Leadership message from Rob Webster - 24 April 2020

Posted on: 24 April 2020

Hello, my name is Rob Webster,

At the recent West Yorkshire and Harrogate Health and Care Partnership (WY&H HCP) Clinical Forum meeting, members agreed that one of the key areas of focus should be clear communications to the public about seeking advice for all urgent conditions. This is often not the case as people believe that services are only available for Covid-19 issues.

Since the lockdown, figures at a national and local level shows that there have been considerably fewer people going to their local accident and emergency departments in comparison to previous years. In addition, medical colleagues are concerned by the drop in the number of people seeking advice about possible cancer, stroke and cardiac symptoms through their GP resulting in a marked reduction in, for example, urgent cancer referrals.

It is feared many people who need primary or urgent/emergency care are worried about accessing local services due to the pandemic. However, not accessing the right care at the right time can see illness and injury worsen, requiring more advanced treatment when these could be dealt with far earlier. This leads to a growing concern that we are potentially storing up health and operational risks in the months ahead if people don’t get the emergency help they need. People must continue to get the right care, at the right time, in the most appropriate way and we have responded positively to ensure that this is the case.

Still here to help The immediate task is to collectively ensure that the messages about the ‘NHS being open’ are promoted appropriately, alongside the stay home, stay safe messages. It is understandable that, after the initial messages about not accessing services, people are now staying away. There is also strong anecdotal evidence that people are frightened of the risks they might be taking if they do attend one of our sites. The emerging evidence of the disproportionate impact of the virus on some communities, covered here last week, means that this is prevalent in older people and our BAME communities. We simply must address this fear. This is especially important as heart attacks, suspected strokes or concerns about cancer, pregnancy, mental health or safeguarding have not gone away.

Last Friday, Bradford District and Craven partners launched a campaign which aims to remind people across the area and beyond that local health and care professionals, council services and voluntary and community organisations are #StillHereToHelp. They have developed communication resources to sit alongside the campaign, as well as films focused on GP services, including one in Urdu. They are freely available for partners to use and have been shared with communication colleagues.

the NHS is still here for you when you need us In the true nature of our Partnership we have also been sharing the campaign resources produced by NHS Leeds ‘Your NHS is here for you’. This important campaign launched on Tuesday. This important campaign also reminds people to seek medical care when they need it with a focus on life changing and life threatening illnesses. Using #NHSHereForYou, the messages include when to see a GP, spotting signs of cancer, when to call 999 and how NHS 111 online can help people to manage less serious health concerns.

In this short film, Dr Bryan Gill, Chief Medical Officer at Bradford Teaching Hospitals NHS Foundation Trust, senior doctor and co-chair of our WY&H HCP Clinical Forum, reminds people that our NHS is still here for serious illnesses and injuries. This includes if you think you’re having a stroke, have severe chest or abdominal pain, severe bleeding that can’t be stopped, a serious injury, choking or blackout. A&E departments at hospitals remain open for all emergency conditions, with processes in place to ensure that people who need to go to the hospital urgently can be treated safely.

In his film, Dr James Thomas, Clinical Chair for NHS Bradford district and Craven Clinical Commissioning Group, our other co-chair of the WY&H HCP Clinical Forum, highlights that although access to local GP practice has changed, it doesn’t mean it should stop people contacting them with their health concerns.

To accommodate the current climate we are living in, GP practices have moved to offering patients telephone, online (eConsult) consultations and, in some cases, video consultations or via digital applications (apps) on mobiles, tablets or laptops. If you need access face to face, please don’t go to your GP surgery, this will be arranged with your GP practice over the phone first. Services are set up to access safely and locally. In addition, health advice is also available to some people by completing an online (eConsult) form on their local practice website and on the NHS website – www.nhs.uk.

As this campaign develops, we will be producing simple visible guides of what to expect when you attend the practice, clinic, hub, or hospital. Showing people what the arrangements are will be just one of the ways in which we can ease the fears in our communities. We really are here for you when you need us.

Have a good weekend, follow government social distancing guidance, and stay safe.

Rob

Coronavirus (COVID-19) updates

Coronavirus resources

Latest information on coronavirus: https://www.gov.uk/coronavirus
NHS information on coronavirus: https://www.nhs.uk/conditions/coronavirus-covid-19/
Q&A from Public Health England on coronavirus: https://publichealthmatters.blog.gov.uk/2020/01/23/wuhan-novel-coronavirus-what-you-need-to-know/
Public Health England’s guidance about coronavirus (COVID-19) for health professionals and other organisations: https://www.gov.uk/government/collections/coronavirus-covid-19-list-of-guidance
Ministry of Housing, Communities and Local Government Twitter:  https://twitter.com/mhclg
The Local Government Association has detailed some common challenges that local authorities are facing with suggested guidance.
From Lancashire Teaching Hospitals, a resource for managing patients post-coronavirus: https://covidpatientsupport.lthtr.nhs.uk

Additional publications

Other updates

Government pledges extra £1.6 billion for councils: Councils across England will receive another £1.6 billion in additional funding as they continue to respond to the coronavirus pandemic.

Government launches Vaccine Taskforce to combat coronavirus: A new Vaccine Taskforce will drive forward, expedite and co-ordinate efforts to research and then produce a coronavirus vaccine.

Yorkshire and Humber Public Health Network: Online courses linked to Covid-19 and Resilience

The Women and Equalities Committee
The Committee want to hear about the different impact that the Coronavirus – and measures to tackle it - is having on people with protected characteristics under the Equality Act. You can find out more here.

Mental health, learning disabilities and autism
NHS England and NHS Improvement have published guidance on visitation. It includes clarification that support for someone with a mental health issue, learning disability or autism is an exceptional circumstance. One visitor is permitted to visit in these circumstances. The guidance explains that a carer will now be permitted to attend with a person with a mental health condition, learning disability or autism where not being present would cause the patient to be distressed.

The Ministry of Housing, Communities and Local Government
The Ministry of Housing, Communities and Local Government published a Q&A note last week setting out the department’s views on the most common queries relating to the technical implementation of the £500 million hardship fund, and how councils might want to implement their schemes.

Wellbeing support

A confidential staff support line, operated by the Samaritans, is available for NHS staff from 7.00am – 11.00pm, 7 days a week.
The Local Government Association has new resources to help employers and managers to think about the wellbeing of staff.

Health Education England (HEE) redeploying staff or training volunteers

Five Ways to Wellbeing module describes how the Five Ways to Wellbeing can be implemented
A Mental Health Awareness module has been designed to highlight the link between mental and physical health diagnoses.
All Our Health: Mental Health and Wellbeing is a bite-sized session to give health and care colleagues an overview of mental health and wellbeing.

What else has been happening this week?

Improving Population Health Programme (IPHP)

The programme is working with members of the Health Inequalities Network, including public health colleagues, to share learning on how to best support vulnerable groups across West Yorkshire and Harrogate during the COVID-19 outbreak.

The Royal College of Physicians has worked with NHS Providers and Provider Public Health Network, a community of practice supported by Public Health England to produce a joint paper on Covid-19 and mitigating impact on health inequalities. This will help inform the view of colleagues in terms of moving forward at pace.

Health Inequalities Grant Fund

Local places will shortly be able to apply for grants to strengthen links between the voluntary and community sector and healthcare services for groups of the population disproportionately affected by COVID-19. The fund will be open for applications from 28th April and will be open for six weeks until 8th June. Funding will then be awarded in June to successful applicants. More information will be on our website at www.wyhpartnership.co.uk next week.

Reducing violent crime

The first meeting on the joint IPHP and West Yorkshire Reducing Violent Crime and COVID-19 Response Network, took place on Tuesday. The Network brings together partners and services across West Yorkshire to understand and respond to the changing needs in relation to violent crime.

The Urgent and Emergency Care Programme

The Urgent and Emergency Care Programme (UEC), in partnership with our Workforce Programme, Health Education England (HEE) and the University of Huddersfield have been successful in their bid to the Health Education England Strategic Support Fund, for the sum of £100,000 to support the development of an Urgent and Emergency Care Nursing Associate Apprenticeship Programme. This funding will go to the University of Huddersfield to support the development of the apprenticeship programme, and is to be used for course development costs. An initial Zoom meeting with the university will take place next week to discuss next steps for the project group.

The UEC Programme has stepped down existing work streams (excluding workforce) and the UECPB meetings until July 2020, to assist in the system wide management of COVID-19 priority work streams. Daily intelligence reporting, which initially started in December as winter reporting, continues to be coordinated and shared by the UEC team across the system.

Harnessing the Power of Communities Programme (HPoC)

Across West Yorkshire and Harrogate, the voluntary and community sector (VCS) continue to experience a high level of demand on their services. The HPoC Programme has been working to ensure strong collaboration with the VCS in the response to COVID-19. Working together we are developing innovative solutions and adapting services and support offers, whilst ensuring as a Partnership we provide much needed support for the third sector during this challenging time.

Work so far has included looking at crime prevention and responding to changes in violent crime; engaging in the development of an increase in bereavement support and services; linking VCS organisations working in direct care into opportunities to access testing and personal protective equipment; access to technology and more up to date IT equipment. Working with NHS Volunteer Responders to establish better links with local provision and better communication so the service is better understood and accessed has also been a priority.

We have also been working with the VCS to respond to the increase in demand for their services at a time when many of their income generating activities such as fundraising and trading are not operational. The HPoC leadership group want to encourage sustainable approaches, partnerships and funding that will continue to support our VCS partners through the recovery period and beyond.

VCS place leads are also assessing the current state of the sector through local resilience surveys, being carried out in each of the six local places (Bradford district and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield). This will give us a clear picture of what is happening in the sector across West Yorkshire and Harrogate.

Mental Health and Learning Disabilities and Autism Programme

There is increasing demand on the community and voluntary sector so its good news that grants are now available to provide mental health services or additional support – in response to Covid-19. Nationally, a reported increase in domestic abuse is being targeted by the Government’s #YouAreNotAlone campaign. This aims to reassure those affected by domestic abuse that support services remain available during this difficult time and there are a number of policy updates relevant to people with learning sisabilities and / or autism in relation to exercise and travel and visitors to the home. Yorkshire and the Humber colleagues have shared a number of useful and number of good practice resources including; communications resources and emotional health and wellbeing of children and young people. Across West Yorkshire and Harrogate we continue to develop a system-wide bereavement support line (more detail will be available once finalised), planning for ‘post COVID’ scenarios, mutual aid discussions between the MHLDA collaborative on workforce, training, service resilience and crisis pathways, and on support for people with a learning disability and/or autism during this time.

New NHS Nightingale Hospital Yorkshire and the Humber

Less than three weeks since work started, NHS Nightingale Yorkshire and the Humber opened on Tuesday. Based in Harrogate Convention Centre, it will provide some 500 more beds for coronavirus patients, if local services need them. The new facility is one of seven Nightingale hospitals to be set up around the country as part of a massive NHS effort to respond to the greatest global health emergency in more than a century. This extra capacity is on top of the 33,000 additional beds freed up across NHS hospitals – the equivalent of building 50 district general hospitals – and the up to 8,000 beds put at the NHS’s disposal through an unprecedented deal with the independent sector.

These measures combined mean that capacity still exists in hospitals to care for patients with coronavirus, as well as other patients who may need urgent and emergency treatment, with the Nightingales standing ready if local services need them beyond that.

Captain Tom Moore was invited to open the new hospital to honour his fundraising efforts on behalf of the NHS. He was joined be Secretary of State for Health and Social Care, Matt Hancock and Chief Executive of the NHS, Simon Stevens. The opening was conducted by video link in line with social distancing policies. You can read more from NHS England about the opening here.

West Yorkshire and Harrogate Workforce Board

The Workforce Programme has established a temporary Workforce Board looking at COVID – 19 related issues. This has representatives from all sectors including primary care, social care, mental health, hospitals and the independent sector. There is also a place-based workforce group, which also has representatives from our six places (Bradford district and Craven; Calderdale; Harrogate, Kirklees, Leeds and Wakefield) where best practice is shared and anything scalable to West Yorkshire and Harrogate is discussed. Both groups meet weekly.

Training requirements across place and sector have been identified and a weekly bulletin has been produced by Health Education England (HEE) outlining all training currently on offer. Colleagues are keen to hear about other training requirements that are not covered in the bulletin and these can be sent to Kay.Butterfield@hee.nhs.uk

Deployment of 3rd year nursing and midwifery students is underway and so far West Yorkshire and Harrogate have had over 1000 students opt in and waiting to be deployed across our organisations. For medical trainees across Yorkshire and the Humber, 421 trainees have been re-deployed which is approximately 8% of the trainee workforce and includes community to secondary care.

A similar process is happening for Allied Health Professionals (AHPs) and physician associate students, as well as 2nd year nursing students. So far across West Yorkshire and Harrogate there have been 156 staff who have been transferred, including 21 AHPs, 23 doctors, 112 nurses and midwives. More colleagues are being transferred and these figures will be updated every week.

Both groups discussed social care and the need for additional staff in this area, particularly in care homes. Many local places are looking at ways to increase the workforce in social care and are speaking to further education colleges.

The groups will continue to discuss these issues going forward with also a focus on post COVID training and workforce requirements.

BAME Network

The West Yorkshire and Harrogate Health and Care Partnership BAME network met virtually on Wednesday.

The network discussed ways their collective leadership expertise could lead work taking place COVID-19 effort, including:

developing resources to support the wellbeing of BAME staff
representation from the network on the health inequalities workstream
shaping the development of new research initiatives locally and nationally on the impact of COVID-19 on BAME communities and mortality rates including work with the National Institute of Healthcare Research (NIHR).
Working with acute trusts to ensure that ethnicity is recorded on all COVID related deaths.

Harrogate and District NHS Foundation Trust recieve thanks

Karl, who has been on a ventilator as a result of having COVID19, has now been discharged home. Karl shares this message of thanks to the hospital team.

We are so pleased to hear from Karl - our first patient who has been on a ventilator as a result of having COVID19 and now discharged home. He, along with a lovely labrador, has shared this message of thanks to #teamHDFT. #coronavirus #COVID19 #NHSCovidHeroes #NHS #harrogate https://t.co/raoSKVMURK pic.twitter.com/92YVF2X8CU
— Harrogate NHS FT (@HarrogateNHSFT) April 19, 2020