 131 heart attacks and 74 strokes, helped over 6,000 people to switch statins (statin treatment lowers the level of cholesterol in your blood), and started 1,000 people with irregular heartbeats on blood clotting prevention medication.

Other areas where our work is influencing nationally, and in some cases internationally, includes the ‘Born in Bradford’ programme led by Professor John Wright; the award winning Virtual Ward run by Bradford Teaching Hospitals NHS Foundation Trust and Airedale NHS Foundation Trust’s telemedicine and enhanced health in care homes vanguard. Bradford District Care NHS Foundation Trust’s work on first response service offers mental health crisis support 24 hours a day, seven days a week, to people needing urgent crisis support. A single phone number means that people can self-refer.

Other achievements include Bradford’s newborn hearing screening programme, which has been recognised nationally for the high standard of care it delivers to babies with suspected hearing loss and their parents.

Airedale Hospital has been highlighted as providing a positive experience for maternity care. In a recent CQC survey Airedale was shown to be amongst the best performing trusts across all three areas of maternity care: ante-natal; labour and birth; and postnatal services.

As health care leaders we work proactively on shared aims and objectives and have invested heavily in these partnerships.For example we have supported capacity and capability building in the voluntary and community sector and general practice to ensure all are equal partners in the provider alliances.You can see evidence of this in the vital role that community organisations play in our urgent and emergency care work, for example supporting demand management in general practice through community connectors.

In the Airedale, Wharfedale and Craven partnership the three communities have multi-disciplinary leadership arrangements in place and are developing plans to further meet local need. This includes children and young people’s mental wellbeing in Wharfedale, loneliness in Craven and same day response in primary care in Airedale.

Bradford Care Alliance of GPs has also embraced the development of the primary care home model. This way of working brings together a range of health and social care professionals to work together to provide better personalised and preventative care for our local communities in areas serving communities of between 30,000 and 60,000 people.

As a partnership we are working with people to act early so they can live a long and healthy life. For example, Better Start Bradford (BSB) is a £49m ten year Big Lottery funded partnership programme which aims to test what works in improving outcomes for children. Colleagues are working closely with parents, communities and local providers, and of course, ‘Born in Bradford’ to gain insight from the world’s first experimental birth cohort. This provides a centre for evaluation of cutting-edge early years interventions, an area we can all benefit from.

Our area has also recently hosted the Care Quality Commission (CQC) who is doing a series of local reviews to inform future policy. The CQC wanted to understand how our health care system works with our communities to help more people stay connected and supported to stay in control.

We received positive feedback on the breadth and strength of our partnership and the commitment from all towards a common ambition of keeping people ‘happy and healthy at home’. The CQC also remarked on how our working relationships with voluntary and community organisations were evident. They also encouraged us to make the most of a wider partnership approach with others who are part of our city - for example local businesses who could become partners in improving people’s experience of health and care.

Our area is also playing a leading role in promoting inclusive economic growth. Local partners have invested in Get Bradford Working, which has helped over 3,000 people into employment, targeting those furthest away from the labour market. Our Education Covenant promotes the involvement of everyone in improving educational outcomes and over 1,000 businesses have so far committed their support. We are forging links between businesses and schools through Industrial Centres of Excellence which are developing a pipeline of talent and skills to meet the needs of local employers.

Our broad partnership approach reflects our belief that #peoplecan, and that communities are at the heart of creating health and wealth.

This week we launched Bradford’s economic strategy. This sets out plans to achieve our ambitions to grow our economy by £4 billion and create 20,000 new jobs; it recognises that as the youngest city in the UK, we really must lay the foundations now for an exciting future. That’s one reason why we are excited to be hosting one of twelve Sport England Local Delivery Pilots to improve young people’s mental wellbeing, quality of life, and social development, through sport and activity.

Last summer we asked Bradford Healthwatch to help us take our challenges out on the road to talk to people about what solutions and actions they thought would make the most difference to them and their communities.We also talked about compromises we might need to make and asked people which, if any they would support.Their views ‘Our Say Counts’ have informed the refresh of our Bradford District and Craven plan which support the overall West Yorkshire and Harrogate Partnership.

Being part of the West Yorkshire health and care family has brought huge benefits to Bradford. We are sharing our resources to help us to do better for the people living across our area, as well as those living in West Yorkshire and Harrogate.We have learnt and also shared some of our successes and it is great to see something that started life as an idea on a flip chart in an office or community in Bradford being taken forward for the benefit of 2.6 million people.

Have a good weekend

Kersten and Helen

What else has been happening this week?

Clinical Forum

Clinical forum members met on Tuesday. The forum is chaired by Dr Andy Withers and includes medical directors, GPs, lead nurses and colleagues from Yorkshire Ambulance Service, NHS England and Academic Health Science Network.

Matt Graham, Programme Director for West Yorkshire Association of Acute Trusts (hospitals working together) discussed the development of a clear narrative to describe how the system will work together, for example clinicians across hospitals and primary care. This will set out the vision for our work and will also be shared with front line colleagues for their views. There was also a discussion on revised terms of reference and membership with the intention of strengthening roles and responsibilities.

Joint Committee of the 11 Clinical Commissioning Groups (CCGs)

The Joint Committee of the 11 CCGs met in public on Tuesday. This is chaired by Marie Burnham, our independent lay chair. Helen Hirst, CEO commissioning lead for mental health gave an update on mental health projects including for young people. There was also an update on coordinating bids for national transformation funding to further develop perinatal services (the support pregnant women and new parents receive) and supporting people with mental health conditions into employment.

Carol McKenna gave an update on the procurement of a new 111 contract. Carol leads on this area of work on behalf of the Urgent and Emergency Care Programme Board. The contract is up for renewal and we are in the process of making recommendations to CCG Governing Bodies on the procurement process we are required to undertake. It is premature to identify who will bid for this contract as we have only requested expressions of interest at this stage. These have been received from a range of organisations from both the public and private sector. The procurement process will confirm in due course which organisations will be invited to bid. The new contract will deliver key elements of the nationally specified integrated urgent care service, in particular 111 call handling and clinical advice. It will take effect during 2019.

Matt Walsh, CEO commissioning lead for elective care and standardisation of commissioning policies gave an update on the high level pathways in eye care and musculoskeletal (for example bones, joints and, muscles). There was also a discussion for the ongoing development of the prescribing programme. We will be welcoming two members of the public onto the board soon.

We welcomed a number of questions from the public on the 111 contract procurement, elective and planned care. You can read the meeting papers and watch the film recording of the meeting here.

Leadership group

The leadership group met on Tuesday. This includes representatives from our partnership sectors, including local authority, health services, Healthwatch and community organisations.

Rob Webster, CEO lead for the Partnership chairs the meeting. There were discussions on the development of the Memorandum of Understanding (MoU). Part of strengthening our partnership approach is the development of a MoU. This will be an agreement between the WY&H health and care partners, setting out the details of our commitment to work together in partnership to realise our shared ambitions. The MoU does not introduce new hierarchical arrangements. Rather, it builds on our current ways of working and will provide a new model of mutual accountability to underpin collective ownership of delivery. The MoU is at an early stage of development. We are discussing it with a range of stakeholders with the aim of finalising it later this year.

Lauren Phillips (Partnership Programme Manager) gave people an update on the check and confirm sessions which took place with our WY&H programme leads. All 15 sessions, including cancer, urgent care, and stroke have now been completed. A number of key themes were identified, including programme capacity, leadership and the importance of connections to our six local places (Bradford District & Craven; Calderdale, Harrogate, Kirklees, Leeds, Wakefield).

Priority programme leads meeting

Our programme leads met on Thursday. This included colleagues working on cancer, urgent care, stroke, workforce and primary care. Colleagues discussed work priorities for next year and the planning guidance. Kate Holiday from Health Education England gave an overview on a mental health event for workforce next Friday which will go forward to NHS England to inform thinking around new roles and thinking. Kathryn Hilliam also gave an overview on workshops taking place in the next few weeks with primary care workforce. There was also an update on the Right Care intelligence.

Trust governor workshop

The first West Yorkshire and Harrogate wide trust governor workshop will take place today. Governors will hear direct from Rob Webster, our CEO lead for the partnership and Matt Graham, Programme Director for WYAAT (hospitals working together) about the work taking place across our area.

What’s happening next week?

  • Local place planners (Bradford District & Craven; Calderdale, Harrogate, Kirklees, Leeds, Wakefield) meet on Tuesday.
  • The memorandum of understanding (MoU) editorial group will meet on Wednesday.
  • Rob and Ian are taking part in a round table event with Professor Don Berwick about what would it take to develop self-governing systems at the Kings Fund.