Posted on: 5 August 2022
This week’s leadership message comes from Jo Webster. Jo is the Accountable Officer for Wakefield District Health and Care Partnership. Her role also includes responsibility for Adults and Health at Wakefield Council and Community Services at The Mid Yorkshire Hospitals NHS Trust.
There is also a blog from Richard Stubbs, Chief Executive at Yorkshire & Humber Academic Health Science Network and Vice Chair of The Academic Health Science Network. Follow Richard on Twitter @richarddstubbs and the Yorkshire & Humber Academic Health Science Network @YHAHSN
Hello, my name is Jo.
I’m the Accountable Officer for Wakefield District Health and Care Partnership. My role also includes responsibility for Adults and Health at Wakefield Council and Community Services at The Mid Yorkshire Hospitals NHS Trust. That long list incorporates most services that are experienced by people in communities across the Wakefield District every day, and I’m in a privileged position to help join up care in their interests.
I’ve been in this unique, triple role for four months now, having taken up my post with Mid Yorkshire Hospitals on 1 April. Here’s what I’ve learned while wearing three very different hats...
I have to look at situations through multiple lenses
I’m one of the first leaders in England to have three executive roles across one local health and care system. That means three things; it means I have a bird’s eye view of what we need to do to prevent ill health, improve people’s life chances, improve care experience, and reduce variation. It means that I work alongside partners who have recognised that by bringing functions together in this way we can move further and faster with our integration ambitions - improving outcomes and experience of care for local people and making the best use of our collective workforce. It also means that I often look at situations through multiple lenses. Very early in my role across the (then) CCG and the local authority, I was faced with a legacy issue between the two organisations and I had to debate with myself as to what the right solution was. The right solution, of course, is always to consider what would be right for the individual resident concerned, rather than what is right for either organisation. It highlighted very early on that I was going to need to really understand different perspectives and develop a different approach to risk and opportunities.
In the past, organisational boundaries and accountabilities might have sometimes got in the way of doing the right thing for the person at the centre of those decisions. The changes in the Health and Care Act are allowing us, formally, to move away from those traditional structures and that’s helping us make better decisions, together. It’s about understanding the collective pressures and delivering solutions which meet all our needs and ultimately improves people’s lives. Keeping the person at the heart of all we do doesn’t take the pressures away, but the solutions become clearer, and those decisions suddenly become easier.
Team work makes the dream work
I can only do what I do because my local provider, council, housing, industry and voluntary, community and social enterprise (VCSE) colleagues have created the conditions that allow my role to work. That single vision of a connected system that supports people in their homes and communities to live healthier, happier lives is the glue that binds us together.
Finding common ground has allowed us to do great things for local people; our Mental Health Alliance brings together partners to address system issues, including supporting people who attend the emergency department in need of mental health support. The Wakefield Safe Space, delivered by voluntary sector partners, supports anyone over 16 experiencing mental health crisis and provides an alternative to A&E where appropriate. The multi-disciplinary team of social care professionals, nurses, therapists, discharge coordinators and third sector agencies in our Integrated Transfer of Care Hub are providing a holistic approach to discharge planning, streamlined processes, and safe, timely and effective transfers of care for patients. And our Shared Referral Pathway is a truly transformational programme that has resulted in a significant change in how primary and secondary care collaborate to support patients.
Now, rather than traditional structures built around specific services or functions, we operate as a collection of teams that come together around specific goals - a ‘team of teams’. Stanley McCrystal, who developed the team of teams concept, said that leaders should “delegate until it hurts, delegate until it feels uncomfortable, then delegate some more, then support and take responsibility for those taking the delegated actions”. We work on a distributive leadership model and have honorary contracts for me and other colleagues to be able to work across organisations. This approach is strengthening our mutual accountability as a system, and it’s empowering and enabling people to make decisions and take action. We’re currently working with the team from Canterbury, New Zealand, learning from their experiences in creating a world class integrated system. In our workshops they often repeat the phrase “we need the whole system to work for the whole system to work”. And that’s the crux of it for me - my role simply couldn’t work if I didn’t work with great people united by a shared vision for our district. We either all succeed, or we all fail.
It’s ok to not have all the answers
Our system, though integrating, is a collection of organisations, of cultures, and of “the way we do things around here”. To get to where we need – and want – to be, means being open to different perspectives, getting underneath the issues, challenging assumptions, continually learning and adapting, and yes, asking the ‘obvious’ questions. It’s not always comfortable, but as leaders we choose courage over comfort and this keeps us focused on tackling the root causes of problems – however difficult they may be.
The last few months have really opened my eyes to the complexity, challenges and the breadth of adult social care, community services and public health. Our community services single point of contact receives more than 10,000 calls every month. The community integrated care team completed more than 31,000 face-to-face visits last year. More than 8,000 people work in adult social care across the local authority and the independent sector in the Wakefield District, with a vacancy rate of 8.1 percent. The team receives an average of 51 new requests for support every single day. Across our district too many babies are born to mothers’ who smoke, childhood obesity is an issue in all age groups, and self-harm and deaths by suicide are high. Throw in covid recovery, stark health inequalities, an aging population and it’s clear we’ve got a lot to do.
I’m not an expert in every facet of health and social care – and that’s actually a good thing. At one point in my career it would have terrified me to not be all over the detail, or to have a gap in my knowledge. But now I recognise that its sometimes useful to take that step back to be able to think differently about resources and structures and delivery. Again, it comes back to having that trusted network of people and teams who are able to respond to the needs of our population collectively utilising our shared assets, energy and enthusiasm. So no, I don’t have all the answers, and that’s ok.
People, people, people
I apply the ‘people test’ to everything we do: is this good enough for me? Is this good enough for my family and for my friends? Is this good enough for people living in the Wakefield District?
Ultimately, I want everyone to be happy and healthy, to feel valued, and know that their time is precious - whether that’s as a patient or service user, a carer, a member of staff or a resident of the district. I don’t want people to fall through cracks, or to tell their story twice. We’re well on the way to realising this ambition, thanks to the introduction of collaborative commissioning arrangements and development of multi-agency, multi-professional teams delivering person-centred care close to home.
Our co-located integrated teams of specialist workers from different health, social care and voluntary organisations support people most at risk to stay well and out of hospital, and our electronic care record system means that everyone involved in someone’s care know what’s happened to that person from the beginning to the end of their journey.
We’ve got a fantastic opportunity now to build on these strong foundations and make people feel like services are wrapped around them, not that they are wrapped around services. This includes putting more preventative and care services into communities with the highest levels of deprivation, such as family hubs to support parents and children, virtual wards supporting care homes to manage more complex patients without the need for hospital admission, access to community diagnostics and extended access to primary care services so that people can receive care in their own communities without the need to travel.
The real test of my role, the changes in the Health and Care Act and forthcoming social care reforms, is the positive difference we are and will continue to make to people’s lives. Because it’s people, not organisations, that are at the heart of everything we do – it’s in our DNA.
Staying true to myself has never been more important
People often ask me how I manage this triple role – surely there aren’t enough hours in the day?! Leadership, system working, transformation - none of it is easy. Alongside a clear vision for the future, a team of wonderful colleagues and a very disciplined approach to diary management, my personal values are the things that help make what I do easier. I act with integrity, I’m honest and I create the conditions for people to be the best that they can be. I’m supportive, I’m collaborative, I choose courage over comfort and I never make promises I can’t keep. These values are my anchors, I hold onto them to steady myself against the waves of challenges and opportunities, under the pressures of good decision-making and through the times when change feels like the only constant. I stay true to them - and they help me stay true to myself – and it’s never been more important.
So, four months in, and there’s so much to do and so much to learn. But I’m as excited and hopeful about my role now as when I was first appointed. Creating a new system takes time. We have made so much progress already but our journey is far from complete. Deepening our approach to integration, engaging all our staff, our communities and people is at the heart of our next chapter.
I am so proud to work in the Wakefield District and to be part of such a dedicated, talented team that puts our communities and our staff at the heart of everything it does. Together, we will work with the people of Wakefield District to create a connected system that supports people in their homes and communities to live healthier, happier lives and that helps them to start well, live well and age well.
Have a lovely weekend.
Jo
Hello, my name is Richard,
I’m Chief Executive at Yorkshire & Humber Academic Health Science Network (AHSN) and Vice Chair of the AHSN Network. We are one of 15 AHSNs located across England focusing on transforming lives by driving the spread and adoption of health innovation and services.
The purpose of the AHSN Network is to transform lives through healthcare innovation. This means that we need to reach all our patients and citizens through our work, and it also means that we need to ensure that our innovation opportunities are accessible to all our NHS staff, as well as the innovators that support us.
Diversity in innovation is essential if we want to transform the NHS in ways that support all our staff and citizens. Diversity of thought, experience and knowledge drives better innovation. In 2019 when launching our first report as a Network on the importance of ensuring greater diversity in health innovation design and implementation, I wrote that: “Our NHS should represent and reflect the communities we serve. This does not just apply to our front-line workforce. The way that we develop and adopt innovation and technology must also be based around our core mission to serve all our population, and to ensure that the transformation of our health service reduces, and not widens, health inequalities.”
This is as true now as it was then and the events since that report, most notably the stark inequalities spotlighted by the pandemic and the global debate on race sparked by the murder of George Floyd, have only served to heighten the importance of this mission. I’ve also been inspired by all the work happening across West Yorkshire to tackle racism at system level. In particular, the ‘Root Out Racism campaign’ which demonstrates West Yorkshire Health and Care Partnership’s ongoing commitment to tackling structural and institutional racism.
In 2019, the AHSN Network made key pledges to demonstrate our commitment to diversity and innovation. Our pledges, adopted by all 15 AHSNs, have guided us to embed diversity and inclusion in all aspects of our organisations and our work. We’ve learnt a lot over the last few years, which we’ve summarised in our recent report Diversity and innovation progress and learning report – reflecting on and continuing our mission. While we recognise our work in this area will never be complete, we have valuable learnings to share, and we want to continue to grow and make changes.
This report is also a call to action to our NHS partners, government, and our innovation and life sciences industries to join us in the mission we have instigated, collaborate with us, and adopt and adapt our pledges for your own innovation programmes.
Some of our takeaways include:
- Culture change initiatives are never easy. Since the 15 AHSN boards committed to the pledges, we’ve learnt that it takes leadership. It takes more than a few volunteers working in the margins. Nor can it just be top-down; colleagues need to be involved and bring their perspectives to the table.
- When taking on pledges, you will face a level of discomfort, and you have to be prepared to have uncomfortable conversations – these conversations are the catalysts of change.
- Sometimes starting the process is the hardest part. We’d recommend setting pledges without necessarily knowing the route map and the end state.
- Diversity initiatives can become scrutinised because parts of this work are emotive and feel less concrete. Recognising this is essential to ensure progress.
- Our work in this area will never be complete. Championing diversity in innovation is a continuing mission. The same is true for the health and care system.
Refreshing our pledges and creating a movement
We established these diversity pledges to provide a commitment and framework that champions the business case for greater diversity in innovation. By embedding diversity and equity at the forefront of identifying and nurturing health innovations and the innovators behind them, we can better serve all communities.
The work that we have done together over the last two years has undoubtedly had real impact on improving the way that we serve our patient and innovator communities. We have no intention of ending this journey of progress. But we now want to open the invitation to join us and create a movement that can be owned and progressed by the wider UK innovation and research communities.
To aid this, we have refreshed our pledges to make them less-AHSN specific with the intention of being adoptable and adaptable by any organisation that wishes to implement them – you can access a copy of these pledges on the AHSN Network website.
Have a good weekend all,
Richard
What else has been happening this week?
British Transplant Games
Last weekend (28-31 July 2022) the Westfield Health British Transplant Games took Leeds by storm as over 2,000 transplant recipients, live donors, donor families and supporters gathered for four days of sport, celebrations and surprises.
The long-awaited Games was the largest gathering of transplant recipients since 2019, finally able to take place physically after three years of lockdowns and shielding due to the Covid-19 pandemic.
Across the weekend, the flagship event of charity Transplant Sport saw events take place, medals given out and runners join the annual Donor Run, which is the only event open to everyone and designed to thank donors and donor families for giving the ultimate gift of life.
A highlight of the weekend and an exciting first for the Games saw crowds at the John Charles Centre for Support surprised by Yorkshire Air Ambulance, when the first ever British Transplant Games branded, region-specific organ donor card arrived by helicopter.
Transplant Sport and Gamer organisers have worked in partnership with NHS Blood and Transplant to develop the Yorkshire Donor Card, designed to leave a legacy and a commitment to organ donation in the region as the Games move on.
Following the changes to organ donation law in England in May 2020, all adults are considered to be organ donors unless they ‘opt out’. However, families still have the ability to override this decision, so it’s now more important than ever for people to have the conversation about organ donation wishes with their loved ones.
Harnessing the Power of Communities (HPoC)
Following the signing of the West Yorkshire ICB VCSE Memorandum of Understanding, HPoC have worked with Paradigm Media to produce a short video to explain what this means to communities. Watch our 2 minute video The West Yorkshire ICB and the VCSE sector working together and find out more about what this means for the VCSE and how we plan to work together across health and care to tackle health inequalities and improve the health and well-being of our population in West Yorkshire.
Please share this video with others and use it to explain our commitment to working with the VCSE across the West Yorkshire Integrated Care Board (WY ICB). We will be having regular conversations between VCSE sector colleagues and Rob Webster (Chief Executive Officer) and Cathy Elliot (Chair) as we move forwards, to keep track of what we are doing and ensure we take forward our written commitments and turn them into actions, building on the exciting work we have already been doing here in West Yorkshire.
Bradford District and Craven Health and Care Partnership - Act as One Festival Recognition Day
The second Act as One Festival Recognition Day, was held on Thursday 28 July 2022, celebrating individuals, teams and projects from across the Bradford District and Craven Health and Care Partnership that demonstrate ‘Act as One’ in the way they work. Over 60 excellent and inspiring nominations were recognised during the event. Nominations included individuals and teams, to whole projects which are transforming the way that people experience care. Each nomination demonstrated how health, care and the voluntary and community sector in Bradford district and Craven are truly working together to help deliver a shared ambition of people living ‘happy, healthy, at home.’ Colleagues were delighted to be joined by Cathy Elliot and Rob Webster for the NHS West Yorkshire Integrated care Board alongside Healthy Minds apprentices and local poet Haris Ahmed. Our keynote speaker was Dr Habib Naqvi, Director for the NHS Race and Health Observatory.
The brochure with details of those nominated is available from our partnership website – the direct link to the PDF is here
At the Act as One Festival Recognition Day there was the premiere of a poem by Haris Ahmed that creatively describes our key achievements and events from our system transformation programme in 2021-2022. As well as watching the poetry performance by Haris, you can read the full version of the annual review on our partnership website.
West Yorkshire and Harrogate backs national campaign targeting England's deadliest cancer
The NHS is encouraging people with symptoms such as a long-standing persistent cough to visit their GP for potentially lifesaving checks in its latest campaign to catch lung cancer earlier when it is easier to treat. This week’s campaign launch comes as figures suggest that people at risk of lung cancer may not be coming forward for care, despite lung cancer being the biggest cause of cancer deaths in England.
West Yorkshire and Harrogate Cancer Alliance is backing the campaign and encouraging our partners to do so. The press release from NHS England can be accessed here. If you would like the campaign toolkit contact tracy.holmes@nhs.net
Although not referenced in the press release, a member of the Cancer Alliance community/patient panel, Ric Myers, has kindly agreed to be a case study for the campaign. You can read Ric’s story here and he also features in an episode of the You CANCERvive podcast – Now That The Smoke Has Cleared. If you wish to share the case study through your channels and require more information, please contact Tracy Holmes, Communications and Engagement Lead, West Yorkshire and Harrogate Cancer Alliance, tracy.
Partnership’s suicide prevention campaign to hit the big screens at Leeds Pride
Revellers at the long-awaited return of Leeds Pride this weekend will be getting a timely reminder to ‘check in with their mates’ as part of the Partnership’s West Yorkshire-wide suicide prevention campaign.
Featuring on the giant screens at this Sunday’s parade will be a special Pride-themed graphic for the ground-breaking ‘Check In With Your Mate’ campaign, launched in May by the Partnership’s Suicide Prevention Programme to encourage the normalising of conversations around suicide and mental health among men.
Carrying the message to ‘Check in with a mate and feel proud’, and with added rainbow colours of the Pride flag, the striking image also features a QR code which links to the ‘support in your area’ section of the Partnership’s Suicide Prevention website.
Office for National Statistics (ONS) data shows that suicide is more common in West Yorkshire than in England as a whole – with significantly more men taking their own lives than women.
It has been consistently reported that in the UK, LGBTQ+ people may experience mental health problems at disproportionate rates compared to the general population and research last year found young LGBT+ people were three times more likely to self-harm and twice as likely to contemplate suicide as their non-LGBT+ peers.
Since the campaign’s launch on 16 May, figures have shown that the first month alone saw 4,023 visit the ‘support in your area’ section of the Partnership’s suicide prevention website via http://www.checkinwithyourmate.co.uk.
The same four-week period saw 860 posts on social media using the hashtag #CheckinWYM, reaching a total audience of 1.6 million people.
Urgent and emergency care programme board update
The urgent and emergency care (UEC) board met on Monday 1 August and was chaired by Dr Adam Sheppard. Updates were shared from the Pre-Hospital and In-Hospital delivery programmes and the West Yorkshire Non-Emergency Patient Transport Service Pathfinder including the West Yorkshire Patient Transport Service (PTS) Review. Key highlights from the workstreams include the confirmation that funding has been secured until the end of Quarter 2 to maintain two key pathways for our West Yorkshire Clinical Assessment Service run by Local Care Direct. Preparations are underway to hold sector specific focus group meetings with commissioners/providers on the West Yorkshire PTS Review. Workshops have also been held for both the adult and paediatric Same Day Emergency Care work programme and a definition along with a set of high-level principles have been agreed by clinicians.
The Board was presented with an update on preparations for winter planning with a focus on system resilience. It was noted that additional factors such as winter fuel, cost of living and availability of consumables will potentially further impact service delivery.
An update was provided on the recent stocktake of urgent care services in relation to Urgent Treatment Centres, Walk in Centres and Urgent Care Hubs. It was identified that a significant number of the current services in place are frequently used by people outside of their local place boundary, and any unexpected change in service provision may affect service demand and create a risk to other places and UEC services. As a result of the stocktake, some key principles based on the learning have been agreed, including the sharing of any proposed service reviews, and an agreement to involve / inform other places and the UEC board of any proposed changes to existing services or plans for new ones
The Board also discussed the recent Care Quality Commission (CQC) inspections, which were carried out in West Yorkshire from the end of March until early June 2022. As well as individual provider reports, a summary report has been produced to provide system-wide findings across urgent and emergency care services within West Yorkshire. Once published, it has been agreed that a thematic analysis of all the reports will be undertaken by the core WY UEC team to identify any necessary actions. The CQC have agreed to publish the majority of reports on the same day and will work alongside communications colleagues on a joint media release.
Presentations were also shared on the final insight report into the behaviours of young adults (aged circa 20-29) who attended Emergency Departments across West Yorkshire. The final report Emergency Departments across West Yorkshire: Insight into 20-29 year olds’ attendance is available to view online. The findings of the report highlighted key interdependencies with other ICB workstreams / priorities and different programmes, and partners have met to make new ideas and opportunities possible and provide a chance to understand what best practice is currently in the system.
An evaluation of the ‘Together We Can’ winter 2021/22, the Partnership’s first collective winter communications campaign was also shared. The campaign successfully drove 25,639 unique visitors to the ‘Together We Can’ website and a final report is available Together We Can - winter evaluation for 2021/22.
Healthier You: NHS Diabetes Prevention Programme – the first choice in West Yorkshire
The Healthier You NHS Diabetes Prevention Programme (NDPP) is an evidenced-based intervention which aims to prevent or delay type 2 diabetes. There are many lifestyle changing programmes nationwide, but the NDPP is unique to those at risk of type 2 diabetes and should be the first option in West Yorkshire. It supports people to make lasting lifestyle changes, like eating healthier and adding physical activity into their daily routine and improving coping skills. Simple interventions require minimal work and will support patients at risk of type 2 diabetes.
For more information including guides, videos and more top tips see the NDPP section of the diabetes communication resource centre.
NHS Low Calorie Diet Programme
The NHS Low Calorie Diet Programme is being piloted in West Yorkshire and we need more referrals to meet the offer of 500 places. There is no limit to the number of patients a practice can refer and the number of places will be increased should demand be greater.
Trials have shown that total diet replacement (TDR) approaches are effective in supporting people with type 2 diabetes supporting healthier lifestyles, weight loss, and, in some cases, putting type 2 diabetes into remission.
We have sent GP packs to all areas with all the information practices need to make referrals. Xyla’s dedicated contract liaison officer for West Yorkshire, Sumaiyah Karim, (Sumaiyah.
Everything practices need to make referrals is available on the NHS Low Calorie Diet Programme section of our diabetes communications resource portal.
Staff Mental Health and Wellbeing Hub updates
The Leeds MIND session ‘Managing Stress and Burnout’ is now fully booked and operating a waiting list. Managing Change (Monday 12th September 10:30-12:30) still has places available. Being able to manage change is important, but this can be a difficult thing to do. In this two-hour peer support workshop facilitated by Leeds Mind, you can explore:
- How you feel about changes in your life
- What helps you cope with change
- A change you want to make and how you can go about it
To book your place, please email: bdcccg.
Following the success of the ICS, Leeds and Kirklees Schwartz Rounds, the Wakefield Round, “The person I’ll never forget”, is now available for booking via this Eventbrite link. Taking place online on 14 September at 12:15, the Round is free and open to everyone who works in health and care in Wakefield, including volunteers.