Hello my name is Ian and welcome to this week’s update

This week I want to talk about the importance of effective clinical leadership and engagement - an area which has been mentioned in previous updates and on which I want to expand further. When I was interviewed for this post I asked the panel what advice they’d give me if I was successful. Helen Hirst (Chief Officer for Bradford District and Craven – Airedale, Wharfedale and Craven, Bradford City and Bradford Districts Clinical Commissioning Groups (CCGS)) response sticks in my mind: ‘Work with the clinicians, because you’ll get nowt done without their leadership’. This is something that is true in all the posts I’ve held in central government or local organisations. Clinicians and frontline staff are where the good ideas come from, as well as the impetus to deliver them.

Strong examples of clinical leadership and engagement are visible through our cancer networks. Clinicians in primary, secondary and specialist care are involved at every level in the work of our Cancer Alliance, which leads on the delivery of our cancer priority workstream. Their experience and expertise helps to shape and support the way we do business and secure funding to deliver on our ambitions. Our Alliance Board is chaired by a former consultant radiologist (now a provider Chief Executive), and the membership of both the Board and our delivery groups, responsible for leading service transformation and improvement, includes consultants, GPs and nurses.

Evidence of our successful clinical leadership is the recent allocation of £4.5 million to five provider organisations, who are the first 11 projects seeking funding from our Capacity for System Change Fund here in West Yorkshire and Harrogate. Clinical involvement has been key to developing the bids and in identifying how they can be rolled-out across the patch for wider benefit and importantly better care.

We are also looking at how clinical engagement can further improve stroke care and support across West Yorkshire and Harrogate. We are ensuring the work is informed by the expertise of leading consultants and other health care professionals, as well as a clinical summit held in May and feedback from the public earlier this year. We are also working with the Academic Health Science Network on preventing and treating atrial fibrillation at scale across the area – see below. This will be discussed in more detail at the Joint Committee of the 11 Clinical Commissioning Groups meeting to be held in public on Tuesday. You can read the papers for this meeting here.

Our GPs and other primary care colleagues are also key partners in delivering our priorities both locally in our six places, and also at West Yorkshire and Harrogate level. The clinical forum, which meets monthly, is made up of 11 CCG clinical chairs, NHS provider medical directors, nursing leads and allied health professionals.

Our aspiration is to improve how we work across the boundaries of hospital, primary and community care and you can see an example of this in the potential redesign and development of stroke patient journeys and our initial conversations on standardisation of policies (also being discussed at the Joint Committee on Tuesday).

Medical leadership is an essential requirement of delivering high quality sustainable services in the future. Doing so means developing new ways of working. Our partnership provides an opportunity to do this. Our local STP culture is based on engagement, mutual accountability and support, as well as professional insight into performance and standards. Hospital consultants sit squarely in that category.

We are strengthening the governance of our partnership as six hospital trusts have come together as the West Yorkshire Association of Acute Trusts (WYAAT) to form a Committee in Common. The WYAAT medical directors meet monthly to consider our priorities. This is developing further into a clinical reference group, with chief nurses reviewing projects from a clinical perspective.

WYAAT are working closely with national medical leaders and a ‘getting it right first time’ (GIRFT) summit took place in October 2017 with over 100 clinicians discussing elective surgery. Clinicians have also been involved in improving vascular services (for example heart disease) through a number of clinical summits in the first half of 2017 and now fortnightly clinical working groups.

Strong clinical leadership from medical directors, GPs, nurses and other health professionals, combined with a common purpose across all sectors of our leadership, will provide both resilience and flexibility to do the best for those we serve now and in the future. It is essential that we engage all clinicians together to promote behaviour change as a partnership.

Every single one of us in the health and care system should look at how we deliver true value. Sir Muir Gray suggests we need a culture of stewardship that brings the greatest value with the highest impact within the resources we have. I think he’s right and this will only be possible if we engage with all our staff across the whole of the partnership, and give them a strong voice in how we move forward.

Finally, it was announced this week that Carol McKenna will take on responsibility for both NHS Greater Huddersfield and NHS North Kirklees CCGs as their single Chief Officer. We now have six shared management teams covering the 11 CCGS across West Yorkshire and Harrogate I look forward to working with Carol in her joint role. You can read more here.

Have a good weekend

What else has been happening this week?

West Yorkshire and Harrogate Stroke Task and Finish Group

Chaired by Dr Andy Withers, the stroke task and finish group met on Tuesday to further discuss how we develop good care to prevent strokes, deliver effective care when people suffer a stroke and ensure that there is good support and rehabilitation for people after a stroke. The work we are currently doing falls into two categories:

  • Work to prevent strokes. In particular, using the best evidence of how we treat atrial fibrillation across West Yorkshire and Harrogate (atrial fibrillation causes a fast and erratic heartbeat which is a major factor of stroke). The work is about detecting and treating people who are at risk of stroke so that around 9 in 10 people with atrial fibrillation are managed by GPs with the best local treatments, saving lives and delivering efficiencies too.
  • Developing proposals to determine the ‘optimal’ service delivery models, standardised pathways and clinical standards for our specialist stroke services (the care our patients receive in the first few hours and days after having a stroke).

As mentioned earlier this will be discussed at the Joint Committee on Tuesday.

Work to support unpaid carers

Our unpaid carer lead, Fatima Khan-Shah, met with colleagues who specialise in supporting unpaid carers this week, including colleagues from Manchester and Surrey. The meeting was chaired by David McNally of NHS England. Fatima gave an overview of our priority areas, which include support for young people caring for parents with long-term health conditions and identifying hidden carers. The group talked about how carer investment can contribute to the sustainability of health and social care and how early support can reduce carer breakdown. A key part of our work is identifying unpaid carer champions across our priority programmes. This will be discussed at our first unpaid carer event in December.

North region communication and engagement leads meeting

STP communication and engagement colleagues, including Greater Manchester; Humber, Coast and Vale, and South Yorkshire and Basssetlaw, came together to discuss national and local priorities, such as staff engagement and communications for the budget announcement later this month (we won’t know until the budget is announced whether any of our capital bids have been successful).

Roger Davison, ‎‎Director of Engagement and Communications for Health System Transformation, discussed winter communications and there was a presentation from Aimee Haggas, NHS Digital work.

What’s happening next week?

  • On Monday, the first combined voluntary and community sector/West Yorkshire and Harrogate Partnership (STP) event will take place in Bradford.
  • The Clinical Forum, Leadership Group and the Joint Committee meets on Tuesday. There will be discussions around finance, winter pressures, VCS involvement in our partnership and also an update on stroke care and how we reduce differences in the care people receive.