2018 brings with it a stronger partnership way of working .…

We wanted to take this opportunity to wish you a happy new year and to share with you the work we are doing in Wakefield to better meet the health and care needs of local people. This means that the way we work together in Wakefield is changing so that we achieve one joined up health and care system across the area to make outcomes better for everyone.

Through Wakefield’s Accountable Care Partnership model the Wakefield system are ensuring a clearer vision for health and care, which will lead to a credible, locally managed system with transformation resources used collectively to strengthen our communities.

It has been agreed locally to develop a defined Strategic Leader of Health and Care Transformation and Integration who will work in partnership with the Chief Executive of the Local Authority (Merran), to ensure that both Wakefield Clinical Commissioning Group and Wakefield Council are working towards a fully integrated health and care system for our area.

Jo will take on this role and will become a member of the council’s senior management team on behalf of Wakefield Council and Wakefield Clinical Commissioning Group. Jo will lead on a number of change management programmes to support and design the strategic commissioning of all health and care services across the District. This new role will help to ensure there is a strong culture of developing the right skills and encouraging the values and behaviours we need to move positively forward.

A key part of the work Jo will do is about ensuring we work seamlessly with West Yorkshire and Harrogate Health and Care Partnership - recognising the benefits of working across a wider system to achieve great outcomes for those we serve locally and at West Yorkshire and Harrogate level.

We are supportive of a West Yorkshire and Harrogate Accountable Care System and the benefits this brings in terms of flexibility and more freedom – whilst recognising that the wider West Yorkshire and Harrogate plan is built from our six local places area plans, which Wakefield is one.

In addition, we have created a successful partnership board in Wakefield to develop new ways of delivering care and are making good progress on our Wakefield Health and Wellbeing Plan. This describes not only what we intend to do but also the principles by which we intend to work together with our communities. This recognises that health and wellbeing encompasses many factors, including where people live, housing, education, employment, and household income.

What this means in practice is the bringing together of commissioners (who buy health and care services) and care providers so that everyone has oversight and ownership of shared priorities.

Wakefield have illustrated their commitment to investing in our voluntary community sector as part of our new model of care and this has been evidenced by the recent award of the Hospital to Home Service to Age UK Wakefield District who will take this service forward for the area.

Paula Bee, CEO of Age UK Wakefield District said ‘working together has enabled us to ensure that some of our most vulnerable older people living in the district are able to access local lower levels of support as part of our integrated offer.’

A committee in common for this work has been established and is underpinned by a virtual Alliance Agreement involving twelve organisations, including GP practices and the voluntary sector. The Agreement aims to ensure that leaders from across the system work together to give local people the right care at the right time, in the right place, delivered by the right person.

You can see the difference our partnership is already making through the Connecting Care Hubs, which joins up health, social care, voluntary and housing through the two Hubs based in the east and west of the district. What makes the Hubs such a success is the fact they are aligned to five GP networks. These are supported by adult community nursing teams, therapists, community matrons, pharmacists, social workers and other community organisations such as Carers Wakefield and District etc.

The Hubs offer a wider health and social care service which includes crisis intervention, to prevent avoidable hospital admission. This not only frees up valuable specialist care so that hospitals can do what only they can do, but is also more cost effective and most importantly delivers better health outcomes for people.

This way of working has led to 1,000+ fewer people being admitted to hospital every year and importantly offers people a seamless service, so they don’t have to tell their story more than once and can get the help they need in, or closer to home. Supporting unpaid carers is a key part of the way we work. There are over 36,000 carers in Wakefield, many providing over 50 hrs of care a week - making sure they are well supported to care for family and friends is a priority to us.

Connecting Care also delivers one of six Enhanced Care Home Vanguard (pilot) sites in the country. The vanguard (pilot) tackles loneliness and fragmented care by joining up services for older people. There are 27 care homes and six extra care facilities within the vanguard and in 2018 this will be expanded. Last year we saw reductions in A&E attendees; ambulance call outs reduced by 5%, with a 28% reduction in hospital bed occupancy and 13% in emergency admissions.

As part of Connecting Care and with funding from Age UK Wakefield and District, we also piloted the ‘Red Bag’ scheme across care homes in partnership with care home managers, Yorkshire Ambulance Service and Mid Yorkshire Hospitals NHS Trust. Each participating care home is given a Red Bag to keep information about a care home resident's health in one place. The bag remains with the person whilst they are in hospital until they return to the care home – making the transfer of care easier for all involved.

Moving forward we will continue to develop Connecting Care Wakefield District, to deliver more innovative care closer to home.

Through our innovative approach to mental health we now have mental health navigators within Wakefield District Housing helping people to navigate their way around health and housing services. We have also launched a new initiative which sees mental health nurses working with police in the Wakefield control room to enable officers to provide a more appropriate response to people who present with mental health issues.

We are also bringing together public health officers alongside regeneration and planning colleagues to ensure we keep in view the 'broader determinants of health', e.g. housing, employment and economic hardship. Our Health and Wellbeing Board partnership now reflects these priorities in the Board’s wider membership, which includes the fire service and the police.

We also recognise the importance of working with locally-elected representatives, such as MPs, and our local councillors are already engaged, and will continue to be so as part of our conversations around issues which may impact on their communities. This is especially important when you consider the significant health and care challenges we face, for example the number of people living across Wakefield District is expected to both grow significantly and demographically change by 2036. You can read more about the needs of our communities in Wakefield’s Joint Strategic Needs Assessment here.

Moving forward in our quest to have one joined up health and care system, we will have one strategic leadership team, working to agreed commissioning principles to support single commissioning arrangement with one set of shared priorities owned by the Health and Wellbeing Board. Therefore what we hope people will see over the coming months is evidence of the leadership trust across our partnership.

We know that our staff are our biggest asset, and as demonstrated in our connecting care approach, they will continue to work together to share their knowledge and skills, so that we can improve quality and importantly identify and address people’s needs sooner rather than later – so that ultimately the cost of care is less and the positive impact on people’s lives is greater.

By working more closely together we can put people, rather than our organisations, at the centre of what we do, and make sure we use all our resources – skills, expertise, money – for maximum positive impact across Wakefield, and our wider WY&H work. Our ultimate goal is to make sure everyone in Wakefield has a great start in life, and receives the support they need to stay healthy and live longer.

Have a good weekend

What else has been happening this week?

Clinical Forum

The Clinical Forum met on Tuesday, Chaired by Dr Andy Withers. The forum includes GP Chairs from the Clinical Commissioning Groups, medical directors, ambulance service reps and lead nurses.

At the meeting Carol McKenna (one of three senior responsible officers leading the WY&H maternity work - the other two are Anne-Marie Henshaw and Suzanne Hinchcliffe) and Karen Poole (the programme lead) gave an update on the work of the Local Maternity System Board, including the development of a multi-agency plan which includes pre-conceptual care.

The plan has been produced in partnership with women and further engagement work with them and their partners will continue. The plan covers personalised care, safer care, and continuity of care, working across boundaries and multi-professional working. Recruitment, retention and supporting staff is a key part of the plan. Clinical summits are being planned and work will take place to communicate and engage with all partner staff in the near future. It was agreed an update on the work would be brought back to the Clinical Forum later this year.

Anthony Kealy, from the core team, updated forum members on the development of the partnership’s memorandum of understanding (MoU) and Fatima Khan-Shah the WY&H lead for unpaid carers gave a presentation on the work to date. This included an overview of the four work streams: workforce, young carers, hospitals and primary care. 1 in 8 of us will become a carer for family and friends at some point in our life. There are around 240,000 carers across WY&H who have identified as being a carer with an estimated 20,000 who don’t see themselves as such. I in 9 carers are employed and it is important that there is employee and peer support to enable people to remain in work. This is not only very important for their wellbeing, but for their household income and local economy too.

A conversation followed about the role of clinicians as community carer champions at both a local and WY&H level so together we can continue to learn from good practice and have a broader strategic approach. There was a willingness from forum members to further support this important agenda.

West Yorkshire and Harrogate Joint Committee of the 11 Clinical Commissioning Groups

The Joint Committee met in public on Tuesday. This is chaired by Marie Burnham (lay member independent chair). You can access the papers and watch the meeting on film here.

The Committee heard from Professor Sean Duffy (the clinical lead) and Amanda Bloor (Chief Officer for Harrogate and Rural District, Clinical Commissioning Group and the commissioning senior responsible officer) for the WY&H Cancer Alliance Board. Amanda praised the partnership commitment and passion to deliver improved outcomes at a WY&H and local level.

Professor Duffy talked about how the collective agreement to work as one of 19 national alliances has enabled £14 million investment into WY&H. The Alliance is made up of many partners from across health and care, including the voluntary, community and charitable sector, such as MacMillan. A communication and engagement plan has been developed, which sets out clearly how we will engage effectively with people, whilst making the most of the good awareness raising material we already have available to target early intervention and prevention. This includes support for unpaid carers and the teenage cancer work in schools.

Tobacco control is important to achieving our ambitions for preventing cancer and Sean explained how we need to ensure we make the most of a partnership approach in terms of making every contact counts. Sean concluded that high quality services are also about multi-disciplinary teams; evidence based clinical guidelines, scoping development of chemotherapy delivery models and networked radiotherapy services.

Two short films were shared at the meeting, one from the event held late last year – which showed the impact of cancer care on people and the other from Caroline Raw who talked about the importance of awareness raising for bladder cancer.

Executive leadership group

Our partnership executive group met on Tuesday. This includes representatives from all sectors including councils, health services and voluntary and community organisations. The group received an update from Jonathan Webb, WY&H HCP finance director on the draft financial plan. We are the 2nd largest health and care partnership in England with a £5.5 billion budget. Jonathan led a conversation on how we make the most of the resources we have available at a local and WY&H level given the financial challenges we are collectively facing so that we have one credible plan. This will be discussed at a meeting later this year.

Other items on the agenda included a conversation led by Tom Riordan (CEO Leeds City Council) and Anthony Cooke (Chief Officer for Health Partnerships, Leeds City Council) around strengthening the relationship between health and local government. Tom and Tony talked about the benefits of co-production in terms of providing the best outcomes for everyone, and the importance of physical and mental health not being seen in isolation of housing, education and employment.

Engagement and conversations with the public and local politicians is key to working together effectively and will continue.

The development of the memorandum of understanding (MoU) and communications to support the work to become an ‘accountable care system’ was also discussed. Whatever title is given to the way we do business, this is about far more than just a name. We are proud to be the West Yorkshire and Harrogate Health and Care Partnership. Our commitment remains the same and our goal is simple - we want everyone in West Yorkshire and Harrogate to have a great start in life, and to receive the support they need to stay healthy and live longer. We remain committed to tackling health inequalities and to improving the lives of the poorest, the fastest.

WY&H programme lead meeting

The WY&H programme leads met this week to discuss the development of the memorandum of understanding (MoU) and work on mental health, stroke and urgent care etc.

NHS Smokefree pledge

MPs in Westminster heard this week how the NHS and local councils across WY&H are joining forces in a trailblazing approach to reducing the prevalence of cancer. Cancer is the biggest cause of death from every illness in every age group in West Yorkshire and Harrogate, expected to affect one in two of the population born since 1960. There are currently more than 330,000 smokers in the area, and lung cancer is the most common cancer affecting local people. Professor Sean Duffy, who leads our Cancer Alliance, was invited to speak at a Parliamentary launch of the NHS Smokefree pledge as a result of the specific approach being taken in the West Yorkshire and Harrogate area. You can read more here

What’s happening next week?

  • Local place based planners meet on Tuesday.
  • The Standardisation of Polices programme will meet on Wednesday.