This week’s leadership messages come from Karen Jackson and Emma Bownas

Posted on: 21 October 2022

This week’s leadership messages come from Karen Jackson, CEO at Locala Community Partnership (a social enterprise that delivers adult and children’s community services across two integrated systems including West Yorkshire Health and Care Partnership), and from Emma Bownas, an occupational therapist, working in Calderdale as the Deputy Director of Improvement for Primary Care. We also have a blog from Matt Spencer, Integrated Stroke Delivery Network Manager for NHS West Yorkshire Integrated Care Board, ahead of World Stroke Day.

Karen Jackson Hello everyone.

My name is Karen, and I am the CEO at Locala. In addition, I have the huge privilege to be the sector lead for community services for the Partnership, the senior responsible officer (SRO) lead for hospital discharge with support from my colleagues Richard Parry, Kirklees Council, Strategic Director Adults and Health and Penny Woodhead, Director of Nursing and Quality for Calderdale, Kirklees, and Wakefield. Richard is the joint SRO for unpaid carers and personalised care – yes, I am supporting the distributed leadership model that our Partnership (an integrated care system) is built upon!

On first sight all the above may seem a bit of a jumble of leadership roles. There is real rhyme and reason to all this in my mind so let me try to explain. Perhaps I should start with the ambition to support people where they live most of their lives. This may be several places all of which bring different challenges about how we wrap our support as a partnership around people. The person who lives in a care home will have very different life needs and wants to someone who lives in their own home or in a supported living scheme. Indeed, it is a sad reality that we need to offer support to those who don’t have a place to call home, who are homeless and have very different needs.

All of the roles I have willingly and enthusiastically become involved in are focused on how we support people where they live, how we ensure that they are discharged from a hospital in a safe way that is sustainable to their remaining in their places and gives them as much independence as possible. It’s also important that we involve unpaid carers in supporting their loved ones and how we can harness the power of really personalising care for every person to meet their goals. I was recently out with one of my district nursing colleagues at Locala who was helping me to understand more about how we empower people to meet their own goals and not ours. My colleague told me the story of a person who needed our support after leaving hospital. We were busy, with all good intention, making sure all their physical needs were met to keep them safe. However, when we take the time to importantly understand their goals it all revolved around being able to enjoy an up-and-coming holiday with loved ones.

I feel strongly about the roles I do (and those who know me well can attest to my being passionate) in supporting people in the places where they live their lives. I also want to support colleagues who are all working in this space to ensure we can deliver this ambition. This includes GP’s, voluntary and community colleagues, mental health, social care, the care and nursing home sector staff, community services and those who work in hospitals. These colleagues working in a complex environment with many moving parts are critical to our success in the future and must be at the forefront of driving innovation and change.

Locala colleague working in the community It is clear to me that if we are to support people where they live there will need to be changes to how we deliver the care they receive. Certainly, more in early help and preventing ill health, harnessing our communities, and considering how we work together to make best use of the whole workforce working in these areas. We may also have to have some difficult discussions with people and must make tough decisions with them about how we best use all our resources. This includes how we focus on delivery of this ambition as we strive together to make collective decisions that may not favour our own organisations. I have seen this appetite in all the places across West Yorkshire and the conversations I have had with colleagues have been truly inspiring.

Yes, there will be challenges – there will be lots of issues to overcome like information governance, data sharing, implementing digital solutions, whilst we engage and include other colleagues on the cultural shift journey we are on, and which will be required. The challenges provide an exciting opportunity for all our services to work together to deliver innovative solutions for people, communities, and colleagues. With the skill, passion, and collective brain power we have across all our places I am convinced “our crowd” can co-design solutions with and for people where they live. You never know we could even be world leaders in this space.

Ambitious – yes. Exciting – yes. Deliverable – yes. Let’s go for it together.

Have a lovely weekend,
Karen

Shepherds, Sherpas, and Population Health Management in Calderdale

Hello, my name is Emma, and I am proud to be an occupational therapist, working in Calderdale as the Deputy Director of Improvement for Primary Care.

Emma Bownas

You may be asking what Shepherds and Sherpas have got to do with population health management in Calderdale. Is it a new type of data warehouse that hasn’t yet been considered? Does it hold the secret to solve the data sharing intricacies that exist? No, it is the type of approach that we have taken in Calderdale to support our primary care networks and localities to use population health management to benefit patients, clinical teams, and the wider system.

March 2020 saw Calderdale leap into the world of population health management just when the world was hit by a pandemic. A group of us in the clinical commissioning group could really see the benefit of using population health management to use data to identify groups of patients/people who would benefit from a different health and care offer; proactive, personalised and tailored to meet their needs. We recognised that the traditional offers and way services worked was not helping our people or our services and resulting in poor health outcomes, overloaded services, and tired staff teams. We saw a great advantage in being data led and invested in some external support from the National Association of Primary Care (NAPC) to join our team. Roll forward to October 2022; we have had success within all our primary care networks (PCNs) including working together with local voluntary sector groups, community teams and social care as we strive to make population health management the way we do things round here.

Amongst the successes have been “Ageing Well” a way of working that is being rolled out across all PCNs, utilising Ageing Well Practitioner Posts (from different professions including nursing, occupational therapy, and physiotherapy) alongside the additional roles employed in primary care networks, local authority, community, and colleagues from the voluntary sector. This has focussed on identifying people at rising risk of frailty; they may be visiting their GP more regularly, experiencing social isolation, starting to find things harder in everyday life. They are contacted and offered a conversation shaped around “what matters to them”. There may be medical issues to address, however often the solutions are beyond improving a physiological marker. The PCNs have taken a multi-disciplinary and multi- agency approach and now match up groups within cohorts with the most appropriate role within the team. Evaluation is showing an improvement in health confidence within the group and a reduction in GP appointments. We are also looking to evaluate the impact on body mass index and HbA1c (a marker in your blood that identifies you as being at risk of diabetes) as an incidental marker and early results are showing a positive impact. This approach to frailty dovetails with the work that takes place with people who are moderate to severely frail (who spend time as inpatients), and the specialists’ teams have been involved to ensure the development of a whole population approach.

Alongside ageing well, we have also seen work going on around people at rising risk of diabetes through the social prescribers and care co-ordinators in our personalised care teams. And then across Calderdale a multi-agency meeting has been established to proactively work with people who are experiencing multiple disadvantages. This has positively impacted on people being able to maintain housing tenancies, providing a level of security for individuals to start and build a different future.

So why Shepherds and Sherpas? Well, the leadership approach to adopting population health management has been one of shepherding and sherpas. A farmer drives sheep from behind, catching the ones left behind, making sure they get to their destination but allowing some freedom to find the exact route, watching out for pitfalls, and navigating them to safety.

A sherpa leader is described as:

one born to climb and connect
a way marker (strategist)
one who lets the environment produce the results – the environment and experience produces growth within the climber
one who knows their role in the climb – it’s a guide, knows the way but can’t make the climb for them
one who lets those they guide be heroes – celebrate the success of the climbers.

In Calderdale we have taken this shepherding and sherpa leadership approach. We have often referred to it as an evolutionary, organic process, going where the energy is and learning from failure as well as success. We have not waited for the ability to link data sets but have used what is to hand. We have been tenacious in the pursuit of progress and lit some fires.

There isn’t just one sherpa or shepherd, we have had a team, all with different attributes, expertise, and knowledge but the secret has been allowing the people climbing the mountain to complete their own climb. It’s a part of my job I am really excited by as I have seen the difference this work has made for the people we service and the fire in the eyes of our health and care teams. Have we reached the top of the mountain, are the sheep safely in the valleys’ – no we have further to go but we will continue our journey.

Thank you for reading, have a good weekend,
Emma

World Stroke Day is FAST approaching

Hello, my name is Matt Spencer, and I joined the Integrated Care Board in the role of the Integrated Stroke Delivery Network (ISDN) Manager towards the end of July. I have worked within the National Health Service (NHS) for the last 16 years, largely in frontline clinical roles for the Yorkshire Ambulance Service (YAS), and most recently as their Lead Clinical Pathways Manager. I applied for the role of ISDN Manager because I am passionate about improving stroke care across our places and wanted to be at the centre of the action. My passion stems from lived experience in respect of my cousin Darren, who had a stroke at the age of 40.

Stroke can strike at any age

Darren had gone to bed one evening with what he thought was a migraine and woke up the following morning and was still in pain, but he insisted on going to work. He had left work at lunchtime that day as he was still feeling very unwell and had driven home, vomiting a few times along the way. On arriving home, he went to bed. The next morning Darren’s wife noticed that he was slurring his words and his face had drooped on one side. He was also having difficulty walking. Unfortunately, an ambulance was not called at this point, and my uncle took Darren to see his GP. Darren eventually ended up in hospital where a scan confirmed an ischaemic stroke, and he was treated with clot-busting medication, a process known as thrombolysis. Due to the length of time since the onset of his symptoms, Darren’s initial prognosis was very poor. However, with the support of local after-stroke services, the dedicated care of family members, and through his unwavering determination, Darren has made a miraculous recovery.

It is now almost 2-years since the stroke, and Darren is doing extremely well, although he can become quickly fatigued, has periodic episodes of aphasia (difficulty with language or speech), and is no longer permitted to drive. He has managed to return to work and regained much of his pre-stroke abilities, but this journey has affected every aspect of his life, and in ways perhaps we have not yet realised or appreciated.

At the time, my cousin and his wife did not believe that his symptoms were caused by stroke, mostly because of his relatively young age, believing as many people do that stroke only affects older people or those with existing medical conditions. It is true that the incidence of stroke increases significantly with age and that certain medical conditions and lifestyle choices can increase the risk of stroke. However, globally more than 60% of strokes happen to people under the age of 70 and 16% happen to those under the age of 50, and in the United Kingdom one in four strokes happen to people of working age. The fact is that stroke can happen to anyone, at anytime and anywhere. This year alone more than 12 million people globally will have a stroke, and 6.5 million will die as a result. Worldwide, 110 million people have experienced stroke and live with the detrimental impacts that can include severe physical disability, communication difficulties, changes in how they think and feel, loss of work, income, and social networks.

Working towards improved outcomes for strokes

In 2019, the NHS Long Term Plan (LTP) identified stroke as a clinical priority for the next 10 years. It began to outline how we could work with partners to improve stroke care along the entire stroke pathway, from prevention to rehabilitation and life after stroke. ISDNs were established as a direct consequence of this ambition and the realisation that the best way to achieve the stroke commitments was through a networked approach based on patient flows that could bring services together to design optimal stroke pathways; from pre-hospital to early supported discharge, community specialist stroke-skilled rehabilitation and life after stroke support.

In 2021 NHS England produced the National Stroke Service Model in 2021, followed by the national service model for an integrated community stroke service and the NHS Rightcare Stroke Toolkit in 2022. The West Yorkshire and Harrogate ISDN is committed to the achievement of these goals, including the development of new system ambitions with a focus on health inequalities, prevention, diagnosis, treatment, rehabilitation, life after stroke, and workforce, education, and training.

The West Yorkshire and Harrogate ISDN is dedicated to working with people who have had a stroke, and the people who subsequently care for them. To that end we have been working together with our Harnessing the Power of Communities (HPOC) team to bring together stroke survivors and their families, health and social care professionals, and representatives from the voluntary community and social enterprise (VCSE) sector, to co-create an improved stroke recovery journey. We are looking to increase the number of representatives within our ISDN groups, and we need more voices from stroke survivors, especially women, carers, and those from diverse communities to shape how recovery from stroke can be supported across the region).

World Stroke Day and FAST

World Stroke Day (WSD) occurs annually on the 29 of October. This year we will be focusing on raising awareness of the signs of stroke with the FAST (Face, Arms, Speech, and Time) assessment tool, to identify stroke symptoms and call for immediate help. Time is precious when somebody has a stroke as brain tissue and millions of neurons begin to fade away, so every second counts. Timely identification and treatment are paramount, helping to save lives, reducing the detrimental effects of stroke, and saving more of what makes someone special and unique. As an ISDN we have much to do over the coming years as our journey is only really beginning, but I believe with the continued support, dedication, and passion of everyone involved we will achieve true transformational change and improve the experiences and outcomes of all people across the entire stroke pathway. This is my aim and my purpose, and I hope you will join me on the journey and help to make it a reality. Expressions of interest are very welcome for the stroke patient and carer group. More information here (pdf).

Best wishes,
Matt

What else has been happening?

24/7 control centres among new plans to step up NHS winter preparation

Rapid response teams to help people who have fallen at home and 24/7 ‘care traffic control centres’ are among new NHS plans to prepare for winter, were shared on Tuesday. NHS chief executive Amanda Pritchard said the additional measures would build on the extensive work already underway to prepare for what will be a “very challenging winter.” New 24/7 system control centres are expected to be created in every local area, which will manage demand and capacity across the entire country by constantly tracking beds and attendances – taking stock of all activity and performance for the first time. You can read more on NHS England’s news page.

Bradford District cost of living campaign launched

Bradford District cost of living campaign graphic A new cost-of-living campaign launched last week which will signpost people to the support available to them. The dedicated website is now live for people to find out how they can access support. The accompanying booklet is also live on the website. The booklet will be available at local libraries, community centres, GP practices food banks and information centres over the coming weeks.

The website and booklet include a range of topics to help people including information about government support; energy and bills; food resources; housing support; debt and gambling; savings; scams and safeguarding; volunteering; looking after your mental wellbeing; things to do and other helpful websites. In the coming months we will be taking each of these topics to develop a campaign around them. Cost of living will be a regular piece in local future bulletins, please keep an eye on how you can support the campaign internally amongst your colleagues as well as externally.

Bradford District and Craven Health and Care Partnership have teamed up with a number of voluntary and community sector organisations in the district this week and are holding information stalls on how people can look after their mental wellbeing during these difficult times.

Innovative Creative Health Review

Creative health review question: why does creative health matter and why does it matter to you? The National Centre for Creative Health (NCCH) and the All-Party Parliamentary Group on Arts, Health, and Wellbeing (APPG AHW) launched a Creative Health Review on Thursday 13 October 2022. The Review will gather evidence of the benefits of creative health in relation to major current challenges and show examples of where this is already working in practice.

Creative health involves creative approaches and activities that prevent ill-health and promote health and wellbeing. It aids the management of long-term conditions, treatments, and recovery across the life course. It can help strengthen social cohesion and reduce health inequalities. Activities can include visual and performing arts, crafts, film, literature, cooking, and creative activities in nature, such as gardening.

Central to the Review will be a series of themed roundtables held between Autumn 2022 and Spring 2023. These sessions will present the most up-to-date evidence and showcase examples of creative health approaches and activities with demonstrable benefits to health. They will highlight how creative health can address pressing policy issues and assist Government to fulfil its strategic aims.

Rob Webster, our CEO Lead is part of the review and took part in the launch.

West Yorkshire and Harrogate Cancer Alliance and BTM walk through videos

West Yorkshire and Harrogate Cancer Alliance and BTM (Braford Talking Media) have recently created walk through videos aimed to show patients with learning disabilities the process of all three cancer screening programmes (breast, bowel and cervical). We wanted to produce the videos to give clear and understandable messaging so an informed decision could be made about attending a screening.

The videos have been translated into the three most commonly spoken languages across West Yorkshire (Polish, Urdu & Punjabi) and a separate video including a BSL (British Sign Language) interpreter to ensure the videos can be accessed by any patient group. You can watch all the videos on YouTube at https://www.youtube.com/watch?v=OpsJKOLkMMI&list=PLSEYtPE8N908S5-oGEk4U_DW7wrgSabb8

Mental Health, Learning Disability and Autism Partnership Board report

The Mental Health, Learning Disability and Autism Partnership Board (the Board) met on 11 October and heard reports from a number of workstreams in the Programme, including:

an update from the West Yorkshire VCSE Mental Health Reference Group on developing the role of the VCSE sector within the MHLDA Programme. The report recognised the positive progress made in empowering the VCSE sector to date and the Board supported recommendations from the Reference Group to strengthen this further
a report on progress against actions taken in respect of tackling health inequalities for Black, Asian and minority ethnic communities, and the workstreams’ and places’ response to Sharing Voices into Suicide Prevention within South Asian communities. Members were asked to support their places and workstreams in providing an update on their Sharing Voices report actions for the next Ethnic Minority focus item in January 2023
evaluation of the recent MHLDA virtual recruitment campaign and next steps, these being:
- purchase of a further year’s licence and delivery of a further four virtual events, plus funding for some in person engagement events
- alignment with the existing inclusion workstream working with Touchstone to support recruitment from under-represented groups
- production of further leaflets to promote the events and specifically CSW / entry level roles and collaborative bank
- support from providers and VSCE to produce the events and get more attendees and exhibitors to take part
an update on the Autism and ADHD deep dive work that is happening at the different groups. The Board heard how:
- All places have seen an increase in referrals under the right to choose, which has had an impact on not being able to forecast budgets, workforce, medication reviews and primary care. Waiting times are increasing across all areas.
- Recruitment and retention across some places is difficult resulting in increasing pressure on existing staff teams’ capacity and wellbeing.
- Funding for Neurodiversity is not ring fenced and service provision varies. Work to generate consistent, reliable data and to consider how to reduce unwarranted variation is being taken forward by the deep dive.
an update from the Information Sharing Workshop that took place in September to reflect on common interactions between our services to understand what happens now in the way that we share information with service users and between services, and to identify what we want to happen in the future.

Learning Disability Health and Care Champions' quarterly report

The Learning Disability Health and Care Champions continue to support the work of the Partnership. They have shared their latest quarterly report about their activities.

People 50 and over invited for autumn boosters and flu jabs

Millions of people aged 50 and over can now book their autumn booster and flu vaccines, as the NHS Covid-19 and flu programmes continues to protect the country ahead of winter. And for the first time, the service will allow some people who are eligible for a flu vaccine to book an appointment online under a new pilot with more than 200 sites across the country.

Propel@YH

Propel@YH colleagues (group photo) Eleven SMEs have been selected for the Propel@YH programme who all have innovations that can help NHS and social care organisations address some of the most pressing challenges including tackling health inequalities; improving their environmental impact; supporting the workforce and helping to manage the increasing patient backlog.

Now in its fourth year, Propel@YH will provide SMEs with a six-month course of structured support and advice. The programme is aimed at companies that already have a base in Yorkshire and the Humber or would be willing to establish one helping to create new job opportunities. It will also help them accelerate their company growth and increase market presence.

The chosen companies will receive support from several expert partners: Hill Dickinson (legal advice); Nexus, University of Leeds, (networking opportunities); Barclays Eagle Labs (funding guidance), Leeds City Council will bring networking contacts to the programme and West Yorkshire Health and Care Partnership and their sustainability leads will support the SMEs to help improve their environmental sustainability impact. A number of supporters including Thrive by Design, ORCHA, YHEC, 6B Digital and HMA will also support the selected companies by providing a series of masterclasses and Yorkshire & Humber AHSN will deliver 1-2-1 and group mentoring sessions.

Find out more about Propel@YH in this article

NHS Digital Weight Management Programme: free self-referral for eligible NHS staff

As we approach the festive season, many will be managing their weight for the pending celebrations or thinking of doing so. NHS England has a range of health and wellbeing programmes available to support NHS staff to do this.

NHS Digital Weight Management Programme graphic - Online support for a healthy lifestyle. Take the first step in managing your weight today

This includes the NHS Digital Weight Management Programme, which has already proved popular with over 15,000 NHS colleagues. They’ve benefitted from the free 12-week programme, which provides online weight management plans for those who want to make changes to their health, have a BMI of 30+ (or 27.5+ for people from Black and Asian ethnic backgrounds due to an increased health risk).

If you think this programme is right for you, you can select from a number of tried and tested plans which provide nutrition advice, wellbeing support and help to boost activity levels. The NHS is working with some established weight-management organisations like Liva, MoreLife, Oviva, Second Nature, Slimming World and Xyla Health & Wellbeing to deliver this. If now is the right time for you, find out more about the programme and start your journey.

The West Yorkshire Communication and Engagement Network

On Thursday 60 communication and engagement colleagues from met virtually. This included colleagues working in the NHS, councils, Healthwatch and the voluntary community social enterprise sector.

There was an update on West Yorkshire campaigns, the work of the Partnership, as well as presentations on communication staff pressures during the pandemic, health inequalities, digital approaches, social media influencers – as well as an overview on Wakefield District Health and Care Partnership.

Thank you to Anne, Amanda, Claire, Sophie, Ben, and Kelsey for presenting to share good practice and learning.

Coming soon – year two of our fellowship to improve population health

Following on from the success of the Partnership’s first Health Equity Fellowship we will shortly launch year two. This year, we are expanding the fellowship to cover other areas of the Improving Population Health Programme. We’ll be on the lookout for:

30 Health Equity Fellows
30 Adversity, Trauma and Resilience Fellows
5 Climate Change Fellows
5 Suicide Prevention Fellows

The fellowship is open to all employees across West Yorkshire irrespective of your current job role, grade, or profession. As a fellow, you’ll need to dedicate one day a week of your time to attend training, be passionate about and work on a project in your chosen area and have the backing of your organisation. If successful, you can deliver projects in your usual work place, or it could be something that contributes to wider integrated care system approaches.

We’ll be posting everything you need to know, including statement of interest forms, on our Improving Population Health Programme pages on the partnership’s website. Come along to an event on 8 or 23 November to find out more. To keep updated and to make sure you get your invite please contact verity.phillips3@nhs.net and caroline.andrews16@nhs.net.

Last year, we appointed 30 fellows who have been carrying our projects to tackle health inequalities and help make West Yorkshire an equity-informed system. Find out more on the Health Equity Fellowship pages.