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

As the lead for the WY&H Partnership, I am supported by a network of CEOs and leaders from local government, the NHS, voluntary sector and community organisations. This networked approach to leadership is essential to delivering joined up care in our neighbourhoods and communities across WY&H.

It was a privilege this week to hear local government and clinical voices presenting research and insights into our communities. At our leadership session on Tuesday afternoon, we welcomed Professor John Wright who talked about ‘improving future lives’ and in particular health research from Born in Bradford. This is one of the largest research studies in the world to find out what influences the health and wellbeing of families. 10 years ago a decision was made to make the most of health research so that future health issues could be tackled head on. This included recruiting thousands of mums and babies to take part in some longitudinal research, which mapped out the data from pre-pregnancy to early childhood.

John’s team has developed unique research insights into the impact on health of ethnicity, air quality, diet, exercise and mental health. This brilliant and insightful work allows us to understand what works in tackling health inequalities. Much of the answers come pre-pregnancy and during pregnancy; for example, the correlation between foetal growth, and how well a child does in their early school years was staggering. Our approach to this can make a huge impact.

Other answers come in developing connected cities, recognising that childhood obesity is one of our biggest public health risks. Looking at the wider environment, for e.g. green spaces, air pollution etc. and how we design our towns and cities is also critical in terms of everything from Vitamin D to links to asthma in Bradford (over 1600 children have asthma). As John said it’s all about communities, social support and promoting connectivity – a helpful reminder of the work of Cormac Russell discussed at the last Leadership Day. To find out more about the Born in Bradford work, listen to this Radio 4 podcast.

Robin Tuddenham, CEO for Calderdale Council, has a population that mirrors many of the issues in Bradford and can learn from the solutions. Robin came fresh from hearing that, by working together, the partners in Calderdale have secured £10m from Sport England to promote physical activity across the area to benefit the physical, social and mental health of citizens. It’s exactly what the Partnership is all about.

Robin provided us with a great insight into the role of the democratic process, the richness of the experience of local elected members and the work of scrutiny committees. In particular, Robin talked about local, neighbourhood partnerships and the importance of joined up health and social care. This all linked to the sustainability of local places and services. The democratic process is important and it’s critical that local councillors are involved in the conversations about health care which may have an impact on their communities – they will help to ensure we enhance the penny in the £ spent in local places. As Robin said, ‘trust comes into the room like a tortoise but can run out like a horse’. We definitely aspire to work in a way which builds and nurtures trust with our communities and their elected representatives, and aim to do things better together – and it is clearly not just about the money.

The rest of the Partnership leaders’ meetings took place on Tuesday. These included the Clinical Forum, which has GPs, public health consultants, trust chief medical officers and colleagues from NHS England, chaired by Dr Bryan Gill, Medical Director for Bradford Teaching Hospitals NHS Foundation Trust, and also a development session for members of the Joint Committee of the 11 Clinical Commissioning Groups.

West Yorkshire Association of Acute Trusts (hospitals working together) and the WY&H Executive Leadership Group also met on Tuesday (reps from each of our partnership sectors). The day’s conversations included the need for us to develop a clear, shared way of describing how clinical services will develop across WY&H, and the importance of developing this ‘narrative’ together with GPs, hospital doctors, other health professionals, social care partners, and voluntary and community organisations.

Through these various discussions we agreed that getting the language right is critical; we need to set out a clear direction of travel that is meaningful to everyone. Bureaucratic language which smacks of US models of care is unhelpful and we need to find better ways of describing how we work together. For example, the Next Steps on the NHS Five Year Forward View signalled a new approach to integrating care locally, with the development of ‘Accountable Care Systems (ACS)’. Any WY&H ‘ACS’ would build on the work of our local places and provide an approach to co-ordinating work that which can only take place at a WY&H level. Most care is delivered locally, managed locally and planned locally. That will always be the case. We just need to find a better way of describing what we are doing and why.

Anthony Kealy, from WY&H Health and Care Partnership team is working on this. He gave the Clinical Forum, Joint Committee and Executive Group an update on the development of a memorandum of understanding (MoU) that would consolidate all the networked leadership arrangements into one place. He also gave an update on how the partnership is evolving, with the aim of becoming a WY&H ‘ACS’ with greater delegated authority in shadow form. This will mean we get more control over capital, workforce and transformation funds and there is a commitment from NHS England to help with both practical and technical support in the development of the partnership.

Above all, we need to ensure we are able to deal with the issues that affect our communities – whether its loneliness or learning disability; housing or mental health; childhood obesity or air quality - we have a mechanism to work together for their benefit. Each of our local places is working through how they will work together more closely to further develop their partnership approach. In line with our WY&H plan, all decisions on services need to be made locally as close to people as possible. The WY&H ACS will focus on the work that can only be done at this level i.e. the nine programmes. Closer integration of health and social care, including relationships with community and mental health providers is critical to this way of working. Clinical leadership will be a key part of achieving this, and we can’t afford to focus on health care alone without considering the 'broader determinants of health', e.g. housing, employment and economic hardship, which are highly correlated with poor health.

We have some genuine expertise in WY&H – from professors like John Wright and from the 2.6million people who make up our communities. We have a chance to work together and harness that expertise.

Have a good weekend


What else has been happening this week?

Primary care delivery plan

There is a requirement for all health care partnerships to produce Delivery Plans that describe in more detail their current position, progress and planned actions in relation to primary care, specifically the General Practice Forward View. The draft plan was considered at the last meeting of the System Leadership Executive in November and again on Tuesday.

WY&H communication and engagement network

Over 20 communication and engagement colleagues from across WY&H met on Wednesday for an update on the partnership’s work as well as a workshop led by Jill Dufton [WY&H engagement manager) on the importance of community engagement in terms of good practice and shared learning. Lee Squires from NHS England gave a presentation on their communication role and there was also a show and tell session on what works well and doesn’t. The group particular liked the 12 days of A&E film from Wakefield CCG and Mid Yorkshire Hospitals NHS Trust. You can watch it here

Urgent and Emergency Care programme

As part of the WY&H Urgent and Emergency Care Programme, over 40 GP practices are now enabled to provide direct appointment booking from the NHS 111 telephone advice service. This means that for these 40 practices when a person calls 111 and needs an appointment at their registered GP practice, 111 can make that booking for them. This improves the patient experience and saves people having to be ‘passed around’ the system. In addition, we are piloting a NHS111 digital product, which allows people who prefer to engage with NHS 111 digitally rather than via telephone, to do so. You can find out more here

Maternity Voices Partnership Task & Finish Group

Maternity Voices Partnership Task & Finish Group met today to discuss how the task group can contribute to the WY&H Local Maternity Board System work and the development workshop taking place in the New Year. You can find out more about the WY&H work here.

Cancer Alliance update

Professor Sean Duffy, who heads our West Yorkshire and Harrogate Cancer Alliance, took part in the keynote question and answer session at this week’s Britain Against Cancer Conference, organised by Macmillan Cancer Support on behalf of the All Party Parliamentary Group on Cancer (APPGC).

The APPGC aims to be the voice in Parliament of cancer patients and their families, and campaigns on multiple issues such as early diagnosis, workforce, rarer cancers and patient experience. On Tuesday, it published its inquiry report into the progress of the 2020 Cancer Strategy for England.

Sean Joined Jo Lenaghan, Director of Strategy with Health Education England; Dr Afsana Safa, GP for NHS Central London Westminster CCG and patient advocate Jo Taylor on the main stage for a panel discussion on the report, chaired by Nick Robinson of the BBC Today programme, who was diagnosed with lung cancer in 2015.

The Cancer Alliance held its first ‘communities of practice’ event this week, sharing ideas, learning and good practice around multi-disciplinary diagnostic centres, part of plans to transform early diagnosis and make more cancers curable. Existing national pilots in Leeds and Airedale were joined by colleagues from Bradford, Harrogate and Mid Yorkshire who have been successful in their bids to the Alliance Capacity for System Change Fund.

What’s happening next week?

  • Supporting NHS and local government partnerships workshop takes place on Tuesday. It has been organised by the Centre for Public Scrutiny (CfPS).
  • The six local place planners will meet on Tuesday afternoon.
  • The first event around supporting unpaid carers will take place on Thursday in Wakefield. This includes guest speakers from NHS England and Carers UK and also Rob Webster and Fatima Khan-Shah, WY&H lead for unpaid carers.