This week’s leadership message comes in the form of a podcast interview with Rob Webster, CEO for South West Yorkshire Partnership NHS Foundation Trust

What else has been happening this week?

Urgent and Emergency Care Programme Board

The Urgent and Emergency Care Programme Board met on Monday. It was chaired by Rod Barnes, in the absence of Dr Adam Sheppard. As well as the business as usual items, the Board heard from Danielle Norman and Dr Phil Foster from YAS Charitable Trust and Soo Nevison from Community Action Bradford, who provided an update on the work undertaken on the YAS Voluntary and Community Services Directory of Services, which was financed by programme transformation funding. Board members also heard about the introduction of YAS volunteer patient advocates. Karen Coleman, West Yorkshire and Harrogate Health and Care Partnership Communication and Engagement Lead, gave members an update on the ‘Looking out for our Neighbours’ campaign as it moves in to the final phase.

These items were received positively by the Board; and they look forward to receiving further updates to these important pieces of work in the future.

Hello to Matthew Gould

We were delighted to welcome Matthew Gould to the area on Tuesday. Matthew is the new CEO of NHSX and is responsible for setting the national technology agenda for healthcare. As part of Matthew’s visit, Mandy Griffin, Managing Director for Digital Health at Calderdale and Huddersfield NHS Foundation Trust and Cindy Fedell, who is the Digital Lead for the Partnership, walked Matthew through the patient journey at Huddersfield Royal Infirmary. The focus was on how technology supports the work of staff to the benefit of people accessing care. Matthew met various colleagues including senior clinicians, nurses and healthcare assistants. There was also a demonstration on what the hospital is doing with Bradford partners around accessing patient records and they work with social care colleagues. Matthew also met the discharge team to see how technology supports people leaving hospital via their care plans and e-prescribing.

Matthew then visited Wakefield in the afternoon. This involved meeting staff at the Connecting Care Hub. The Hub is made up of local health, social care, housing and community organisations from across the Wakefield district. These organisations work together, as partners, to deliver joined up health and care to ensure local people receive person-centred, co-ordinated care which is delivered at the right time, in the right place and by the right person. Rob Hurren, Director of Integrated Care from Wakefield Council, hosted this part of the visit. He explained how the use of technology supports joined up ways of working to benefit people living across in the area.

The afternoon visit was hosted at the Wakefield Intermediate Care Unit by Debbie Newton, Director of Community Services at the Mid Yorkshire Hospitals NHS Trust. Debbie gave an overview of the community services digital journey. Matthew met staff and found out more about the therapy and nursing digital records.

Thank you to all involved for making the visit possible and to Ian Holmes, our Partnership Director, and Dawn Greaves, the Digital Programme Manager, for their time in the afternoon too.

Mental Health, Learning Disability and Autism Collaborative Board

The Board met on Tuesday. It includes colleagues from across mental health trusts / providers and is chaired by Dr Sara Munro, CEO for Leeds and York Partnership NHS Foundation Trust.

Children and young people’s mental health

Leeds Community Healthcare NHS Trust (LCH), in partnership with Leeds and York Partnership NHS Foundation Trust (LYPFT), has submitted a planning application for a new mental health in-patient unit for young people in West Yorkshire. The brand new, purpose-built facility proposal is to build it on the St Mary’s Hospital site in Armley. It will provide 22 in-patient beds and deliver much needed improvements and facilities for young people in West Yorkshire. The funding for the building was announced as one of 12 successful bids to receive NHS England capital funds in November 2017. We will keep you updated when we know more.

New models of care

The West Yorkshire Children Adolescent Mental Health Services New Care Model (CAMHS NCM) went live on 1 April 2018. Overall the CAMHS NCM aims to reduce admissions for children and young people to inpatient mental health beds. We are doing this by ensuring that we have made use of all local offers before an admission is made. Where an admission is clinically necessary, we ensure that the young person comes back to community care as soon as it is clinically safe. This contributes to an overall reduction in occupied bed days (OBDs).

The success of the work is measured against the following performance targets:

• Reduction in the use of out of area tier 4 beds
• Reduction in average length of stay in hospitals
• Reduction in admissions, readmissions and occupied bed days
• Reduction in distance travelled for care
• Positive self-reporting of the young person and family experience

Three areas were identified to drive the transformation of services for children and young people in West Yorkshire. These are:

• 24/7 crisis care across West Yorkshire, a flexible service that responds to children and young people’s needs
• Community intensive services (home treatment or outreach) offer for those who need more intensive support
• ‘Safer spaces’ in the region – to avoid crisis situations.

Colleagues updated on the progress being made in these important areas of work.

Adult mental health

NHS England specialised commissioning have invited bids from Partnerships like ours (also known as integrated care systems) by the 5 July to move to steady state commissioning for CAMHS tier 4, adult eating disorder and forensics. If successful this would result in four year contracts being awarded to the provider collaborative to lead on the delivery of these services for the Partnership. This builds on the new care model pilots we have been running for 12 months. We will be submitting bids in July. We expect formal decision on the contract award in the autumn.

Suicide prevention

Our Partnership has set a target of a 75% reduction in targeted areas and 10 % reduction in overall suicides by 2020. To help achieve this, the Partnership has invested £22,000 in a basic ‘train the trainers’ fire and rescue service pilot.

We have also recently received notification that the Partnership has been allocated £114,000 of funding to support suicide prevention trailblazer for the area and also £173k for postvention work, which will be used to roll out the Leeds model. You can view the suicide prevention annual report here.

Supporting people with learning disabilities

In line with NHS England’s Transforming Care Programmes, we are looking at how best we can provide and deliver community services, including homes and housing and support and care so people with learning disabilities can live the life they chose with the support they need. In order to do this we are working together with our three Transforming Care programmes with the aim to support people with learning disabilities as close to home as possible and to keep them well and out of hospital. Colleagues have recently completed initial engagement around assessment treatment units for people with learning disabilities. You can read the engagement report here. You can also read more information about the work here.

The Five Year Strategy Group

Colleagues from across the Partnership met on Wednesday to discuss the development of our Five Year Strategy – which is our response to the NHS Long Term Plan. Our priority programme leads have been reviewing and refreshing their plans where necessary to ensure that their work aligns to the NHS Long Term Plan.

Following discussions at the Partnership Board meeting in June, proposals are being developed to consider an approach for children and families; and health inequalities – looking at where the Partnership can add value to the work taking place in our six local places (Bradford District and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield). This will be discussed further at the Partnership Board meeting in public in September.

Funding was given from NHS England to Healthwatch England to provide extra engagement support to Partnership’s like ours to develop their Five Year Strategy. Each Healthwatch received a funding grant of £2,500. Hannah Davies, CEO for Healthwatch Leeds coordinated the work for West Yorkshire and Harrogate.

The outcome of this work is an engagement report. This is being finalised and will be published in July on our website. The report outlines themes and findings from two surveys completed across our area, one with a particular focus on digitalisation and personalisation, the other around long term health conditions. Fifteen focus groups with seldom heard people from different equality groups, such as those with mental health conditions; dementia and carers, LGBTQ, disability, faith groups and young people, took place during April and May. Healthwatch engaged with 1806 people in total.

To accompany this work, colleagues (Jill Dufton and Dawn Pearson) have produced a West Yorkshire and Harrogate digitisation and personalisation mapping report. This demonstrates how a number of organisations across the area have started conversations at a local level. Both reports provide a baseline for future work needed at a local and West Yorkshire and Harrogate level. The local insight will be shared with communication and engagement leads in each of our six local places.

It’s important to note we are not starting from scratch. WY&H engagement and consultation mapping documents and timelines have been updated and there is a wealth of other expertise via our WY&H and local place engagement networks, for example public assurance groups, patient reference groups and community champions – as an asset based approach.  We will keep this in view and make sure we maximise all existing engagement mechanisms without duplication of effort and cost. We also need to identify where there may be gaps to ensure we reach all protected groups as defined by The Equality Act 2010.

The draft Five Year Strategy will be discussed at the Partnership Board meeting in public in September. We hope to publish the Strategy on our website by the end of the year.

Quitting smoking and planned care

On 3 May 2019, the Partnership told everyone about its support for a major new campaign, ‘Don't be the one’ to reduce smoking-related illness and deaths in West Yorkshire and Harrogate. The Improving Planned Care Programme is raising awareness that, as well as increasing the risk of developing a major health condition, smoking can have a significant impact for patients who are going through planned care. The news item here includes a quote from Dr Matt Walsh, Chief Officer for NHS Calderdale CCG and the Senior Responsible Officer for the Improving Planned Care Programme. Whilst no surgery is risk free, Matt reminds everyone that the level of risk can be reduced by stopping smoking as early as possible before a scheduled operation. You may find this news item useful for your communications around smoking cessation and / or planned care so please feel free to use it however you see fit. For further information, please contact Christine Hughes.

System Oversight and Assurance Group

The Partnership’s System Oversight and Assurance Group (SOAG) meet today. This group has been established to take an overview of progress with our shared priority programmes, and to agree collective action to help tackle shared challenges. Today they will be discussing mental health, learning disabilities and autism; primary and community care; preventing ill health; workforce and the harnessing the power of communities work.

West Yorkshire Association of Acute Trusts (hospitals working together)

WYAAT held a clinical summit on Tuesday to share good practice and collaboration around orthopaedic elective hip and knee surgery. Robin Jeffrey, Clinical Lead for WYAAT will be writing our leadership message for Friday 5 July. Watch out for that to find out more.

WYAAT Committee in Common

At a recent Committee in Common for the West Yorkshire Association of Acute Trusts, members received updates on an number of key projects which support the development of hospitals working together and improve services for people across our region.

Cancer Improvement across West Yorkshire and Harrogate

The West Yorkshire Association of Acute Trusts recognises the importance of delivering the best possible cancer care to our patients in a timely manner for clinical and patient experience reasons. Many of our patients receive care within the appropriate timescales but unfortunately some do not, and this is not acceptable.  The WYAAT Committee in Common supported work, led by the West Yorkshire Cancer Alliance, to develop an Improvement Collaborative which would look at the timely treatment of patients on the 62 day pathway (the total number of days that a patient waits from a referral for suspected cancer to the first treatment).  This work will use proven improvement methods and techniques to ensure the involvement of staff across the service in developing collaborative solutions to ensure patients receiving care on the 62 pathway receive it in a timely fashion.  We will monitor progress closely and keep you updated.

Pharmacy supply chain

WYAAT trusts plus acute trusts from Humber Coast & Vale STP agreed in 2017 to form a collaboration to explore the opportunities arising from establishing a shared medicines supply chain. The four key objectives were to improve service levels, reduce operational costs, manage supply chain risk, and drive future innovation. This shared supply chain would manage medicines with an annual value of £280m.

Since then, the project team has worked through a detailed process to identify a delivery model for this work and as part of this process has recognised that at this stage, this cannot be delivered in an efficient manner that would bring about the benefits we are looking for.  As a result of this, the project team recommended to the WYAAT Committee in Common that we should not proceed with the plans for a shared medicines supply chain.

The project team were keen to point out that undertaking the process has been highly beneficial and as a result of the regional collaborative work they have a much better understanding around data, information and ways of working, all of which will enable them to drive forward efficiencies and better more collaborative ways of working in the future.  The team will continue to work together collaboratively looking at future opportunities for efficiencies and smarter working to improve service delivery.

Getting it Right First Time programme

Getting it Right First Time (GIRFT) is a national programme delivered in partnership with the Royal National Orthopaedic Hospital NHS Trust and NHS Improvement to improve the quality of care within the NHS by tackling unwarranted variation in services and encouraging the sharing of best practice between trusts. WYAAT and GIRFT have worked together in a number of areas, such as orthopaedics and ophthalmology, to support these aims across the whole of West Yorkshire and Harrogate.

Recognising the maturity and strength of their collaboration, GIRFT asked the six WYAAT trusts to provide a case study of how we work together, what we aim to achieve and the programmes of work we are focused on, as part of a larger report on collaboration and system leadership in the NHS. You can read the case study here.

Pathology

Pathology services are one of the areas of focus as part of WYAAT’s wider work to look at how we can improve services for both patients and staff in the region. Agreement has been reached to establish a West Yorkshire and Harrogate pathology network, which will enable us to address the challenges that pathology is currently facing, and invest in developing services and staff. The network will build on the informal collaboration already in place to work together to provide services rather than as individual trusts.

Much work has been happening over the last few months to engage with staff from the pathology services across the region and work with them to shape the best possible options for the network and sustainable collaborative working.  We will keep you updated as this work progresses. 

Annual Report

The West Yorkshire Association of Acute Trust has produced an annual report summarising the work it has been driving forward over the last 12 months.  This was approved at the Committee in Common and is now being produced in an accessible format before being published on our website.  We will share this with you in the near future.