Welcome to the latest newsletter from the Together We’re Better health and care partnership.

It is an exciting time as we head out across Staffordshire and Stoke-on-Trent to listen to the views of patients, carers, staff, stakeholders and the public on what works well, what should be improved and what is important when it comes to health and care locally.

There has been a lot of work by each of our partners to reach this point since we first published our Sustainability and Transformation Plan at the end of 2016 – matched by the tireless work being done each day by thousands of dedicated staff.

Likewise, the health and care landscape has also changed in that time – most recently with the publication of the NHS Long Term Plan.

We, alongside other Sustainability and Transformation Partnerships across the country, are being asked to produce a refreshed Five-Year Strategic Plan that outlines how the priorities set down in the Long Term Plan will be implemented locally. We are also about to embark on the process of developing proposals to the challenges we face across the system upon which we will ultimately formally consult people about. Part of this conversation is also about revisiting the plan that was produced in 2016 and the proposals that were contained within it.

In order to achieve these two aims, it’s important that we hold a single conversation across Staffordshire and Stoke-on-Trent – one that seeks views on broad-reaching themes that align to the Long Term Plan’s ambitions and results in viable options for transformational change that are financially and clinically sustainable in the longer term.

The areas where we know we will need to make most significant change are where we will focus, but not limit the conversations, and we will use the feedback received to inform both the Plan and the Pre-Consultation Business Case. Whilst the health and care partners across the system will play a full role in this conversation, it is the Clinical Commissioning Groups that have the statutory responsibility for formal consultation in our system, as per the 2012 Health and Social Care Act.

These areas of focus are:

• Simplifying the local urgent and emergency care system
• Developing a new vision for health and care in Staffordshire and Stoke-on-Trent that is focussed on high quality community based care centred on the patient – this will include maternity services, mental health services and planned care (surgery and outpatients)
• How the local health and care system can embrace and fully utilise new technology and ensure the buildings we deliver services from are fit for purpose
• Reviewing the use and function of the community hospitals in South Staffordshire
• Exploring what ‘integration of health and care services’ really means for local people
• Identifying additional priorities that will deliver clinical and financial stability.

This conversation launches today (3 June) and over the course of 12 weeks will include a series of public and staff listening events held in each district across Staffordshire and Stoke-on-Trent and a raft of roadshows in clinics with service users and in public places such as supermarkets and leisure centres (more details on these are below).

People will be able to share their views by completing a survey, both online and hard copy, and we will also be meeting with a range of voluntary and community sector organisations.

This work builds on the recent survey run by Healthwatch Staffordshire and Healthwatch Stoke-on-Trent that sought views on the key priorities of the Long Term Plan.

In order we get this right it’s crucial that we do all we can to encourage our patients, service users, colleagues, stakeholders and followers to get involved and make their voice count.

The NHS Long Term Plan sets out our path towards becoming a fully Integrated Care System and, as part of this the Clinical Commissioning Groups (CCGs) in Staffordshire and Stoke-on-Trent are exploring proposals with their GP membership and the public to become a Strategic Commissioning Organisation. I would encourage you to share your own views about this and more information about this can also be found below.

Simon Whitehouse, STP Director

As outlined above, our 12-week public conversation has launched today. As well as helping us to develop proposals for change, it will also support the development of our Five Year Strategic Plan in response to the challenges set down in the national NHS Long Term Plan.

Survey

A survey seeking the views of local people is available electronically via our website at www.twbstaffsandstoke.org.uk. Hard copies and an easy Read version are available on request.

Public listening events

As part of this public conversation, the following listening events are being held across Staffordshire and Stoke-on-Trent:

Public roadshows

The following public roadshows are being held across the county in areas of high footfall:

Staff listening events

Due to space restrictions in each of the venues, we ask that you book a place by clicking on the relevant link and following the process:

Staff roadshows

Other involvement

We are holding focus groups and meeting with a diverse range of voluntary and community sector organisations, patient groups and stakeholders to talk about the public conversation and receive their feedback.

Our public-facing Health and Care in Staffordshire and Stoke-on-Trent document provides further detail and background information. A summary document has also been produced, with both available to read on our website.

UHDB Chair John Rivers to retire at end of July

University Hospitals of Derby and Burton NHS Foundation Trust (UHDB) Chair John Rivers CBE DL will be retiring at the end of July 2019 following more than 10 years of NHS service. We would like to take this opportunity to thank John for his support during his time as Chair and wish him all the best in his retirement.

During this time John has overseen a transformation in care since the new Royal Derby Hospital opened and the merger between Burton Hospitals NHS Foundation Trust and Derby Teaching Hospitals NHS Foundation Trust. In John’s tenure, the trust has grown to become one of the largest university teaching hospitals in the country.

Governors at UHDB have successfully recruited a new Chair. The appointments at foundations trusts are made by representatives of the trust’s Council of Governors, who are elected from the wider membership or from the trust’s staff, or appointed by key stakeholders.

Dr Kathy McLean OBE has been appointed as Chair of the Board from 1 August 2019. Until recently Kathy held a national role as a member of the Board of NHS Improvement as Executive Medical Director and Chief Operating Officer.

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Prevention programme

From Dr Paul Edmondson-Jones, Programme Director

Following the successful refresh of the programme, we are excited to share a set of areas we are proposing to focus on over the next three years. Following collaborative conversations across a number of health and care partners involving key stakeholders, the Together We’re Better Health and Care Transformation Board has now approved a series of programme priorities. The programme’s plan is to tackle the following four areas through a delivery programme of small to large-scale transformational change - Cardiovascular, Locomotor,  Respiratory and Wellbeing. Each area has four sub areas. You can read more about these areas by clicking on the 'read more' link below. 

The programme will also focus on two major enabling areas of work – Population Health Management and Social Prescribing. Both already have a significant work programme in place and we will update you in a later newsletter on these areas in more detail.

To help us deliver this change and make a difference to health inequalities and outcomes we will use existing evidence from the likes of NHS RightCare and local Joint Strategic Needs Assessments to tell us where we need to prioritise our focus. In addition, we will work with existing Together We’re Better work programmes, Public Health Teams, Primary Care Networks, voluntary organisations and local communities to enable the change.

We will shortly be identifying the areas where we can have an impact relatively quickly and as soon as we do, we will share these with you.

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Mental Health programme

From Jonathan O'Brien, Programme Director

The first wave of our successful trailblazer service was launched in April following the extra national funding received to develop school and college-based mental health support in North Staffordshire and Stoke-on-Trent. We have submitted a second proposal for September 2019, which would offer the same service for children and young people in the south of the county and spread this great initiative.

We mentioned in out last update that we are hoping to start some new ways of working which will increase efficiency and improve people’s experiences of care and support. Further progress has been made and we hope they will be in place by the end of the summer. They are:

• Support for people who are frequent attenders to accident and emergency departments
• Getting people into specialist treatment for their alcohol problems will mean that there is a greater chance of success in reducing their need for alcohol in the future
• The third service we are keen to introduce is to support people with learning disabilities to live as independent a life as possible, living in their usual communities and ensuring the support they receive is of the right quality.

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Planned Care and Cancer programme

From Duncan Bedford, Programme Director

In our last update, we talked about high impact initiatives that have been identified as areas where change can be delivered quickly. We previously spoke about how we are working to achieve a reduction in unnecessary outpatient appointments and follow ups at local NHS service providers. For this update, we wanted to focus on the work we are doing as a programme on Gastroenterology.

Gastroenterology is a medical speciality which focuses on the digestive system and includes the study, diagnosis and treatment of diseases affecting the gastrointestinal tract. These may affect the esophagus (swallowing tube), stomach, small and large intestine, rectum, liver, gallbladder or pancreas.

Within Staffordshire and Stoke-on-Trent, our workforce have been struggling to meet the demand for this speciality service. We’ve been working to identify a number of initiatives to benefit both patients and staff whilst also helping to reduce waiting times. We are working on developing a Clinical Assessment Service for all Gastroenterology referrals that is delivered by Gastro Consultants and provides advice and guidance to staff working in primary care services, with the aim of reducing unnecessary hospital attendances. This will be supported by diagnostic tests available in primary care that are less invasive than traditional procedures.

We will be particularly focussing on preventative interventions, such as Gall Bladder Disease to ensure appropriate services are in place in a timely manner to reduce the number of people having to attend A&E whilst waiting for treatment.

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 into the system and help to improve waiting times. It also means patients will be seen and treated in a timely manner and are not unnecessarily in pain for long periods of time before receiving their procedure when required.

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Maternity, Children and Young People programme

Children and Young People update from Helen Riley, Senior Responsible Officer for Children and Young People

In my first update for the newly formed Children and Young People part of the programme, I shared the priorities we had developed to date based on our Joint Needs Assessment and that we planned to share these priorities with our partners. If you recall these priorities are:

• Reducing demand across both health and social care services with a focus on the most vulnerable (looked after children in need)
• Embedding a preventative approach with a focus on early years, positive parenting and early interventions
• Work across the system to improve pathways and transition points for children with complex health needs.

In April we engaged with representatives from Staffordshire’s Young People’s Forums to test out the priorities. We have also held a workshop with the Together We’re Better Clinical Leaders Group this month where we received very positive and constructive feedback, alongside suggestions on how we can join up local government approaches to place-based working within the new Primary Care Networks and Integrated Care Teams.

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Workforce programme

From Greg Moores, Programme Director

The programme team have been focusing on several projects across the health and social care system since we last updated you. Firstly, workforce listening events are scheduled throughout June to July 2019. Events will include roadshows, organisational engagement events and cross sector events, and there will also be an opportunity to complete a survey. The team will be engaging with staff and listening to how they feel service provision is currently working well, what can be improved and what’s important to them. More information is available on Together We’re Better’s website at www.twbstaffsandstoke.org.uk.

In terms of the Health and Care Graduate Pathway, two focus groups were held in April with students from Newcastle-under-Lyme College. This presented an opportunity for students to find out more, ask questions and engage with the process, with 43 students having expressed an interest in being considered.

The Staffordshire and Stoke-on-Trent Talent Academy is now live on the Together We’re Better website. We’re excited to showcase working in Staffordshire and Stoke-on-Trent through our three unique user journeys - ‘About Staffordshire’, ‘Want to Join Us?’ and ‘Already Work for Us?’.

Health Education England hosted a New Roles Conference in partnership with Together We’re Better and Shropshire’s STP this month. This was an opportunity to showcase new roles, new ways of working and good practice to support collaboration across the systems.

Finally this month, we’re excited to share that Palliative Care Rotational Apprenticeship interviews have concluded and apprentices have been appointed for several host organisations. Next steps will include finalising exciting placement plans with our partners ready for start dates around September 2019.

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