Our Partnership is made up of organisations working closely together to plan services and address the challenges facing health and care services across the area.
In this section you will find links to useful information and publications about our partnership.
We are committed to meaningful conversations with people, on the right issues at the right time. We believe this is an important part of the way we work.
In this section you will find all Freedom of Information (FOI) requests made to our Partnership. You can also ask a question of your own.
... to the ‘Improving planned care’ pages of the Partnership’s website.
This programme, like our other priority areas, will help support people to have more control over their own health and wellbeing by tailoring care to suit people’s needs and choices. We know that patients who are actively involved in their own healthcare generally have more positive experiences, and better outcomes, than those who feel their treatment is out of their hands.
As a programme team, we also want to make sure that the work we do creates more opportunities for everyone to improve their quality of life through better health and wellbeing. In addition to the benefits for individuals, families, communities and the economy in West Yorkshire and Harrogate, having a healthier population will help to counteract the rising demands on local health services.
In summary, our focus is as much about prevention as it is about cure by supporting people to make healthier choices whilst making sure that the most effective and appropriate healthcare services are there for when people do need them.
Dr Matt Walsh, CEO lead - Improving planned care
The West Yorkshire and Harrogate Joint Committee of Clinical Commissioning Groups met in public on Tuesday 14 January 2020 where it agreed the adoption of single commissioning policies for hip replacement surgery and arthroscopic hip surgery, to be implemented across the region within the next 12 months. The policies align with the wider musculoskeletal (MSK) pathway that was introduced back in May 2019.
The Committee also agreed a single clinical pathway and policy for cataract surgery, with a timescale of up to three years for implementation. Under the new pathway, better use will be made of the many community optometrists we have in West Yorkshire and Harrogate and this will have a number of benefits for eye care services and the people who use them.
The West Yorkshire and Harrogate Joint Committee of Clinical Commissioning Groups met in public on 5 November 2019 where it agreed the adoption of single commissioning policies for knee surgery. These standardised policies cover knee replacement surgery (arthroplasty) and keyhole surgery on the knee (arthroscopy) and will be implemented across West Yorkshire and Harrogate within the next 12 months.
The policies can be found in Our West Yorkshire and Harrogate commissioning policies section, on the orthopaedic and musculoskeletal (MSK) page. You'll also find 'mapping and gapping' documents that show how the single policies compare to the existing policies of our local Clinical Commissioning Groups (CCGs).
The West Yorkshire and Harrogate Joint Committee of Clinical Commissioning Groups met in public on 5 November 2019 where it agreed the adoption of a single clinical pathway and commissioning policy for hydroxychloroquine and chloroquine retinopathy monitoring.
These drugs are used to treat various conditions, particularly autoimmune diseases like rheumatoid arthritis, but they can cause side effects. Some people who take them for more than five years, or in high doses, are at increased risk of damage to their retina, a condition known as hydroxychloroquine retinopathy.
The introduction of this pathway and policy will ensure that local patients who are prescribed hydroxychloroquine or chloroquine are effectively monitored, preventing avoidable sight loss and avoiding unnecessary interventions.
As part of the Improving Planned Care Programme, project teams are currently developing plans for service improvements around age-related macular degeneration, diabetic retinopathy, glaucoma, cataracts and children’s eye services. These improvements may be in the form of a shared clinical pathway, a new use of technology or a workforce initiative for example, but all will reflect clinical evidence, best practice and patient insight.
In episode 2 of our We Work For You podcast, Steve Clark, Chair of the West Yorkshire Eye Health Network, talks about some of these eye conditions in more detail. Steve, who is also an experienced optometrist, explains what the symptoms of certain major eye conditions are and how those conditions can be treated.
In conversation with Christine Hughes, the Programme’s Communications and Engagement Manager, he also talks about a little known consequence of sight loss for many people ‘Charles Bonnet Syndrome’ and how we can keep our eyes healthy to reduce the risk of developing a major eye condition that could affect our sight.
This podcast episode all about eye health also features eye care service users Terry, Deanna, Sam, Adeel and Hajra who are all members of the Kirklees Visual Impairment Network. They talk openly about the impact of sight loss and share their experiences of living with a major eye condition.
We're delighted to announce that West Yorkshire and Harrogate has been awarded £55,000 worth of funding which has been made available by Health Education England through its workforce development fund. This funding will give local community and hospital-based optometrists the opportunity to undertake the ‘Professional Certificate in Medical Retina and Independent Prescriber’ training at the University of Bradford’s school of Optometry and Vision Science. Read more here.
The first episode of the Partnership’s ‘We Work For You’ podcast features Dr James Thomas, Clinical Lead for the Partnership’s Improving Planned Care Programme.
James explains what planned care actually is and how the programme is working to deliver the most appropriate and effective planned care for the people of West Yorkshire and Harrogate.
He talks about the so called ‘postcode lottery’ and why access to health services, and the eligibility criteria for them, should be the same for everyone.
And how exactly is the Improving Planned Care Programme working to get rid of any variation that currently exists in West Yorkshire and Harrogate? Listen here to find out.
For West Yorkshire and Harrogate, the aim of our collaboration with the Institute for Voluntary Action Research, through its Building Health Partnerships programme, has been to work with community and voluntary groups to improve the health of people across two specific localities, Calderdale and Wakefield. Each locality has focussed on a different initiative but they both emphasise the importance of prevention and self-care. Read more here.
View all our previous programme updates here.
Improving planned care is one of our West Yorkshire and Harrogate priorities.
Planned or ‘elective’ care is treatment that people choose to have to help manage a health problem, rather than treatment that is required urgently or in an emergency. Planned care includes scheduled operations such as hip and knee replacements and cataract surgery. People are usually referred onto planned care by their GP or other health professional.
The overall aim of this programme is to deliver the most appropriate and effective planned healthcare for the people of West Yorkshire and Harrogate, and achieve the best value in how we use our resources to deliver that healthcare.
This programme can only be progressed through collaboration with those who deliver planned care services. The West Yorkshire Association of Acute Trusts (WYAAT) brings together the NHS hospital trusts in West Yorkshire and Harrogate to drive forward the best possible care for local patients. Along with WYAAT, the involvement of GPs and other healthcare professionals enables us to look at how things are done now, what works well and not so well, how things need to change and what benefits those changes could bring for patients and staff.
We serve a diverse range of communities and recognise that people have different needs that require different solutions. A big part of this is not presuming we know what people think, but asking, involving and listening instead. You can find details of all engagement and consultation work that has taken place across West Yorkshire and Harrogate relating to this programme of work.
More people are currently being referred to hospitals for treatment than hospitals can treat. This is leading to longer waiting lists and longer waiting times for patients. This programme of work will help the NHS manage the rising demand for planned care by providing more patient focussed health services, out of hospital settings where appropriate. This shift away from hospitals will help to improve access to healthcare and patients’ experiences of it.
Providing the most efficient care and making the best use of our existing capacity is vital if we are to increase the responsiveness of our services and improve access to them. This will also reduce the numbers of people who have to wait longer than they should to receive planned treatment.
One significant way in which we can improve planned care is by removing the so called ‘postcode lottery’ that currently exists across West Yorkshire and Harrogate, to make sure that the care people receive is fair and consistent. Access to health services and the eligibility criteria for them should be the same for everyone. By removing existing variation wherever it exists, we can make sure that all patients have a positive experience of care, regardless of where they live.
We have nine clinical commissioning groups (CCGs) in West Yorkshire and Harrogate that are responsible for commissioning (planning and buying) healthcare services for their communities.
Different CCGs currently have different commissioning policies for some of the healthcare services they provide. To make sure these policies are fair and consistent, the CCGs have formed a joint committee that is working towards standardising these commissioning policies and reducing this unnecessary variation.
All the single (standardised) commissioning policies that have been approved for implementation across West Yorkshire and Harrogate, and any supporting information, can be accessed from our West Yorkshire and Harrogate commissioning policies page.
These five key areas make up our first phase of work for this programme. Our joint committee of the nine CCGs has agreed that we will move forward with this approach.
The expectation is that phase 1 will be implemented in stages across West Yorkshire and Harrogate over the next few years resulting in an end point where all local CCGs are taking the same approach for their areas by 2020/21
Experts believe that certain routine treatments have only limited or temporary benefit. These treatments are referred to as ‘Procedures of Limited Clinical Value’ (PLCV). In many cases, there are alternative treatments that are more effective and some of the more traditional procedures will have been replaced by modern techniques.
We are reviewing these procedures because we believe that more needs to be done to make sure that such treatments are not routinely performed, or only performed in specific circumstances. This review also gives us the perfect opportunity to standardise the commissioning policies for the treatments. By reducing the unnecessary variation that currently exists in the area, we can make sure that people can access the same treatment for the same reasons, wherever they live in West Yorkshire and Harrogate.
The outcome of this work plan will be that, instead of having a procedure of limited clinical value, patients would be offered a better alternative.
There may be cases when a GP or consultant believes that a patient would benefit from a PLCV rather than an alternative. In such cases, the individual funding request (IFR) process can be followed to potentially apply for the treatment to be funded. Each request for treatment would be considered on a case-by-case basis.
As part of this work to reduce unnecessary medical procedures, we have adopted NHS England’s Evidence-Based Interventions (EBI) policy which will be implemented across West Yorkshire and Harrogate. The policy aims to prevent avoidable harm to patients by making sure that treatments routinely available on the NHS are appropriate and clinically effective. The EBI policy will ensure that people who would benefit from one of these ‘traditional’ procedures are offered them but for most people, there is a safer and less invasive alternative. Read more about the EBI policy, and the 17 procedures it covers, here.
The demand for orthopaedic and MSK services continues to increase year on year which has resulted in the budget for these services being one of the largest in the NHS.
There’s no doubt that this rise in demand will continue, particularly as we have an ageing population, so we must address this concern and make positive changes that focus on patients’ needs.
By providing more integrated care, and reducing the number of unnecessary follow-up appointments, we can maximise capacity to reduce waiting times and make sure we have sustainable orthopaedic and MSK services for years to come.
In addition to transforming orthopaedic and MSK services, we are working in partnership with hospitals and service providers to reduce variation in the way those services are delivered in West Yorkshire and Harrogate. By having standard patient pathways and policies, we can remove the ‘postcode lottery’ and variation that currently exists.
We have developed a new MSK pathway that sets out the various steps in the care of people referred onto MSK services by their GP or other healthcare professional.
As part of this work, we have adopted NHS England's Evidence-Based Interventions (EBI) policy which aims to reduce unnecessary medical procedures and prevent avoidable harm to patients by making sure that treatments routinely available on the NHS are appropriate and clinically effective. The EBI policy covers 17 procedures, some of which are related to muscles, joints and bones such as knee arthroscopy, injections for non-specific low back pain and shoulder decompression. The EBI policy will ensure that people who would benefit from one of these ‘traditional’ procedures are offered them but for most people, there is a safer and less invasive alternative. Read more here.
Eye care services don’t always have to be delivered in hospitals and many can be safely delivered at local clinics or high street opticians for example. By adjusting how and where eye care services are delivered, we can make the best use of the expertise we already have in our communities and move some services out of hospitals and into local settings. This is usually much easier and more convenient for the patient - and often less daunting.
We do have a great deal of expertise when it comes to eye health services in West Yorkshire and Harrogate, from eye surgeons to visual impairment rehabilitation officers. This handy guide to who works in eye health has been produced by VisionUK and explains the different roles, where they are based and what services they offer.
It’s a shocking fact that around half of all sight loss is preventable, and many people are unaware that smoking, obesity, diabetes and high blood pressure can all contribute to avoidable sight loss. One key aspects of our eye care work will be to support and promote eye health, sight checks and the use of medicines where appropriate to reduce people’s risk of sight loss.
People with learning disabilities are much more likely to have serious sight problems than others so it's really important that everyone with a learning disability has regular eye tests. SeeAbility supports better eye care for people with learning disabilities. There is an introduction to eye care for adults and children with learning disabilities on the charity's website here.
We all know that our eyesight tends to get worse as we get older but this doesn’t always have to be a done deal and help is available. We are assessing the support that is currently available in West Yorkshire and Harrogate to make sure it is as good as it can be.
People who are referred onto planned care services will be encouraged and supported to make healthier choices such as stopping smoking, losing weight or becoming more physically active. These lifestyle changes will help to improve their health in case they need an operation.
In some cases, the result of such lifestyle changes could mean that an operation is no longer needed and if it is, being in better shape will give patients the best possible chance of a good outcome from their surgery.
Of course it’s much better for everyone if people live healthier long before they may need to access healthcare. To support this, we are working with colleagues from social care, public health, housing and community organisations to direct people to local services that could help them get started on those lifestyle improvements that will make a real difference now and in the future.
By supporting people to make healthier choices and prevent avoidable conditions we can improve the health of the population and, in the longer term, reduce the demand on some planned healthcare services. This will release money that can be used to good effect elsewhere in the NHS.
We want to identify and address unwarranted variation and waste in prescribing. To do this, we must make sure that the same criteria apply throughout West Yorkshire and Harrogate by introducing a standard prescribing policy for CCGs to implement. Everyone should have the same access to the same treatments, including when new medicines become available on the NHS.
We are already very efficient in relation to prescribing and achieving best value from our medicines budgets, but there are still opportunities to improve. We will continue to reduce the prescribing of medicines that have little evidence to show that they work well, and medicines that can be bought ‘over-the-counter’ such as paracetamol and antihistamines for short term use.
Catherine Thompson is the Director for the Improving Planned Care programme. Catherine is responsible for making decisions and providing approvals that will ensure the progress and delivery of the programme and she does this with the support of a programme board.
Our programme board meets on the third Tuesday of every alternate month and is made up of members who work in hospitals, in councils and in Clinical Commissioning Groups (CCGs), as well as public representatives who act as lay members.
The programme board’s terms of reference sets out the purpose and aims of the programme. It also details the board’s membership and its role and responsibilities.
The board also maintains and publishes its register of interests which supports the Partnership’s commitment to transparency.
Reducing variation by having standardised commissioning policies for the whole region is a key priority for the Improving Planned Care Programme.
This approach means that access to health services, and the eligibility criteria for them, is the same for everyone, regardless of where they live in West Yorkshire and Harrogate.
These single commissioning policies reflect the most up-to-date clinical evidence, best practice and patient insight.