Posted on: 21 May 2021
This week’s leadership message comes from Dr James Thomas, Clinical Chair for Bradford District and Craven Clinical Commissioning Group. James is also Chair of our Partnership’s Clinical Forum and Co-chair of the Improving Population Health Programme.
We also have a blog from Race Equality Network members Usha Kaushal, Wasim Feroze and Cherill Watterston to talk about the launch of the West Yorkshire and Harrogate Health and Care Partnership Racial Inequalities Training.
Hello, my name is James.
"If a man will begin with certainties, he shall end in doubts; but if he will be content to begin with doubts, he shall end in certainties."
- Sir Francis Bacon (1561-1626)
As a GP and a clinical leader, I have many memorable working moments - whether unexpected or not.
I won’t forget that Saturday night on 1 March 2020 when I was contacted by our Director of Public Health, Sarah Muckle, to inform me that we had our first confirmed case of Covid-19 in Bradford District and Craven. At the moment of being contacted, seeing what was happening in China and Italy, and trying to comprehend my doubts on what was going to happen next here, I was brought back to the basics of managing uncertainty.
As a clinician, I manage uncertainty on a daily basis; it’s what I enjoy and strange as it might seem, it excites me. It’s about listening and sharing; it’s about understanding and accepting and it’s about going on to facilitate and find solutions in partnership with others. This time, however, it was different. The difference was that my colleagues, my friends, my family, and I were also potentially in danger. Early on in the pandemic when we were all trying to keep up to date and comprehend the changing guidance on management and protection it often left my colleagues and I worried, concerned and frightened – it was a feeling that I wasn’t prepared for, but it was no time to drop one’s guard or retreat as the Covid-19 pandemic unfolded.
Since that day we will all have had difficult, painful experiences and at some point, we must all reflect and process the impact for ourselves as we dealt with the challenges of Covid-19. I make no apologies as a clinician, but I want to highlight what clinical leadership enabled this last year. Please don’t get me wrong – the painfulness and distress of losing someone you love and care for cannot be underestimated and one death is one too many.
As we now start to look forward with hope and optimism and as we work in different ways it will be important to hang on to the key elements that have enabled us to get to where we are today and recognise the huge potential we have in our clinical leadership within our organisations and networks across the West Yorkshire and Harrogate Partnership.
We must also recognise the unintended consequences of the pandemic on us as clinicians. Like many, we have not stopped, we have dealt with death in a way most of us would never have done before, both in the manner and the volume, and doing all of this whilst also managing our own fears and uncertainties. As a GP I have seen the consequences of this, dealing with our patients and their grief and mental health but also seeing colleagues deal with personal stresses as a consequence of the pandemic. Many of us have changed our clinical roles and the way that we work - in unknown surroundings and teams - how we have managed clinical risk. These are not simple requests and for some it has taken us out of our comfort zone and how we are used to practicing – it’s extremely hard for our patients and hard for clinicians. Unfortunately, I know we are seeing some of these clinicians as patients; some are managing and being well supported but some are struggling but seeking help. It is therefore fantastic to know that West Yorkshire and Harrogate Health and Care Partnership has recognised this and that we have set up resources for our staff and clinicians to access further help to ensure they can get the support they need.
I am also so proud of the way our clinical leadership, in its broadest of sense, continues to demonstrate how it can manage uncertainty, maintain resilience, and do what’s right for the patient at the centre of this. We have seen how our clinical leaders have owned what they were creating and this enabled clinicians to do the change; in our community pharmacies, our laboratories, the emergency department, the intensive care units, in our communities and in our GP vaccination centres. They all were able to influence and inform decisions that would affect the services they were delivering and ultimately the care of the people. We were able to break down barriers and understand each other’s’ challenges and to find solutions that worked seamlessly with colleagues in other departments, other organisations in the care sectors and within our communities.
We have all seen how the pandemic has amplified the health inequalities we have sadly known about in our communities but we have also seen how this has focussed us to work closer to tackle these and to make our services more accessible.
Reducing inequalities is a key ambition and as a Partnership we have been very busy over the past 12 months; working jointly with Public Health England to pilot a national tool aimed at addressing health inequalities, supporting other partnership programmes to identify opportunities to address health inequalities, developing a Health Inequalities Prevention Pathway resource pack to support partners to understand health inequalities and identify targeted interventions to reduce inequalities.
Last July we awarded £553,000 Health Inequalities Grant Fund to 14 voluntary and community organisations working in partnership with statutory health providers (on top of additional local grants). We have been supporting the system response to NHS England health inequality requirements and establishing a vulnerable groups sub-group which has allowed sharing good practice for population specific interventions including: refugees and asylum seekers, children and young people, Black, Asian and minority ethnic groups – all with a focus on engagement.
This system partnership working helped launched our West Yorkshire and Harrogate Heath Inequalities Academy earlier this year but more importantly is that we are seeing this work taking place in our communities, the building blocks of our places and our system; examples that include the work in Bradford with Reducing Inequalities in Communities making a real difference not only to individuals but relationships.
The vaccination centres that have gone out into the communities where there are real inequalities and clinicians are working with and within these communities, with the voluntary organisations delivering the vaccines from community centres, buses, mosques and churches to make the services easier to access, working with trusted community leaders as “health coaches” to have those discussions in their communities to support people.
Within West Yorkshire Association of Acute Trusts there are some great examples of our clinicians in our hospital trusts working with their communities and looking at their services and operating lists to ensure their services are focusing on those most affected by inequalities. These are just a few examples that demonstrate how using population health intelligence and the real bottom up approach can drive and support how our Partnership works to get results and connect the system to more of itself. This is true partnership: working to innovate and improve our services and influence to enact our Partnership’s ambitions to tackle inequalities and improve the health and well-being of all our people.
Innovation and improvement are a key role of clinical leadership and the pandemic has produced some great positives here. We have seen how real change can happen with real work like the Care at home service in Bradford District and Craven led by clinicians in hospitals and communities working with allied health professionals, pharmacists, nurses, consultants, GPs, social workers and voluntary groups. They have provided wrapped care around those most vulnerable in our care homes or house bound using technology and regular monitoring to ensure they and our staff feel safe.
In West Yorkshire and Harrogate we were early leaders to coordinate and trial the Covid-19 vaccine, helping in the international effort to find multiple vaccine options and we have seen how our partnership, working across West Yorkshire and Harrogate and through our vaccine centres has enabled our clinical leaders to work together and with their communities to deliver a successful roll out of the biggest vaccine campaign in history.
I started this message with how I felt as a clinical leader at the start of the pandemic, but I think, whilst we strive for more, you will agree that our clinical leaders have listened, have understood the challenges. We have worked collaboratively to innovate and improve our services so that now we can all talk about hope and optimism as the levels of Covid-19 deaths and infections reduce and the numbers of people being vaccinated increases and we all start to regain some of what used to be normal.
Our Partnership, working collaboratively is enabling agility, dealing with uncertainty, and innovating to improve. Working together has helped our clinical leaders and their teams to deal with some of the most challenging moments many of us will see in our professional life time but also to change the way we work to have a better understanding of our populations. We must hold onto this, to support the next generation so that our clinical leadership reflects our populations and meets their future needs and tackles persisting inequalities; by doing this the future we will get looks certain to be stronger.
Have a wonderful weekend and stay safe,
James
Launch of the West Yorkshire and Harrogate Racial Inequalities Training
In our earlier blog ‘being comfortable with the uncomfortable’ (27 November 2020) we talked about not shying away from the challenging and uncomfortable conversations that need to happen as we all work to make the positive changes in our society and workplaces for our ethnic minority communities.
We spoke about the profound impact of events, particularly over the past year including the murder of George Floyd and the international attention on the Black Lives Matter (BLM) movement bringing into sharp focus the ongoing racial injustice, inequity and everyday discrimination faced by colleagues from ethnic minorities. Indeed, this has been highlighted further in the midst of this global pandemic revealing that inequalities and discrimination which ethnic minorities face, continue to exist within our society.
The Partnership’s commitment to become an anti-racism system continues to progress at pace powered with the ambition and innovation that is at the heart of everything we do, such as the co-production of an anti-racism movement and recruitment to the third tier of our award-winning leadership development programme for colleagues from ethnic minorities. Not only this, but we also feel it is important that when we engage with colleagues on this agenda, we highlight the importance of recognising the rich diversity of our ethnic minority communities and amplify the diverse voices and different lived experiences which our colleagues have bravely shared- something which the Race Equalities Network strongly supports and is exactly the approach we have taken with the launch of our Racial Inequalities training.
We are very pleased to be able to share the news this new suite of training is now available on the Partnership website, building on the Black Lives Matter workshop hosted with senior leaders last year. This training will be accessible for colleagues, partners and beyond at no cost, and all that we require is a personal pledge, recognising that in order to progress positively and systemically, that starts with a personal resolution in self-challenge and commitment to learn.
This bespoke training package is unique to the West Yorkshire and Harrogate Health and Care Partnership made possible by working alongside the Race Equalities Network. This currently includes the modules: Black history month, white privilege, Allyship and unconscious bias and micro-aggressions. Tackling structural racism is inherently complex and we recognise that talking about how we can address these barriers is not always the most comfortable conversation to have and is likely to provoke strong feelings, however it is through sitting with these emotions and processing them that allows us to move forward. We cannot afford to shy away from the challenging and uncomfortable conversations that need to happen as we all work to make the positive changes in our society and workplaces for our ethnic minority communities.
The bespoke training modules provide an opportunity to build a better understanding of key issues in a safe space where we can critically challenge our own beliefs and biases in efforts to reduce the everyday discrimination faced by our colleagues from ethnic minorities. It is through developing an understanding of how our individual behaviours are influenced by a range of factors that we can effectively respond to tackle the barriers which so many of our ethnic minority colleagues face on a daily basis. This is a journey we are on together and it starts with education. It starts with us.
From 24 May this training will be available on the partnership website and is accessible to colleagues, partners and others to help educate and raise awareness and be a catalyst for positive change.
We believe that we can deliver the positive change we all want to see and that it is vital we do this together, so please do get involved with this important opportunity and share with your networks.
Have a good weekend all
Usha, Wasim and Cherill
What else has been happening this week?
West Yorkshire Mayor urges people to get their second dose
West Yorkshire Mayor, Tracy Brabin, is urging people to get their second COVID jab as soon as it is offered.
Tracy, who had her second jab at the Elland Road Centre on Tuesday 18 May, thanked the staff at the centre and said she was very pleased to have had both doses.
“I'm so grateful to the scientists, researchers, doctors, nurses and all others who made this possible. The second dose of the vaccine helps to provide longer-term protection so please don’t delay and have your 2nd dose as soon as it is offered.”
Dr Phil Wood, Chief Medical Officer at Leeds Teaching Hospitals NHS Trust and Senior Responsible Officer for the West Yorkshire Vaccination Programme said:
“It is really important that people get their second dose. This gives people a much greater level of protection against Covid-19 and means they will be protected for longer. Please keep your appointment if you have one already or book yours as soon as you are invited. This will help protect both you and others, which is even more important now that restrictions are being eased.”
Improving Population Health Programme
The programme met last Friday. Members include public health, NHS, council, and community colleagues. The meeting is chaired by Dr James Thomas, Clinical Chair for Bradford district and Craven. James is also the Chair of the Partnership’s Clinical Forum; and Robin Tuddenham, CEO for Calderdale Council and Accountable Officer for Calderdale Clinical Commissioning Group.
There was an update on climate change including the ‘lunch and learn’ sessions (please see below). The Greener NHS Programme in mandated to see through the delivery of a net zero NHS, which is currently forecast for 2045. We are hoping for significant programme funding to support the work we are doing. This would include transport, medicines, and food / catering. There was a discussion on transport, electric charging points and zero admissions.
Diabetes engagement and communications with communities continues. There was an event last week targeting social prescribers, link workers and others to raise the profile of the national diabetes programme and where people can receive support.
Work continues to support people who are rough sleepers with progress taking place in Leeds and Bradford with the role of specialist support workers. Other work taking place includes preventing fire setters. Housing colleagues are working together to identify risks whilst supporting people in need of help.
Our Health Inequalities Academy is developing a health equity fellow proposal with Health Education England. System training resources for inequalities in transgender health and health of Gypsy and Traveller populations is being progressed. We are planning a learning and good practice event for organisations who received our health inequalities awarded grant funds in July.
Humankind, a national charity, which delivers services in West Yorkshire, has been commissioned to undertake ‘The Changing Systems and Integrating Care Project’ between May and July 2021. The project will help to embed future transformation and sustainable change at system and operational levels to reduce trauma, adversity and build resilience for people across West Yorkshire and Harrogate.
Restoring elective surgery and planned (routine) care services across West Yorkshire and Harrogate
As hospitals are working hard to bring back elective surgery and restore planned care services, the Partnership is looking for people to join its new Planned Care Citizens’ Panel.
We want local people to get involved and tell us about their experiences of waiting for a routine procedure during the pandemic. The insight of panel members who are on the waiting list, or who have a close connection with someone who is, will help us shape the way we communicate with others in the same position.
This new citizens’ panel will be in place from 21 June to 10 September 2021, meeting every two weeks online. At these meetings, planned care colleagues and clinicians will share details about how services are being restored, including how patients’ needs are being assessed, prioritisation, options and support whilst waiting - for discussion with the panel.
To encourage more people to get involved, we’ve extended the deadline for applications to 13 June (was 23 May). More details in this media release.
Community of practice
As part of work to tackle health inequalities, we have set communities of practice on various crucial policy areas. These include refugee and asylum seeker health; embedding a public health approach in policing; reducing serious violence and tackling inequalities; mental health and preconception; early years. A community of practice involves a group of people, who share a common concern or interest in a specific topic or issue, working together to improve knowledge, share best practice and achieve fulfilment of individual and shared goals. They aid collective learning, encourage innovation, and create a support network for members.
White Paper Legislation
The proposals set out in the White Paper are intended to support health and care partnership like ours to continue to deliver quality care to communities, in a way that is less bureaucratic, more accountable, and more joined up. If the legislation passes through Parliament during the summer, our integrated care system (ICS) will become a statutory organisation from April 2022. The proposals support things that we already do together, with local places continuing to manage and provide care locally, the power of an equal partnership that is broader than just the NHS; providers working together to join up care and our collective effort to tackle health inequalities.
The Queen’s Speech set out the government’s legislative priorities at the State Opening of Parliament on Tuesday 12 May. In her speech, it was announced that the government plans to bring forward several bills in this term of Parliament which include health and social care. The bill is intended to lay the foundations for a more joined up, efficient, and accountable health and care system – one which allows colleagues to get on with their jobs and provide the best possible treatment and care for people. We await more information on social care reform later this year.
Public involvement/engagement work takes place at a local level and will continue. An independent review into the way we work at a system level is underway to identify further improvements. This has involved a series of focus groups. The report will be published on our website at the end of July 2021. We will keep you updated.
Staff Mental Health and Wellbeing Hub
Growing evidence suggests effective coaching skills contribute to personal well-being, innovation, care outcomes, teamworking and leadership effectiveness.
Across West Yorkshire and Harrogate numerous organisations are investing in coaching and seeing the results. As part of the Staff Mental Health and Wellbeing Hub we want to build on this work by developing a train-the-trainer model in “Better Conversations for Better Care” that targets some of the groups we know are currently under-represented in the group of people already using coaching skills. This includes staff working in the voluntary sector and staff from different ethnic minority communities.
If you are interested in coaching, want to develop your coaching skills or just want to share your perspective - especially if you identify as coming from these under-represented groups of staff or volunteers, read the attached document and get in touch. Please email the hub bdcccg.