October 2019
Welcome to the latest newsletter from the Together We’re Better health and care partnership.
I would like to begin this newsletter by both acknowledging and thanking, all colleagues across our health and care system for the work that they do every day in delivering effective care to the local population that we serve. It is even more important to recognise that effort as we head towards the winter period where the demand and pressure on our services increases significantly. If we are being honest then it feels as though we have been dealing with some of the winter pressures for quite a while already – did last winter actually end?
All of the partner organisations have respective responsibilities when responding to the winter challenges but we also have a responsibility to each other. We should be looking out for one another and doing all we can do to look after our own health and wellbeing as individuals during this period – such as getting the flu vaccine and making best use of any time off to look after our own health and wellbeing. We can also make efforts within our local communities and with our neighbours to recognise the challenges that come with social isolation, the challenges of keeping houses warm and similar issues that can be right under our noses without us often realising.
Against this backdrop we are also very aware of the challenges that we have across our system in regards to our in year (2019/20) financial position. The money is always important but needs to be set in the context of the quality of care provided and the amount of care being provided – we need to get the balance right. It is important every year that we get control of expenditure and that we use the allocation across our system wisely, but where we finish at the end of this year then sets our position for the 5 year plan and the delivery of the our local system plan. This remains an ongoing challenge to ensure that we remove duplication and unwarranted variation in all of our clinical work and recognise that we all have a responsibility to make sure we use the taxpayers’ pound as wisely as possible.
In November, the Five Year Plan faces a series of interim submissions and then subsequently the final submission to NHS England. The plan sets out how we will transition from a Sustainability and Transformation Partnership to an Integrated Care System, and also sets out our ambitions for the system to deliver the integration agenda. This includes
- integrating health and social care services,
- integrating physical and mental health services,
- integrating primary and secondary care services
These three lenses are important but we have to understand the reasons behind the drive for integration – it is about improving our service offer for local people. This is based on strong GP services and the building blocks of our 26 primary care networks that will have integrated care teams wrapped around them. Delivering this in conjunction with voluntary and third sector to look after people in their own homes or closer to home and to deliver the most effective services possible. We are driven by an ambition to support people to use the system responsibly, but to ensure that our system is then responding when people need it.
Finally, it was a pleasure for myself and Sir Neil to be invited to join the cohort of the ‘Stepping Up’ leadership development programme in October. We spoke to the black, Asian and minority ethnic (BAME) colleagues who have gone through the programme, and it was genuinely uplifting to hear them use the words of feeling more confident, being empowered and inspired – now more hungry for change and wanting to make a difference. Some great ideas and suggestions were shared for addressing the barriers restricting BAME colleagues from progressing. There was a clear message – as one health and care system with one workforce, we can make a big impact on sustainable inclusion.
Simon Whitehouse
STP Director
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Over the past month the feedback gathered during this summer's listening exercise has been analysed to produce a draft Report of Findings, with the final version soon to be reviewed by the CCG Governing Bodies.
Together We’re Better has now begun the next stage in this journey, by commencing the option appraisal process. Technical experts, including medical directors and clinicians are reviewing emerging scenarios to develop future proposals for service change. This process will take several months to complete and involves reviewing the feedback from the listening exercise alongside detailed population and service analysis.
The first round of technical workshops, on the 15 October, saw the experts apply essential ‘hurdle’ criteria, which looked at whether a proposal was clinically safe, whether it delivered national priorities/guidance, and whether it met the local needs of the population. At this stage there are still over 800 potential scenarios across a range of services, including urgent and emergency care, maternity, planned care, community care and mental health that will need to be refined before we have a short list of proposals. We want to reassure you that no decisions have been made, and it is too early to predict what changes will be identified.
In parallel with these workshops we are running a series of workshops during October and November with members of the Local Representatives group, service user groups, voluntary sector, partners, and the workforce. Participants are discussing the emerging scenarios for transformational change. This conversation includes agreeing the ‘desirable criteria’ that will be weighted and used to score the proposals, for example quality of care, meets local needs and accessibility.
Following the pre-election period, we are planning further workshops with the public and workforce to inform the development of a refined list of proposals. Participants will use the agreed criteria to help score the list of proposals, evaluating potential solutions to the problems which patients, workforce and members of the public identified during the listening exercise.
This will support the technical experts to develop a future short list of proposals that will inform the Pre Consultation Business Case.
This is an important milestone in a critical programme that will help us to tackle the clinical and financial challenges we face collectively as a system.
The feedback gathered during the summer is also being used to feed into the Together We’re Better Five Year Plan. This is the partnership's response to the national NHS Long Term Plan, published in January this year. The first draft of the local plan was submitted at the end of September, with final submission due in November.
There are a number of areas and services which Together We’re Better is gathering feedback on to further develop the Five Year Plan before the final submission. Key stakeholders in the partnership are currently being approached for their views to help develop and take this plan forward, for the people of Staffordshire and Stoke-on-Trent.
Conference Shines a Spotlight on the Need for Everyone to be Aware of Suicide Prevention
The second annual Suicide Prevention Conference was held at the Bet365 Stadium on 11 October by Together We're Better. More than 250 people came together to work towards reducing the number of deaths by suicide in Staffordshire and Stoke-on-Trent to zero.
NHS Long Term Plan Work Results in National Review of Patient Transport
Earlier this year, the Healthwatch network carried out a nationwide conversation asking communities how they want the NHS to improve locally, engaging with over 30,000 people across the country. Locally, Healthwatch Stoke-on-Trent and Healthwatch Staffordshire worked together to gather and report the views of 870 individuals.
New Service to Improve Children's Wellbeing in Stoke-on-Trent
Coinciding with World Mental Health Day on 10 October, the new service ‘Stay Well’ has been introduced by Stoke-on-Trent City Council and Stoke-on-Trent Clinical Commissioning Group. It will be run on their behalf by a well-established local charity ‘Changes’ in partnership with North Staffs Mind and the Dove Service.
Maternity Transformation Programme
From Mary Barlow, Programme Lead
NHS England have confirmed phase two and the Local Maternity Services (LMS) has received regional approval of the spending plans. A significant reduction in the LMS workforce has resulted in the need to review the workforce establishment. Due to the number of vacancies within the LMS team, including the MTP Senior Programme Manager, post mitigations have been put in place to ensure workload and trajectories are under close monitoring.
The five key projects within Staffordshire and Stoke-on-Trent Maternity Transformation Programme:
- Enhanced quality and safety of women and newborns (led by a consultant obstetrician)
- Authentic engagement with women and their families (led by project support officer of the Pan Staffs MTP)
- Reconfiguration of maternity services (led by the Heads of Midwifery)
- Improved health and wellbeing of women and their babies (led by Public Health at the local authorities)
- Improved access to perinatal mental health services (led by Service Manager for Perinatal Mental Health Services)
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Enhanced Primary and Community Care programme
From Steve Grange, Programme Director
EPCC is evolving – the delivery component of the STP programmes have been redefined, many of which are sitting with the Transformation Delivery Unit (TDU). The TDU was formed on 1 August 2019 to harmonise the project governance and implement a discipline of project delivery, whilst showing clear accountability through to our system as we embark on becoming an Integrated Care System.
To that end, as a system, we agreed that we would change EPCC to have that strategic lens and would focus on the following:
- Primary care strategy
- Social prescribing
- Primary Care Network development
- Care home stratification/development
- Dentistry
- Pharmacy
- Pre-Consultation Business Case – assurance and overview
- End of life care
- Long-term conditions strategy/management
- Ophthalmology
The EPCC board continues to provide the governance needed to inform and influence system decisions and projects. Projects will not be accepted by the TDU until they have been vigorously tested using robust methodologies.
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Digital Programme
From Marc Talbot, Programme Manager
In the New Year we will begin the roll-out of the pan-Staffordshire integrated care record. Patients’ health and care records in Staffordshire and Stoke-on-Trent will be available electronically to authorised health and social care practitioners. This will mean that a doctor in a hospital, or a paramedic who attends a 999 call will be able to access the same crucial information as a GP, such as details of allergies and current medications, bringing potentially life-saving benefits.
On 28 October we launched a ‘Fair Processing’ campaign, which will run for eight weeks. This campaign will outline the benefits of One Health and Care electronic integrated care records and explain how to opt out if people wish to. The main focus recently has been the development of communications materials as part of this work. This includes circulating a GP Bulletin to primary care in Staffordshire and Stoke-on-Trent; issuing updates to the communication leads of respective STP organisations; distributing communications toolkits for GPs and other health and care professionals and printing the fair processing leaflets and posters for stakeholders. You can read more about the One Health and Care integrated care record below.
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OD & Leadership programme
From Jane Rook, Programme Manager
We have received a significant number of applications for the high potential scheme. These have been sifted and scored, and we now have our potential candidates ready to undertake the assessment centres over the next fortnight. Since these candidates represent our future talent and future executives in our Staffordshire system, we are particularly keen that the process of selection is thorough, innovative and rigorous.
We are fortunate to have assessors, scenario players and career coaches from our system to support of our future talent. This is truly a piece of co-produced, collaborative working, and we are proud of the progress we have made to get to this point.
The shared delivery of the assessment training centre days for our assessors was a particular highlight. Thanks go to all our provider trusts for working with such enthusiasm to deliver in such tight timescales.
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