July 2019
Welcome to the latest newsletter from the Together We’re Better health and care partnership.
The recent publication by NHS England of its Implementation Framework for STPs to provide their Five Year Plans in response to the NHS Long Term Plan has sharpened the focus of the work collectively taking place in Staffordshire and Stoke-on-Trent.
As a system, we are working collaboratively and at pace to ensure our draft is in place by the end of September, with the final submission due in mid-November.
Our work programmes have spent the past few months refining their priorities in line with the Long Term Plan, while there is a collective responsibility and commitment among our partners to work together on a refreshed Five Year Plan that addresses the major service changes outlined in the Long Term Plan, in particular:
- Boosting out-of-hospital care
- Redesigning and reducing pressure on hospital services
- Giving people more control over their own health and more personalised care when they need it
- Mainstreaming digitally enabled primary and outpatient care
- Focusing on population health and local partnerships with local authority-funded services.
Throughout the 12-week listening exercise that launched at the start of June and runs until Sunday 25 August, we have spoken of it being ‘one conversation’ that will not only help the day-to-day improvements being made by our partners and guide any potential system change, but also support the development of our Five Year Plan.
We’ve had the opportunity to listen to the views, ideas and experiences of hundreds of people – including service users, health and care staff, volunteers, stakeholders and the wider public and we’re starting to see a number of themes develop on the services that are working well and those that require further improvement.
We also very much welcome the recent Long Term Plan engagement that has taken place by our partners in Healthwatch Staffordshire and Healthwatch Stoke-on-Trent to gather local views on general health and care services and on specific conditions, such as mental health. It’s a thought-provoking report and we would encourage you to read it by clicking here where you can read the full report, and clicking here for the summary.
All of this feedback will form a foundation stone in the development of the Five Year Plan as we gain a clearer understanding of how the challenges that exist in the local health and care system can be addressed most effectively.
As mentioned, the 12-week public conversation is not yet finished. I would ask that you continue to get involved in sharing your views on local health and care by visiting www.twbstaffsandstoke.org.uk/get-involved/health-and-care to find out more.
In other news, I am delighted that the Suicide Prevention Workstream, which is led by Public Health colleagues in Staffordshire County Council and Stoke-on-Trent City Council and forms part of the Mental Health programme, has secured £300,000 of national funding to support a suicide prevention programme.
This important funding will help to support the work being done in Staffordshire and Stoke-on-Trent to tackle this issue and to work towards achieving the goals of the zero suicide charter that was signed at the regional Together We’re Better Suicide Prevention Conference in Autumn 2018. You can read more on this below.
I'm also really pleased that Staffordshire and Stoke-on-Trent has been chosen as a pilot to spearhead the new NHS High Potential Scheme in partnership with the NHS Leadership Academy. Congratulations and thank you to our Organisational Development and Leadership programme for their hard work on securing this pilot, which is a real feather in the cap for Staffordshire and Stoke-on-Trent. You can read more about this exciting initiative below.
Finally, I'd like to take a moment to say a big thank you and to wish all the best to John Rivers CBE, who is retiring at the end of this month as Chair of University Hospitals of Derby and Burton NHS Foundation Trust. John oversaw last year’s merger between Burton Hospitals NHS Foundation Trust and Derby Teaching Hospitals NHS Foundation Trust, as well as its recent ‘Good’ CQC rating. John’s replacement as Chair is Dr Kathy McLean and I very much look forward to working with Kathy going forwards.
Simon Whitehouse, STP Director
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 In response to public demand, additional listening events were held in Tamworth (29 July) and Stafford (31 July); this followed the listening events that took place in each of these districts in June having been oversubscribed.
As part of the involvement work that has taken place during the public conversation, a total of 13 listening events have been held across each district/borough/city in Staffordshire and Stoke-on-Trent; and 10 public roadshows in busy public areas such as shopping centres, supermarkets, leisure centres and libraries.
We have attended dozens of events and forums with voluntary and community sector organisations, patient groups and other stakeholders to gauge the views of their staff and service users, while also participating in overview and scrutiny meetings held by our local authority colleagues. In addition, listening events and roadshows have been held for our health and care staff.
We are keen to listen to views on any aspect of health and care in Staffordshire and Stoke-on-Trent, but are particularly welcoming feedback on:
- 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 individual – 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.
The 12-week public conversation runs until midnight on Sunday 25 August. More information can be found on Together We’re Better’s website at www.twbstaffsandstoke.org.uk/get-involved/health-and-care.
As well as taking part in listening events and roadshows, we also have an online survey that seeks your views. Hard copies of the survey, including an Easy Read version can also be provided by getting in touch through our Contact Us page.
Our Health and Care in Staffordshire and Stoke-on-Trent document, and Summary document provide more detail about what this is about, why change is needed, the challenges and opportunities locally and the areas we need to talk about.
Healthwatch publishes NHS Long Term Plan report
Healthwatch Stoke-on-Trent and Healthwatch Staffordshire have published a report into local views gathered on the NHS Long Term Plan - focusing on general health and care services and on specific conditions, such as mental health. Click on the link below to take you to a news article that provides further information and links both to the full report and summary.
Primary Care Networks bring GP practices closer together to better serve patients
From the start of July, groups of GP practices across Staffordshire and Stoke-on-Trent are formally committing to working together so that they can better serve patients. They will be joining together as Primary Care Networks (PCNs) – with each PCN typically serving 30,000 – 50,000 patients. Working together brings economies of scale and potentially allows a wider range of services to be offered. [News from Staffordshire and Stoke-on-Trent Clinical Commissioning Groups]
CQC rates MPFT as 'Good'
In its first inspection by the Care Quality Commission, Midlands Partnership NHS Foundation Trust received a 'Good' rating overall and wards for older people with mental health problems were rated as 'outstanding' in the effective domain. The effective domain relates to people’s care, treatment and support. It assesses the outcomes achieved, the quality of life and whether care is based on the best available evidence. [News from Midlands Partnership NHS Foundation Trust]
Dramatic reduction in delayed transfers of care
Figures that show the number of patients who are in hospital beds, even though they are fit to leave, have reached a new low for Staffordshire patients. Figures show that the number of patients in hospital unnecessarily has fallen by over 40 per cent in the last 12 months. They are now lower than they have been for many years and comparable to the rates for Stoke-on-Trent. Officially called Delayed Transfers of Care (DTOCs), it means patients who don’t need to be in hospital are in a bed because the support they need to live at home is not available. Staying in a hospital bed unnecessarily can rapidly lead to Deconditioning Syndrome - serious muscle wastage and loss of confidence – especially for patients who are frail and elderly. [News from Staffordshire and Stoke-on-Trent Clinical Commissioning Groups]
Mental Health programme
From Jonathan O'Brien, Programme Director
We are delighted the Suicide Prevention Workstream, which is led by Public Health colleagues in Staffordshire County Council and Stoke-on-Trent City Council and forms part of the Mental Health programme, has secured £300,000 from NHS England to support a suicide prevention programme.
The funding will help in providing a range of initiatives to support middle-aged men and people who self-harm. Men generally, and middle-aged men in particular, are often the most reluctant group to seek help when dealing with stress and mental ill health. Letting those problems build makes mental health crisis more likely, and suicide is one of the biggest killers of men in our society.
It will introduce a service to increase support for people attending hospital for deliberate self-harm who are at high risk of suicide, as well as patients visiting primary care settings, such as GP practices and pharmacies. It will also enable training to be offered for workplaces, alongside universal and clinical/specialist services to support early intervention in communities.
The Mental Health programme has a zero suicide ambition in Staffordshire and Stoke-on-Trent. Our partners signed a zero suicide charter at the regional Together We’re Better Suicide Prevention Conference in Autumn 2018 and we are really pleased this new funding will help towards achieving that ambition.
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Planned Care and Cancer programme
From Duncan Bedford, Programme Director
Our previous two updates have focused on high impact initiatives identified as areas where change can be delivered quickly. For this update, we focus on how we are working together to provide high quality, efficient eye health (ophthalmology) that ensures service users receive the right care in the right place at the right time and reduces unnecessary hospital attendances. The Ophthalmology transformation work has been divided into three distinct projects:
- A system wide project team is identifying the eye health needs of the population, projected over the next 10 years. This work will inform our approach to designing, planning and commissioning services in Staffordshire and Stoke-on-Trent.
- Significant work has been undertaken to review ophthalmology waiting lists and prioritise by risk, ensuring patients at the highest risk are prioritised. Additional capacity has been made available, resulting in a significant reduction in the waiting list backlog and a significant increase in patients seen within their intended follow up date.
- A comprehensive analysis has been completed which has highlighted any gaps in the provision of care for eye health, identifying areas of the highest demand. Clinical pathways, focused on prevention, will be developed and we will increase community provision, particularly for pre- and post-cataract patients and expand eye services in the community for children and young people.
The aims of these projects are to:
- Promote self-management by ensuring patients are provided with education regarding their condition, treatment and impact this may have on their lifestyle
- Ensure patients receive appointments in the community, where clinically appropriate, reducing demand on hospitals and promoting care closer to home and right care, right place, right time
- Ensure only those patients who need to be seen in specialty clinics are offered face-to-face appointments
- Minimise disruption to patients and carers by offering them a range of alternatives to hospital appointments
- Offer patient-initiated appointments for routine follow-ups where clinically appropriate
- Ensure all patient experiences are reported as positive and that they would recommend the service to family and/or friends
- Support the achievement of reduced waiting times by effectively managing demand for hospital services.
We are expanding the provision within the community by offering Optometrists the chance to undertake additional qualifications that enable them to deliver glaucoma provision.
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Prevention programme
From Andrew Donaldson, Programme Director
Following on from our last update in May, we have been working hard to understand what work is currently happening in each of our agreed priority areas - Cardiovascular, Locomotor, Respiratory and Wellbeing.
This has meant that we have been talking with our partners and existing STP programmes, along with local authority Public Health teams, Primary Care Networks, Clinical Commissioning Groups and voluntary organisations. Through these conversations, we have identified work that will achieve better outcomes with system wide engagement within our six workstreams.
During the next couple of months, we will be engaging and co-designing our delivery plan with localities and wider system colleagues. We will also be aligning with existing evidence from the likes of NHS RightCare and local Joint Strategic Needs Assessments to tell us where we need to prioritise our focus. Our plan is to have a draft ready for sharing and ultimately approval at the Health and Care Transformation Board in October.
What is clear so far is that there are three major strategic priorities with opportunities to deliver quickly across systems:
- Social Prescribing (Supportive Communities)
- Making Every Contact Count
- Population Health Management.
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Organisational Development and Leadership programme
From Linda Holland, Programme Director
Following a great deal of work within the programme, I’m delighted to announce that the High Potential Scheme (HPS) pilot launched in Staffordshire and Stoke-on-Trent on 29 July. HPS is an innovative and exciting new NHS Leadership programme that offers bespoke career development to help high potential, aspiring mid-level leaders accelerate their career to senior health and care roles at a faster pace.
The first of its kind for the NHS and not offered nationally until late 2020, HPS has been developed by the NHS Leadership Academy and will be tested in partnership with seven Sustainability and Transformation Partnerships (STP) and Integrated Care Systems (ICS) areas – with Together We’re Better being the first to welcome applications for the scheme.
The scheme is open to all NHS-funded middle level leaders (Agenda for Change bands 8a-d, or equivalent in other pay structures, clinical or non-clinical), based within Staffordshire and Stoke-on-Trent. It offers two development streams and each relates to key career transitions identified for mid-level leaders progressing to senior roles. Applicants will need to select the stream they wish to apply for based on their current level of leadership experience. The emphasis of the 24-month scheme is on gaining practical leadership experience in a range of roles and settings, alongside strategic experience through assignments and projects. With the help of a career’s coach, participants will design a bespoke development plan to help them gain the knowledge, skills and behaviours they need to become outstanding, compassionate and inclusive senior leaders across health and care.
Applications close on Sunday 8 September 2019. More information on HPS is available on Together We’re Better’s website at www.twbstaffsandstoke.org.uk/HPS.
Meanwhile, this month’s Health and Care Transformation Board welcomed three of our Stepping Up graduates to hear the positive impact of the programme. They shared some of their personal insights and experiences, including how the programme built confidence as Black, Asian and Minority Ethnic (BAME) role models, and how it empowered them to want to do and be more than they thought they could. There was also the opportunity to start the discussion on what needs to be put in place to maintain the momentum and passion the programme engendered in participants, so that more of our BAME leaders can have the opportunity to progress their development and their careers.
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Workforce programme
From Alex Brett, Programme Director
At the end of May we bid farewell to Programme Director Greg Moores, who had worked within the local system for over 10 years and moved to a new position in Greater Manchester. At the beginning of June, I took over from Greg as both the new Workforce Programme Director, and new Director of Workforce and Development at Midlands Partnership NHS Foundation Trust (MPFT).
Recruitment sessions were held in June at Newcastle College and Longton Cottage Hospital for students looking to undertake their Health and Social Care Apprenticeship. A total of 17 students attended, along with representation from MPFT, North Staffordshire Combined Healthcare NHS Trust, University Hospitals of North Midlands NHS Trust and the local voluntary sector to facilitate the days. Facilitators provided positive feedback, with some saying it was a “really amazing opportunity” and they felt “empowered to be helping these young adults onto the first step of their career ladder”. Following both events, all 14 placements have been recruited to and rotational placements are scheduled to commence in September 2019.
We have continued leading on the workforce involvement events alongside STP colleagues during the 12-week public conversation. Roadshows, meetings, events and workshops have been held across multiple organisations and areas throughout Staffordshire and Stoke-on-Trent, encouraging staff to share what works well, what they think should be improved and what is important to them about local health and care.
Further exciting news to share is the launch of the Staffordshire & Stoke-on-Trent Talent Academy on Together We’re Better’s website at www.twbstaffsandstoke.org.uk/careers. You can now access information on lifestyles and living in Staffordshire and Stoke-on-Trent, apprenticeship and work experience in health and care and events across our organisations. Employers will also be able to access information on the Apprenticeship Levy Transfer. Furthermore, members of staff within the STP will be able to access our New Horizon’s Hub which has information and advice to help with career decisions and managers will soon be able to access advice to best support their staff, when it comes to doing what’s best for them in their career.
The Staffordshire and Stoke on Trent Mental Health Workforce plan has been recently commended by NHS England/Improvement and Health Education England (HEE) in its response to the Mental Health Five Year Forward View and HEE workforce growth target. The plan was developed in partnership with NHS and non-NHS providers, commissioners and STP leads and will now be used as an exemplar plan regionally.
Finally, the redeployment service continues to provide support and guidance to members of staff at risk of redundancy across Staffordshire and Stoke-on-Trent, seeking suitable alternative employment wherever possible. To date the service has co-ordinated the successful redeployments of more than 150 members of staff and have saved the NHS over £4m in redundancy costs.
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