Preventing ill health
We want to improve the way that services are provided with a greater focus on helping people earlier rather than later and keeping people well. Examples of this include:
- Supporting people to stop smoking - nearly 20% of people smoke in West Yorkshire and Harrogate. This is higher than the national average
- Reducing the number of people admitted to hospital due to alcohol consumption by 500 every year and reducing the number of ambulance call-outs for related incidents. In West Yorkshire and Harrogate alcohol consumption is a major concern - there are around 455,000 heavy drinkers across the area
- People with long term health conditions spend most of their time looking after themselves. We want to support them to do this with a focus on preventing illness, so they can stay well
- In West Yorkshire and Harrogate there are higher than average childhood obesity levels and 50% of people are overweight. We want to provide more people with support to help them to lead healthier lives
- Over 200,000 people are at risk of diabetes in the area. Our aspiration is that 50% of these people are offered diabetes prevention support.
You can read this presentation to find out more about our plans for a preventative approach to health and social care for our local population.
We want to make sure that mental health services are integrated orcombined with physical health servces - this will ensure we care and treat the ‘whole’ person. For example, we will support people with long-term physical health conditions to cope with anxiety or depression.
We are developing services across the area to reduce the difference in the quality of mental health care that people receive in order to improve their wellbeing and make services better.
It is important to us to develop services to improve the experience of care for people in mental health crisis, and we want to reduce the number of people taking their own lives, so we are creating a region-wide multi-agency suicide prevention strategy.
Organisations from across West Yorkshire and Harrogate are joining forces to adopt a ‘zero’ suicide approach, where every death by suicide is viewed as preventable.
Mental health providers, ambulance, police and fire services, local councils, prison services and voluntary community organisations are coming together to make a real difference through what is an ambitious but practical strategy to tacking suicide. You can read the plan here. An info graphic is also available here. The plan sets out how they will reduce suicide by 10% across the West Yorkshire and Harrogate area, and by 75% in targeted areas.
Our NHS mental health providers in West Yorkshire have developed new arrangements to further build on the work already underway across the area.
Known as the West Yorkshire Mental Health Services Collaborative, the organisations have been working together for the past 12 months to improve mental health services for local communities as part of our wider partnership approach.
The mental health collaborative includes:
· Bradford District Care NHS Foundation Trust
· Leeds and York Partnership NHS Foundation Trust (LYPFT)
· Leeds Community Healthcare NHS Trust
· South West Yorkshire Partnership NHS Foundation Trust (SWYPFT)
Each organisation’s Board has approved the establishment of a ‘Committees in Common’, with each maintaining its statutory responsibilities to its own Board and responsibility for delivering its own services.
The new committee will help ensure that decisions are made together and in a streamlined way around a shared programme of work. It will also see that collective ambitions are achieved, for e.g. eliminating out of area placements for young people, and delivering the region’s five-year suicide prevention strategy, launched in November 2017.
The first quarterly meeting took place on 30 April. The chair of the committee will rotate every twelve months and beginning with Prof Sue Proctor, chair of LYPFT.
The four organisations’ chairs and chief executives sit on the new committee with an overarching set of principles, which will see the organisations:
- Working on the greatest challenges together to ensure high quality, sustainable mental health services
- Reducing variation in quality by sharing good practice which achieve better outcomes for people
- Taking a collaborative approach across the region to the delivery of acute and specialist mental health services, via clinical pathways and networked services (rather than individual place / provider-led developments)
- Developing ‘centres of excellence’ for more specialist mental health services such as forensic services, inpatient child and adolescent mental health services, and adult eating disorders
- Delivering economies of scale in mental health service support functions.
For further information on recent work, read Dr Sara Munro’s blog here
Suicide prevention - click on the links below to find out more about the work we are doing across our area to prevent suicide.
For information on who to contact in a crisis visit one of the following sites. You will find contact details and options listed per area.
Bradford District Care NHS Foundation Trust
Leeds and York Partnership NHS Foundation Trust
South west Yorkshire Partnership NHS Foundation Trust
Tees, Esk and Wear Valley NHS Foundation Trust
Every week 250 people in West Yorkshire and Harrogate are diagnosed with cancer and sadly 115 people will lose their fight each week. By working together in our partnership, our ambitions are to:
- Prevent cancer where possible and significantly reduce the 40% of cancers which are caused by behavioural, environmental and lifestyle factors, with a particular focus on tobacco control
- Make more cancer curable by improving the speed at which patients receive their diagnosis. We also want to support people to understand and act upon the early signs and symptoms of cancer
- Promote access to screening programmes for cancers
- Ensure that the experience of individual patients is taken as seriously as the seriousness of their clinical care and treatment
- Support people to live as full and active a life as possible with and beyond their cancer diagnosis
- Invest in modern and high quality services
- Transform the way that organisations work together to make sure that cancer treatment, care and support is wrapped around the patient and not purely based on a single condition or organisational boundaries.
Here in West Yorkshire and Harrogate, our Cancer Alliance works within the context and framework of the health and care partnership, taking forward the recommendations of the national cancer taskforce strategy to achieve world class outcomes for patients in the area. This includes agreeing, coordinating and assuring the delivery plans that are developed in the six local places of the partnership.
Our work on stroke will focus on the whole experience, aiming to preventing it happening in the first place. We want to provide better urgent care and community support in the first 72 hours to help people to make the best recovery possible.
Please read our strategic case for change and a shorter public summary of the strategic case for change to find out about our proposals to adapt stroke services in West Yorkshire and Harrogate. There's also an easy-read version. You can also view the NHS Yorkshire and the Humber Clinical Senate's independent feedback on the strategic case for change.
You can also find out more about our engagement with patients with experience of stroke to find out what they think about our proposals.
We know that a stroke can have a devastating impact on a person's life, as well as their family members.
This information has been produced to give you an update on West Yorkshire and Harrogate stroke care work so far.
Keeping everyone updated is an important part of our work. We want to keep you regularly updated so that you have the opportunity to discuss developments as they progress. You can also view the stroke report presented to West Yorkshire and Harrogate Joint Committee of the 11 Clinical Commissioning Groups on the 7 November 2017 here.
The Yorkshire & Humber Academic Health Science Network working with our partnership to prevent stroke
AF 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 AF are managed by GPs with the best local treatments, saving lives and delivering efficiencies too.
AHSN are also working closely with Right Care and the British Heart Foundation
to ensure the support they give is evidence based and delivers the best health care outcomes possible.
The work also highlights the importance of further improving awareness of the signs and symptoms of stroke.
The West Yorkshire and Harrogate programme involves the 11 clinical commissioning groups across the area. The AHSN will support 80 general practices to improve the care people receive across the area, saving a minimum of 190 strokes, over the next 3 years.
The intractable problem of irregular heart rhythm causes real problems. Every year, one in 20 people with AF will have a stroke. For every five people with AF that have a stroke, two will die, two will have to go into a care home and only one will return to their own home.
The AHSN has previously worked with West Yorkshire and Harrogate through the Heathy Futures Collaborative. In 2015, the collaborative created a commissioning strategy to improve care for people known to have AF. This successful strategy has benefitted 8,094 patients and is calculated to be preventing around 200 strokes a year.
Keeping everyone updated is an important part of our work. We want to keep you regularly updated so that you have the opportunity to discuss developments as they progress. Please see attached the draft timelines for the coming months work. Please note these are subject to change.
West Yorkshire and Harrogate stroke care event 2 February 2018
Over 50 health and social care professionals, community organisations, councillors, people who have experienced stroke and carers attended an event organised by West Yorkshire and Harrogate Health and Care Partnership (WY&H HCP) in Bradford on Friday 2 February. The event builds on the public engagement work from February and March 2017, and a clinical summit in May 2017, where consultants, doctors and other health care professionals came together to consider how they could further improve stroke care across the area. You can view the slides here and a report from the event will be published here soon.
Primary and community care
Primary care includes a wide range of services including your local GP, pharmacies and mental health and social care services.
We would like to see more care delivered in local community and primary care settings for example, a GP practice, rather than people needing trips to hospital. We think many of the tests and treatments for minor injuries and minor surgery that are usually provided in hospital could be provided closer to home.
We would also like to:
- Consider what other services could be provided under one roof, including physiotherapy and citizens advice services, bring everything together into 'community hubs'
- See more GPs in training, work together more closely with community and mental health services. By working in teams, health and social care professionals can provide advice and treatment for you together, instead of you needing lots of appointments in different departments
- See more GPs delivering 'social prescribing'. This is connecting up GPs with community based solutions to help people to manage their health conditions as effectively as possible. To find out more about what social prescribing is, and the work that the Patient Empowerment Project has been doing in Leeds, watch the video below
- Work with our GP practices to make sure that you can easily book an appointment, view your medical records, and request a repeat prescription online. Advice and support should be as convenient as possible for you, including making the best possible use of smart phones and digital technology.
To find out more about how we want to use digital technology to engage more people in health and social care services, watch the video below.
Please also find out more about how we want to support carers in the community.
Read this report to find out more about work commissioned by West Yorkshire and Harrogate Health and Care Partnership about primary and community care. The report talks about the benefits of the ‘left shift’. The left shift is about moving clinical care, as appropriate, for patients from hospitals into the community; with the intent that this will lead to better health and wellbeing, better quality of care as well as making sure services meet people’s needs now and in the future
Urgent and emergency care
Many people believe that A&E is a convenient place to go if you have a problem with your health, as it is seen to offer the highest level of expertise, with access to diagnostic equipment such as x-rays. However medicine has changed – GPs, ambulance staff and people working in a wider range of services can and do provide urgent and emergency care.
We wanted to find out why people use A&E as a first port-of-call. As a member of our partnership, Healthwatch Kirklees carried out an exercise to find out why people use A&E and you can find out what they discovered by reading the engagement report.
Our vision for urgent and emergency care is that we should provide a highly responsive service that delivers care as close to home as possible, minimising disruption and inconvenience for patients, carers and families.
You can read lots of examples of how we are already taking new approaches to urgent and emergency care close to home.
The West Yorkshire Acceleration Zone (WYAZ) was set up to deliver improvements in urgent and emergency care delivery across our area. WYAZ is the only urgent and emergency acceleration zone in the country.
The Next Steps for Urgent and Emergency Care (UEC) was appropved by the UEC Programme Board in July 2018. This document outlines our three key priorities and deliverables.
This milestone tracker template was submitted to NHS England to set out our draft targets in achieving progress in key areas of work to deliver better urgent and emergency care across our area. Please note that the figures in red have been set by NHS England.
We are continuing to monitor the number of patients who are entering our urgent and emergency care system within West Yorkshire and Harrogate. An updated dashboard is now available to view which gives a breakdown on the latest figures including A&E attendances, how we are managing our discharge processes and more importantly the experience that patients receive when they access these services.
The dashboard will be produced and updated monthly.
Hospitals working together
We would like to see local hospitals working in partnership with one another to give you access to the very best facilities and staff. This could mean care will be provided by a team of expert medical staff who work together across a number of hospital sites within a single, high quality service.
Please read this document to find out more about the West Yorkshire Association of Acute Trusts and how it is bringing hospitals together.
Professor Liz Kay from Leeds Teaching Hospitals NHS Foundation Trust talks about improving the medical prescription supply system and the benefits to patients by working together.
Making commissioning policies the same
There is a big opportunity to make all our commissioning policies (the policies we have about buying health and social care services) the same and reduce the difference in the treatment that people across West Yorkshire and Harrogate can access. People often call the difference in treatment that they receive based on where they live a ‘postcode lottery’. We want to make sure that what care people receive is fair and consistent no matter where you live.
Our 11 Clinical Commissioning Groups have joined together to form a Joint Committee, which will help us to make all commissioning policy the same.
You can read more about making our commissioning policies the same and best practice about getting rid of the postcode lottery.
The elective care and standardisation of policies programme is one of our nine West Yorkshire and Harrogate priorities. Others include cancer, mental health, and acute hospitals working together, maternity, urgent and emergency care.
What do we want to do?
Elective care means health care and treatment that is planned or ‘chosen’ by people to help manage a health problem, such as an ongoing condition, rather than treatment that is required urgently or in an emergency.
Standardisation of polices means reducing differences in the way health care can be accessed in different places across West Yorkshire and Harrogate. Reducing unnecessary differences helps to ensure that what care people receive is fair and consistent no matter where they live.
The ambition for the elective care and standardisation of commissioning policies programme is to deliver the right care, at the right time, in the right place so that we achieve the best health for the people of West Yorkshire and Harrogate, and achieve best value in how we use our resources.
By supporting people to make healthier choices and preventing avoidable ill-health we can, in the longer term, reduce the demand on some of the elective health care services in West Yorkshire and Harrogate.
Providing the most efficient care and making the best use of our existing capacity is important if we are to increase the responsiveness of our services, improve access for patients and reduce the number of people who have to wait longer than they should to receive treatment.
By harmonising our health policies we aim to remove the postcode lottery and variation that currently exists across West Yorkshire and Harrogate, so that access and eligibility criteria are the same for all people, regardless of where they live and all people have a positive experience of care.
Our work plan
The programme is divided into the following strands which address various aspects of planned care:
1. Supporting healthier choices is a programme to ensure people are encouraged, and supported to make healthier lifestyle changes such as stopping smoking, losing weight or becoming more physically active at the time when they are referred to elective care services.
2. Our work on outpatient services will reimagine and transform how and where outpatient services are delivered, focussing on the needs of the patients. This programme will focus on elective orthopaedic and musculoskeletal services, and on eye care services.
3. Working in partnership with acute hospitals we aim to reduce variation in the delivery of services across the area, maximising capacity to reduce waiting times and ensuring a sustainable NHS for the future.
4. People’s perception of a postcode lottery is driven in part by the variation in clinical thresholds and commissioning policies across West Yorkshire and Harrogate. We will work to align these across the area ensuring equality in access for patients, starting with procedures of limited clinical value and policy for elective orthopaedic and eye care procedures.
5. The prescribing programme will address unwarranted variation and waste, ensuring we are achieving best value from the medicines budget across West Yorkshire and Harrogate.
The West Yorkshire and Harrogate Joint Committee of the Nine Clinical Commissioning Groups has agreed that we will move forward with this approach over the next couple of years. It will take time to build the support we need in our communities; however we are not starting from scratch.
We already have some fantastic services in place, but they need to be able to meet the needs of a larger number of people and we will need to change the way in which that support is offered.
We serve a diverse range of communities and recognise that people have different needs which require different solutions. A big part of this is not presuming we know what people think, but asking, involving and listening instead.
Over the next few months we will be working to understand the differences in elective health care services and policies across West Yorkshire and Harrogate, and what we need to do to reduce the variation. We will be looking for examples of where things are working well so we can spread this across West Yorkshire and Harrogate. Most importantly we will be talking to staff and our communities.