March 2019
Welcome to the latest newsletter from the Together We’re Better health and care partnership.
As we embark on the new 2019/20 financial year, the importance of the next 12 months cannot be underestimated.
The pace has continued to build during 2018/19 and we’ve been pleased with the progress made as a health and care partnership over this time.
It is in 2019/20, however that the work to deliver tangible transformational change properly gets underway with the launch of our 12-week period of public, workforce and stakeholder involvement taking place across Staffordshire and Stoke-on-Trent following the local elections, which will take place on 2 May this year.
This will be a very busy period that will see us talking with and listening to people across both Staffordshire and Stoke-on-Trent – with the feedback helping to shape the development of any proposals going forwards. More information on our involvement plans can be found below.
Alongside this, 2019/20 will see the publication of our Five Year Plan for Staffordshire and Stoke-on-Trent that responds to the priorities and challenges set out in the NHS Long Term Plan.
We are working towards developing a Five Year Plan that is ambitious, but realistic and provides a ‘single line of sight’ for how we will develop into a fully integrated health and care system. We will need your input to help develop and shape this to ensure that it truly reflects our local system and the challenges that we collectively face.
We also need to get a firmer grip on the serious financial challenges that are facing the area. It’s no secret that the financial situation in Staffordshire and Stoke-on-Trent is far from where we would wish it to be. This is clearly not acceptable and needs to be addressed more decisively in 2019/20. The reality of the position in which we find ourselves is fully accepted across all partners and the onus collectively falls on us to tackle this challenge head on. It is important to stress though that this is not just about ‘chasing the money’. We need to make decisions that are clinically sound and in the best interests of local people. Delivering high quality, efficient and effective health care is frequently also the most cost effective.
That does not mean, however that our ambitions should be limited. The work being carried out by our clinically-led programmes to deliver transformational change within the system will continue to play an essential role in the development of our Five Year Plan and achieving our vision of ‘Working with you to make Staffordshire and Stoke-on-Trent the healthiest places to live and work’.
It’s crucial that we continue working together to get this right – it is no less than the people of Staffordshire and Stoke-on-Trent deserve.
Simon Whitehouse, Director
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Ahead of the launch of our 12-week period of public, workforce and stakeholder involvement following the local elections this spring, we are continuing to raise awareness of our work.
A workshop event was held in Stoke-on-Trent on 12 March involving about 20 representatives from Healthwatch, the local voluntary and community sector, patient groups and local government, who provided feedback on our plans for public involvement, also known as pre-consultation.
This pre-consultation will be clinically led and focus on the following areas:
- Developing a new vision for health and care across Staffordshire and Stoke-on-Trent
- Simplifying urgent and emergency care
- Reviewing Community Hospitals in South Staffordshire
- Identifying additional priorities that will deliver clinical and financial stability.
Our NHS and local government partners are continuing to hold conversations with staff using a workforce involvement toolkit that supports consistent messages and helps staff to give early feedback.
A total of 11 face-to-face public involvement events are to be held, with one each in the boroughs and districts of Staffordshire and three in Stoke-on-Trent to take account of its population size. Public roadshows will also be held across the county in areas of high footfall, such as shopping centres and supermarkets.
Alongside this, roadshows will take place in key buildings for health and care staff and focus groups held with community and voluntary sector groups and organisations. We will also be actively meeting with a range of voluntary/community sector organisations, patient networks and protected characteristics groups, while people will be able to share their views by completing a survey (both online and hard copy).
We are working on updating our Case for Change document, first published in March 2016 while a public facing Issues Paper is being developed to support pre-consultation and provide further detail and background information. In addition, we are continuing discussions with NHS England about the assurance process to make sure we are following national guidance and best practice.
In preparation for the launch of our pre-consultation engagement, we have been running a series of workshops for our programme leads to help develop new models of care. These stress test workshops were designed to identify any interdependencies between the programmes and support a system-wide approach to transformation.
You can find out more information about our involvement plans on our website www.twbstaffsandstoke.org.uk.
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Valuable feedback at latest Local Representatives workshop
Our Local Representatives continued to provide a strong independent voice at the latest face-to-face workshop session.
As well as discussing the role of Local Representatives over the next 12 months, the workshop also featured a session to help shape the conversations we will be having with the public, workforce and stakeholders on simplifying access to urgent and emergency care in Staffordshire and Stoke-on-Trent.
The views, experiences and other feedback provided on the day by members was extremely valuable and will help the Urgent and Emergency programme with their preparations for the public involvement due to commence following the local elections this spring.
Local Representatives come from all walks of life, including existing Patient Participation Groups, Healthwatch members, local community advocates and school governors. They are passionate about delivering real change and improving health and care services for local people and are a vital conduit between local groups/organisations and communities and Together We’re Better – feeding back on the views, comments and ideas they receive.
For more information about Local Representatives, including how to get involved, please visit www.twbstaffsandstoke.org.uk/get-involved/local-representatives.
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Combined Healthcare is rated as "Outstanding" by Care Quality Commission
North Staffordshire Combined Healthcare NHS Trust is delighted and proud to announce that the Care Quality Commission have awarded the Trust an overall "Outstanding" rating - the highest overall rating they can award.
The news means that Combined Healthcare is 1 of only 2 specialist mental health Trusts in England with an overall 'Outstanding' rating.
The CQC rated Combined Healthcare as Outstanding in Caring and Responsive domains. It was rated Good in Safe, Effective and Well-led domains.
Enhanced Primary and Community Care programme
From Steve Grange, Programme Director
We’ve been working particularly closely with the Urgent and Emergency Care programme over the past few weeks on a number of high impact initiatives centred around integrated urgent care and reducing urgent activity and attendance at A&E relating to care home residents, frail elderly patients and patients with more than one long term condition. We’re also working in tandem with the Planned Care and Cancer and Mental Health programmes, particularly around bridging the gap between physical and mental health.
A steering group has been established to monitor progress on the delivery and formation of Primary Care Networks (PCNs) within Staffordshire and Stoke-on-Trent. The delivery of PCNs – networks of GP practices – is one of the priorities set down in the NHS Long Term Plan and the steering group will also be overseeing the development of our primary care strategy.
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Planned Care and Cancer programme
From Duncan Bedford, Programme Director
We’ve been focussed over the past couple of months on refreshing both our governance structure and priorities going forwards. Alongside this, we have identified a number of high impact initiatives where change can be delivered quickly, including achieving a reduction in unnecessary outpatient appointments first and follow ups at local NHS service providers.
We’re working on developing alternatives to pre-assessment outpatient appointments to avoid patients having to unnecessarily come in to hospital for tests – for example, blood tests, ECGs, lung function tests – where this is clinically appropriate. We’re also seeking alternative out of hospital services to meet the needs of new and follow up patients and are working on developing new pathways for priority specialties to determine when, where and how often we will have contact with patients.
By working in a smarter and more efficient way, this will lead to a reduction in the number of hospital visits for patients, release more capacity in the system and help to improve waiting times.
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Mental Health programme
From Jonathan O'Brien, Programme Director
We are currently looking at how we can deliver better services for the most vulnerable people who use services in our main hospitals when their need is for mental health support or help with alcohol addiction. We’re aiming to work with community services to provide joined up care for people who have attended Accident & Emergency several times over a short period. People will be supported by a team of skilled staff who will give treatment and advice to enable them to manage their health and improve quality of life. This expands on the successful High Volume and High Intensity User services which are already delivered across parts of the system. We are also planning to provide a better link from A&E to specialist alcohol services so that people can be supported at an earlier stage and begin their recovery journey in a more planned way.
Specialist Learning Disability services are undertaking a review of how people can be discharged quickly from hospital and return home. The Children and Young People’s Trailblazer project is progressing well and has started to make progress connecting to schools across North Staffordshire and Stoke-on-Trent. We've recruited 30 trainees and nearly 20 support staff, who will be able to support pupils experiencing difficulties with their mental health.
Local people can now receive urgent and intensive mental health care without the need to go outside of Staffordshire for bed-based care. North Staffordshire Combined Healthcare NHS Trust and Midlands Partnership NHS Foundation Trust are working together to make out of area treatment unnecessary so links with family and loved ones can be maintained and access to recovery services made easier.
Finally, the programme is changing its leadership due to the current Chief Executive of Combined Healthcare, Caroline Donovan, leaving to take up her new post as CEO of Lancashire Care NHS Foundation Trust. Peter Axon, Combined Healthcare’s new Chief Executive will take the programme forward from April as Senior Responsible Officer.
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Maternity, Children and Young People programme
Maternity update from Heather Johnstone, Programme Director for the Maternity Transformation Programme
I’m delighted that the Staffordshire and Stoke-on-Trent Maternity Transformation Programme has launched a campaign aimed at raising awareness and destigmatising perinatal mental health issues. Increasing the provision of perinatal mental health services is a key part of the programme, and this campaign will go some way in helping signpost people to the services that can help them.
Alongside the great work that is being carried out locally by mental health service providers, we're working to increase the level of support available and raise awareness of what is an important issue in Staffordshire and Stoke-on-Trent. More information about perinatal mental health, the support available locally and the wider campaign is available on Together We're Better's perinatal mental health web page here.
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Workforce programme
From Greg Moores, Programme Director
Staffordshire and Stoke-on-Trent has been leading the way nationally with the pioneering Staffordshire Physician Associate (PA) Internship, the first initiative of its kind to offer placements for groups of PAs within primary and secondary care along with a structured teaching programme. Led by the North Staffordshire GP Federation in partnership with local NHS provider trusts and a number of GP practices, we’re delighted the programme has been shortlisted in the ‘Primary Care Initiative of the Year’ category in the national HSJ Value Awards. The Federation is holding a Physician Associates in Primary Care Conference on Thursday 13 June at Keele Hall, Keele University. The conference will explore the current climate, showcase the role of PAs and the opportunities for them within primary care.
In other news, we’ve been working to develop a framework for the retention of health and care staff alongside a toolkit to include best practice and case studies from partner organisations. The Staffordshire and Stoke-on-Trent Talent Academy will soon be going live on Together We’re Better’s website, including an STP careers advice and support service – the New Horizons Careers Hub – which is being developed with partners to retain and attract existing and future workforces within Staffordshire and Stoke-on-Trent.
Finally, we’re really pleased a Health and Care Graduate pathway has been developed with our partners to improve the entry of young people into health and social care careers, with the plan to have first cohort in place by September 2019.
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