This week’s leadership message comes from Mathew Mathai, Consultant Paediatrician at Bradford Teaching Hospitals NHS Foundation Trust.

Posted on: 5 February 2021

This week’s leadership message comes from Mathew Mathai, Consultant Paediatrician at Bradford Teaching Hospitals NHS Foundation Trust. Matt is also the Clinical Lead for the Child Health in the Community (CHiC) workstream for our Children and Young People Programme as well as being the Clinical Lead for the Born in Bradford Programme.

Mathew Mathai Hello my name is Mat,

When we held our first West Yorkshire and Harrogate paediatric ambulatory care network (PACN) meeting in September 2019 we could never have imagined what was round the corner. Yet our shared vision across the system for children to be ’Happy, Healthy and at Home’ has been helpful in providing us with a focus and a path through the current storm.

The findings of Michael Marmot’s review published in early 2020 came as no surprise to those of us working on the frontline in adult and children’s health and social care. The unprecedented and sustained effects of COVID-19 on both sectors has shone a spot light on the weaknesses of our organisations, systems, structures and processes in keeping the nation safe and well.

It’s difficult not to be moved by the effects of the pandemic on children and young people in West Yorkshire and Harrogate and around the UK. Those of us working with children in health, care and education are witnessing the inevitable pandemic fallout of these age old inequities.

The affects are certainly going to be with us for years to come.

Yet despite the gloom there are many glimmers that fill me with hope.

COVID-19 has shaken the health system to its core but revealed its heart, seen in the dedication of staff in community services, primary care and our acute hospitals. I have seen first hand how teams have pulled together, through adversity, and found innovative and creative solutions for complex problems. There has been greater employee support with an onus on all of us to look out for each other, to show kindness and model compassion. The argument for greater provider integration is now leading to collaborative ways of commissioning services. There has been greater freedom to experiment, with an acknowledgement of successes (and failures), and a spirit to try again or take a longer term view. Technological solutions have come to the fore and professionals and those accessing services have embraced virtual consultations and trialled new ways of remote assessment and monitoring.

The Child Health in the Community (CHiC) workstream that was borne out of the PACN meeting in 2019 has explicit principles to:

Increase engagement with children and families to co-design services
Understand and reduce inequities and increase access for our most vulnerable groups and;
Monitor and reduce our carbon usage.

Across West Yorkshire and Harrogate teams have been working hard on projects to provide the best possible care for sick children as close to home as possible. To better understand progress we have been meeting to agree suitable system wide metrics and to collect and share data across the Partnership. Projects currently running include:

Standardising senior clinical review for inpatients based on Royal College of Paediatrics and Child Health recommendations (Harrogate)
A senior clinician telephone triage service for community practitioners (Leeds)
Specialist paediatric clinics held in community settings (Leeds)
Hospital at home and ambulatory services (Mid Yorkshire Hospitals NHS Trust, Calderdale and Huddersfield NHS Foundation Trust and Bradford Teaching Hospitals NHS Foundation Trust)
Community delivered mental health services (Airedale)
The use of novel technology to provide remote clinical assessment (Mid Yorkshire Hospitals NHS Trust, Calderdale and Huddersfield NHS Foundation Trust, Airedale NHS Foundation Trust and Bradford)

A brand new Masters level training programme for children’s nurses, entitled Enhanced Paediatric Nursing Skills (EPNS) ‘that empowers teams to provide high quality, integrated nursing care for sick children in hospital and at home’ developed in collaboration with BTHFT, Health Education England and Bradford University.

CHiC have also been keen to learn from innovations around the country for example the ‘Healthier Together‘ programme from Wessex that provides advice for parents, young people and pregnant women, and clinical resources to support healthcare professionals give consistently high-quality care; Manchester’s ‘bed tableau’ that provides real time activity reporting to help manage demand on acute services; and the British Society for Antimicrobial Chemotherapy (BSAC) pathways to improve antibiotic stewardship and promote ambulation for common childhood infections presenting to hospital.

Yet despite these initiatives perhaps the most important ‘discovery’ to emerge from the pandemic has been the realisation that our health and wellbeing is primarily a social, economic, environmental and political matter not a medical one. The NHS can therefore never be the ‘solution’ to the health needs of our diverse communities in West Yorkshire and Harrogate. Instead the NHS should focus on supporting and advocating for local people and communities to find solutions to maintain and promote good health and wellbeing.

Our second PACN meeting in December 2020 aimed to highlight the strengths to be discovered in our places. It was a privilege to co-host the event with Nubi a final year behavioural sciences student from Huddersfield University. Nubi gave an inspiring talk on her experience of becoming an expert patient and told us about her role as a Disabled Student Ambassador. We heard about how she was advocating for her own health and she shared the many ways she was challenging preconceptions and prejudice.

We also heard from Tahira who had set up a community garden and allotment that had become a haven for her neighbourhood and a place for sharing practical ideas on healthy eating and exercise. We heard from Haris on how he was using the NHS Youth Forum to transform local services and from Huma, Rebecca and Sonjia on using their personal experiences to support and care for young people in their area.

Our role as health professionals in the coming years will be to discover and harness what’s already happening in our places, to support and advocate for our local ‘activists’, and rather than focussing on trying to invent new solutions, to become the supporting structure that allows transformation to happen in our streets, schools and neighbourhoods.

Have a safe weekend and thank you for reading,
Mat

What else has been happening this week?

West Yorkshire and Harrogate Clinical Forum

Dr Sal Uka The Clinical Forum met virtually on Tuesday. The meeting was chaired by Dr James Thomas. Forum members include medical directors, GPs, pharmacists, allied health professionals, lead nurses and NHS England colleagues. Clinicians discussed the national consultation on integrating care systems and the work underway to reduce serious violence and make West Yorkshire and Harrogate a trauma informed and responsive system. Superintendent Jackie March, Emm Irving and Carrie Rae (from the Partnership) introduced the item and gave an overview on the work of the West Yorkshire Violence Reduction Unit which has established a key operational, strategic relationship within our Partnership. There is a shared commitment to improving the lives of people involved in serious violence and ensuring safe and healthy communities across West Yorkshire. Our shared focus is on primary prevention, reducing risk factors, promoting protective factors, addressing inequalities and the root causes of violence, commissioning insight, evidence and evaluation – all seeking to explain what contributes to this behaviour. The aim is to support people who are vulnerable, facing multiple difficulties, complex needs, adversity and childhood trauma. Clinical leaders were fully supportive of the work taking place and discussed how preventative work could be embedded.

Clinicians also discussed the current COVID-19 position and work underway by the West Yorkshire Vaccination Programme. Ahead of the system leadership executive group meeting, clinicians shared their views on the Partnership’s response to people with learning disability deaths and COVID-19; and early thoughts on the development of the Partnership’s Anti-Racist Movement.

Mental Health, Learning Disabilities and Autism Collaborative (MHLDA)

The Committees in Common (CiC) of the NHS Mental Health, Learning Disability and Autism Providers met and received an update on the full MHLDA programme of work last week. The update focused on a response to the PHE/LeDeR report into Learning Disability deaths during the pandemic, timescales for work on complex rehabilitation and adult secure projects and appraisal of the transformation funding being discharged through the programme across a range of developments, including community mental health, perinatal mental health, crisis alternatives and discharge support. Colleagues gave an update on engagement work for the assessment and treatment unit for people with complex learning disabilities and the work to develop a consistent approach to prevention and management of violence and aggression across partners.

Work is well underway on the development of the staff Mental Health and Wellbeing Hub; with an early focus on ensuring staff needing mental health support get it quickly. An introduction workshop for partners was held on 18 January and more than 130 people have expressed interest in supporting the work of the Hub. This group will be given opportunities to contribute ideas about what they want to do locally and what they think we should be doing at scale across West Yorkshire.

We are sharing an information film from NHS England/NHS Improvement for people with learning disabilities and/or autistic people about vaccination. You can watch the film here.

Harnessing the Power of Communities Programme

Following the voluntary, community and social enterprise (VCSE) Business Case being agreed at Partnership Board in December, Harnessing the Power of Communities (HPoC) has been working to better connect funding and support for the VCSE, and strengthen their active engagement in shaping services system wide. As a result of two VCSE surveys, six areas have been agreed for development:

Prevention
Joined up, longer term, accessible and inclusive funding
VCSE engagement at all levels
Streamlined, simplified commissioning
Investment in local VCSE infrastructure
Investment in volunteers.

The Partnership has signed up to these areas of change and are now working with partners to turn these into concrete actions at primary care network, local place and system levels to take this work forwards.

Shielding experts webinar

The shielding experts - webinar Our Partnership alongside the Local Resilience Forum, West Yorkshire Prepared, hosted ‘The Shielding Experts’ webinar on Wednesday, providing a valuable opportunity to listen to people about their experiences of shielding, including Connie from Leeds who welcomed the opportunity to share her story as part of the session. Over 100 attendees heard insight from research and colleagues to inform our health and care practice. The aim is to support people who live and work across West Yorkshire and Harrogate to put the right conditions in place to enable those with the highest clinical risk to stay happy, healthy and safe.

Rachael Loftus, Head of Health Partnerships said: ‘Councils are working hard to ensure that clinically extremely vulnerable people have the right support to enable them to follow the shielding advice. We know how hard shielding is for people and we hoped our webinar contributed to improving the quality of their care and increase understanding of the people who are making extraordinary efforts and significant sacrifices to stay safe at this time’.

Health Inequalities Academy Launch

Over 400 colleagues from across the area and beyond took part in a three day event this week with a stellar line-up of regional and national experts for its Health Inequalities Academy launch.

2020 was an incredibly hard year for people’s health and wellbeing. The pandemic brought a sharper focus on inequalities in our communities and a demand for work at scale and at pace to improve the lives of the most disadvantaged people living in our area. The Health Inequalities Academy brought together learning, experiences and plans for further action to be delivered by the health, care, community and voluntary services organisations that make up the Partnership. For example on day three we were joined by The Health and Care Champions, a group of adults with disabilities who work with us to discuss health inequalities and create change within health care organisations.

The commitment of influential national and regional leaders to our Health Inequalities Academy event was confirmation of how serious these issues are. As a health and care system we have a number of ‘big ambitions’ for addressing inequalities and we will use our enhanced knowledge about the people who have been disproportionately affected through the COVID-19 pandemic to build robust plans for interventions that will help us take them beyond the current crisis and into a better future. You can read the event programme here or follow @wyhpartnership or #WYHtacklinginequality on Twitter.

It's time to talk about mental wellbeing

'Check-in' staff suicide prevention campaign

We launched our staff suicide campaign targeted at more than 100,000 health, care, and voluntary and community service colleagues working in organisations large and small across the area on Thursday, ‘Time to Talk’ day. The campaign aims to get people in the workplace talking about mental health to prevent the risk of suicide. Over 170 organisations have registered to get involved so far, including NHS, councils, Healthwatch, large, small voluntary and community organisations, and many others including the Police and prison service.

West Yorkshire and Harrogate Health and Care Partnership's 'Check-in' campaign aims to prevent staff suicide and promote a wellbeing culture by normalising the conversation around suicide and mental health as well as providing training, including links to credible sources such as the Zero Suicide Alliance, and signposting to support in and out the workplace.

The campaign, co-produced with people who have direct experience of suicide, has been created by staff coming together from NHS services, councils, Healthwatch and community groups, including the Samaritans and Platform 1 in Huddersfield.

Our Partnership has secured funding from NHS England/NHS Improvement to the end of March 2022 of more than £1million to develop and maintain a Mental Health and Wellbeing Hub for all staff working in health and care services in West Yorkshire and Harrogate. The campaign will link to this important support.

Rob Webster, CEO Lead for our Partnership said: ‘While people at risk of suicide may try to hide how they are feeling, they often give out warning signs, when at work. You might notice changes in their behaviour or be aware of events in their life that could be affecting them. Many of us may be unsure what to say, or how to approach the situation. By knowing what to look for, having the skills and confidence to have a conversation and provide support, you can make a huge difference to someone’s life. I’m urging everyone to get involved so they know the signs and how to respond by doing the online training provided at zerosuicidealliance.com’.

Digital programme

The West Yorkshire and Harrogate Health and Care Partnership's Digital Programme team ran a co-design workshop last week to look at how we can develop a process where old devices can be donated to those who need them - with the help of the data and the right supporting education programme. A diverse group of people attended. This included technical people to help us understand what governance measures we’ll need and mobile phone providers offering support with free or cheap data sim cards. Voluntary sector colleagues also attended which helped to provide a better understanding of the barriers that people face and how we identify the people who need the devices the most. The mHabitat team is helping to develop the process and set up a trial, whilst we look at how we can develop and spread the approach across the region.

Clothing guidance when attending for scans or examinations

clothing guidance We know that many people have privacy or dignity issues with hospital gowns and prefer not to wear them. Sometimes, having to wear a hospital gown for a scan or examination is necessary but in most cases, people can wear their own clothes. Working with the Cancer Alliance Patient Panel, our radiology teams have developed a series of patient information leaflets that provide clear, illustrated guidance on what people can wear, and what they should avoid wearing, when attending hospital for a particular scan or examination. As well as avoiding any privacy or dignity issues, the aim of these leaflets is to help a patient’s scan or examination take place as quickly as possible, and reduce waiting times for other patients. You can view or download the leaflets from the Partnership’s website. Please feel free to share the link with others who may find the leaflets helpful.

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