Hello my name is Rory…
Welcome to my first blog for West Yorkshire and Harrogate Health and Care Partnership.

I lead a Healthwatch organisation that works in Kirklees and Calderdale, and represent local Healthwatch on the West Yorkshire and Harrogate Health and Care Partnership Leadership Group.

You can find out more about Healthwatch here or by watching this short film where my colleague Nichola Esmond (CEO for Wakefield Healthwatch) explains more about what we do.

I am passionate about the idea of a changed relationship with our communities, one that see’s people not as consumers of health and care services, but as equal partners who are able to make a vital contribution to the challenges we collectively face.

The idea of a changed conversation and relationship with people, patients and carers in our communities has been raised across a number of our programmes of work over the last 18 months.

For example:

Last autumn, Cormac Russell (Nurture Development) urged us to start to see communities as assets that can generate their own health, as opposed to consumers that need to be provided with services and solutions. Cormac helped us to further develop our understanding of seeing communities as assets that exist in our local ‘place’. He wanted us to further understand what’s really important to people, and that it’s the development of “community” itself that will support resilient, empowered and healthy citizens.

In January 2018, The Kings Fund wrote that ‘Future models of community-based care should support people to take control of their own health as far as possible. This might involve encouraging people to lead healthier lifestyles, improving their understanding of their health or supporting them to manage long-term conditions’.

So we seem to have some agreement that a changed relationship with people, patients, carers and our communities is something we want and need.

In October 2017 the York Health Economics Consortium advised us that changing how people access services and manage their health conditions is a fundamental element of the change we need to make. The big question is ‘how do we change the nature of our relationship with the 2.6 million people living across our area and at pace?’

Last year we explored whether we could use social media as a vehicle to reach out and have different kinds of discussions with some of our communities in Kirklees. In partnership with public health colleagues in Leeds and Kirklees, we explored the use of social media to #changetheconversation about health, wellbeing and what really makes us healthy. You can read how we get on in this draft report here. Although it doesn’t contain all of the answers, it does at least start to address the question and gives us a methodology to build upon.

My key reflection from the work is that we need to start seeing communications, engagement, and public health communications differently. That they are tools which can be used to open up genuine reciprocal, relationships that recognise people as assets.

It could be argued that on some occasions we’re too rigid - we engage – or we send a message – or we run a campaign.

We need to be more flexible - overlapping engagement and communication strategies that put public health and preventing ill health at the core of what we do, actively listening to what people really want, not just what is available or on offer. We need to make sure our messages align with, and contribute to wider determinant strategies, around education, housing, transport, education and employment.

Leeds GP Andy Sixsmith calls this changed relationship between people, councils and the NHS ‘the most important transformation’ adding ‘we will just keep adding sticking plasters until that happens’. Whatever form this transformation takes, whether by social media or social movement, we need to make sure that we don’t forget how critical it is to our partnership’s success.

Thanks for reading and have a good weekend.


What else has been happening this week?

The Clinical Forum

The Clinical Forum met on Tuesday. The forum is chaired by Dr Andy Withers and includes GPs, medical directors, and directors of nursing. Representatives from the Ambulance Services, NHS England and Academic Health Science Network also attended. There was a discussion around the refresh of the terms of reference for the group and how this links to the development of the memorandum of understanding. There was also a presentation on insight around diabetes and cardiovascular disease and a discussion around the opportunities this brings to improve care by sharing learning from other areas; for example in Blackpool they are improving the detection and treatment of hypertension; the use of telehealth in Stockport and further identifying those at risk of CVD, for example through the Bradford Healthy Hearts work. Addressing health inequalities is a key part of this work. There was also an update from Dr James Thomas on elective care and standardisation of policies. You can read more about this in last week’s blog.

Joint Committee of the 11 Clinical Commissioning Groups

The Joint Committee met on Tuesday. The Joint Committee is chaired by Marie Burnham, an independent ‘lay’ chair and has two lay members, Fatima Khan-Shah and Richard Wilkinson. There was an update on the proposed Cancer Alliance framework to support and empower local cancer leads develop ambitious, but realistic plans to improve our offer to people affected by cancer. The framework has a clear focus on improving outcomes for patients - based on our priorities which are: prevention, diagnosing early, screening, rapid access, high quality services, living with and beyond cancer, and patient experience. The commitment to ensure the views of the public and people affected by cancer are fundamental to all levels of Alliance activity was restated. This was also discussed with the West Yorkshire and Harrogate Association of Acute Trusts CEOs earlier in the day.

Leadership group

The leadership group also met on Tuesday. This includes leaders from across the partnership including hospitals, councils, clinical commissioning groups and voluntary organisations. The meeting was chaired by Rob Webster, our partnership CEO lead. There was a discussion around the development of the memorandum of understanding; next steps for our partnership and forward planning. Rob talked about the NHS England planning guidance and highlighted the role of health and care partnerships (also known as STPs) within this.

Ian Holmes, WY&H HCP Director, updated people on our journey to become an integrated care system and the move towards greater flexibility and autonomy.

Robin Tuddenham (CEO for Calderdale Council), gave a presentation on local government priorities and explained what is meant by universal services ‘everyday, everyone’ and the importance of sustainability, workforce and the economy. He also emphasised the role of Overview and Scrutiny as a helpful sounding board.

Emma Fraser (Mental Health Programme Director), gave an update on the work taking place across WY&H, including out of area placements for people in crisis, and how working together across the Partnership brings together the collective expertise of the region’s NHS mental health providers - Leeds Community Healthcare NHS Trust, South West Yorkshire Partnership Foundation NHS Trust, Bradford District Care NHS Foundation Trust and Leeds and York Partnership Foundation NHS Trust.

We also heard from colleagues on learning from some of the Vanguard (pilots) work which has taken place across WY&H, including Airedale, Wharfedale, Bradford District and Craven, who talked about integrating local care in partnership with voluntary organisations. There was also a presentation about Connecting Care Wakefield around transforming local care. This joins up health, social care, voluntary and housing through two Hubs based in the east and west of the Wakefield 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. If you would like to attend the team’s‘Show and Tell’ event next week please register here.

Amanda Bloor (Chief Officer for Harrogate and Rural District Clinical Commissioning Group) and Richard Webb (North Yorkshire County Council) and Roz Tolcher (Chief Executive, Harrogate & District NHS Trust) also gave a presentation on Harrogate District Partners Vanguard Programme – ‘what matters to us’.

Cancer Alliance

Lynda Thomas, Chief Executive of Macmillan Cancer Support, visited West Yorkshire on Monday with a packed itinerary at the Bexley Unit of St James’ Hospital in Leeds. She met Sean Duffy, Carol Ferguson and Amanda Bloor (Cancer Alliance Lead, Programme Director and Board Vice Chair); Julian Hartley and members of the Leeds Teaching Hospitals Trust Executive team; members of the Yorkshire Cancer Patient Forum and the Macmillan award-winning speech and language therapy team supporting head and neck cancer patients at LTHT. You can read more here.

Urgent Care and Emergency Programme Board (UCEPB)

Following the leadership workshop at the beginning of winter, colleagues have been working to identify five changes that we feel would make a difference to sustainable performance improvement if adopted across West Yorkshire and Harrogate. Workforce is one of the key areas with the view that we could develop an alternative model to the current medical model for urgent care (including the A&E Department) which is competency based not professional constrained and facilitates better flexible use of this between primary and secondary care.

West Yorkshire and Harrogate Lay Member Assurance Group

The group will meet today (Friday) to receive an update on the work of mental health and WY&H business intelligence. This was the last meeting chaired by Graham Prestwich. Special thanks to Graham for all his hard work and commitment to the development of the group since. Graham is keen to continue with his work to champion public, patient involvement and we hope to be working with him again very soon.

Update on STP, and clinical leaders session

Rob Webster (CEO Lead for the Partnership), Dr Andy Withers (Clinical Lead for the Partnership) and Jo Harding, Director of Nursing at Leeds Clinical Commissioning Groups attended the STP leaders and clinical lead session on the 1 February. Attendance at the session was high – and there is a real appetite for learning and peer-to-peer networking across the 44 STPs. It is clear from the session that there is a lot of common ground between the different systems, and so the sharing of experience and lessons learned is of immense value.

What’s happening next week?

  • Local place base planners will meet on Tuesday.
  • The memorandum of understanding editorial group will meet on Wednesday.
  • West Yorkshire and Harrogate Health and Care Partnership programme leads meet on Thursday.