Hello, my name is Anthony

I’m the NHS England Director for West Yorkshire and Harrogate. I want to update you today on how my role is helping to change the relationship between the NHS national bodies and the local organisations in our health and care partnership.

NHS England is responsible for allocating funding to local Clinical Commissioning Groups
(CCGS) and for ensuring that the CCGs are effective in planning and securing high quality health services for people. A separate national body, NHS Improvement, oversees how well health care providers, such as hospitals, community and mental health services, and ambulance services are performing.

Over the next few months NHS Improvement and NHS England will be coming together to work in a more joined up way, so that we can support local health systems more effectively and speak with one voice for the NHS. We will create a single regional team for the North East and Yorkshire, bringing together colleagues from both organisations under one regional director.

One of the key reasons for this change to the way the national bodies operate is that it’s time for local organisations to be given the freedom and support to deliver improvements for their local populations. We need to develop a new, more streamlined approach to enable this.

The NHS has always been used to a top-down performance management culture. Aneurin Bevan’s famous words that “if a hospital bedpan is dropped in a hospital corridor in Tredegar, the reverberations should echo around Whitehall”, has continued to set the tone for the last 70 years. But this centralising approach hasn’t been successful in achieving consistent improvements, and certainly won’t work for a 21st century health and care system which needs to respond to the needs and aspirations of diverse local populations.

We believe that local partnerships between NHS providers and commissioners and Councils provide the best opportunity to succeed in making these improvements sustainably, so that people will have better health and care, now and for future generations.

Change must be driven not from Whitehall, or from NHS HQ, but from the local Town Hall, where local partnerships meet and shape services together.

NHS England and NHS Improvement will continue to have formal responsibilities to regulate and oversee local services, but we will increasingly discharge these responsibilities as peers within local partnerships, rather than sitting above them.

In May this year West Yorkshire and Harrogate Health and Care Partnership was approved as an ‘Integrated Care System’. This means the partnership will be given greater freedom to focus on achieving its ambitions for local people, in return for taking greater collective responsibility to manage its resources and performance. 

My role as NHS England Locality Director will be to work as part of the partnership, helping to develop a new approach to all partners working together in this new model of collective mutual responsibility.

The work we are doing in West Yorkshire and Harrogate is leading the way in developing a new integrated approach to leading performance development and culture change. We are determined that our approach will be better than the current NHS model of performance management. It will enable us to focus more on whole places rather than the individual organisations within them. We are introducing a strong element of peer review and challenge – aiming to learn from well-established peer review arrangements in local government; and we will develop a clear approach to improvement-focused intervention, support and capacity building.

At this time of huge risk and opportunity for the health and care system building a genuine partnership between local and national bodies, our colleagues in the voluntary and community sector, and the people we serve gives us the best chance of success.

Have a good weekend



 What else has been happening this week?

 West Yorkshire and Harrogate Partnership Working Group

The Partnership Group which includes representation from the unions met on Friday 10 August. The meeting was chaired by Rob Webster our CEO Partnership Lead. There was a discussion around the work of stroke; clinical engagement; the workforce plan; the draft partnership memorandum of understanding and transformation funding, which includes money for primary care network and communities. The next meeting is in October and colleagues from primary care and hospitals working together will be invited to attend.

West Yorkshire and Harrogate Maternity Board

The WY&H Local Maternity System held their Board Meeting on Monday. The Finance Director for the LMS presented initial work on financial scoping.  He articulated that the LMS needs to start with a baseline that all understand and accept with the aim of better systems and cost effectiveness.  It was a valuable discussion and a progress update will be given in November.

The Board heard about recent work around the LMS workforce. This follows a workshop with heads of midwifery and obstetricians.  A workforce task and finish group is being established.

There was a conversation around the development of a micro website that will allow both women and professionals to gain insight into the services available across the area. Further work will continue.

Local area planners

Our six local area planners (Bradford District and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield) met on Tuesday. We heard from colleagues in Bradford who updated us on the partnership framework for health and social care. Kirklees colleagues told us about the work they are doing on an integrated commissioning plan – and Harrogate colleagues explained they have recently published their plan ‘Your Community, Your Care’

Newton Europe has been working with Leeds partners around improving patient flow and reducing hospital delays. Initial findings have been shared with Leeds health and care system leaders.

Wakefield will be sharing their revised local plan with their Health and Wellbeing Board in September. The plan includes the wider social determinants of health, for example poverty, employment and housing. Wakefield colleagues are also coordinating a partnership share and learn session later this year.

Ruth Twiggins gave colleagues an update on the national personalised care demonstrator sites, which we are one. This work is all about meeting people’s needs with their views at the heart of decision making. It’s all about tailored support and helping people to stay as healthy as possible.

West Yorkshire and Harrogate Health and Care Partnership Programme Leads Meeting

Our priority programme leads met on Thursday. The meeting is chaired by Ian Holmes, the Director for the Partnership. This included an update from Karen Poole on the work of the Maternity Board (please see above) and an update from Alastair Cartwright, our programme lead for digital. Alastair explained that the Secretary of State’s announcement of £412.5m for Health System Led Investment (HSLI) provides an opportunity to accelerate the adoption of digital technology across the NHS. For West Yorkshire and Harrogate it means we will have access to up to £18,697m over the next three years to drive our digital strategy forward at pace, with a particular focus on developing shared clinical records.

Shane Hayward-Giles gave an update on the Healthy Hearts work and the partnership with Academic Health Science Network. We want to reduce the impact of heart disease and diabetes; and prevent the number of heart related illness, including heart attacks, every year across West Yorkshire and Harrogate. The number of people who could be supported is very powerful; for example targeting people most at risk and making sure they have the best medication. We will keep you updated as the work progresses. Carol Ferguson, Programme Director for Cancer gave an overview on how the work in our six local place plans aligns to the West Yorkshire and Harrogate Cancer Alliance priorities.

There was also an update from Anthony Kealy on the long term plan (also known as the 10 year plan) which is being developed. It builds on the themes of the Five Year Forward View with some additional priorities added, for example digital technology and specific themes for children services – which is very helpful.


What’s happening next week?

  • The Urgent and Emergency Programme Board meets on Monday. This is chaired by Dr Adam Sheppard.
  • There is a Yorkshire and Humber Children's Palliative Care Network meeting next week.