June 2021
Dear colleague
At the start of the pandemic we paused our system-wide newsletters in order to support partners to focus their energy on the COVID-19 response. Our transformation work was put on hold, staff were redeployed, and the world changed significantly. Many lost loved ones during the past year and many lost colleagues and friends - our thoughts continue to be with you.
Equally, I continue to see our staff across the system going above and beyond in order to meet the needs of our population. The demand that is coming through to all parts of our system is significant and putting additional strain on our staff. We must continue to support each other, avoid the temptation to blame others and be compassionate.
Although, we are still fighting this virus, rapidly rolling out the vaccine and anxiously monitoring the impact of the new Delta variant, the system’s focus is moving towards building back in a fairer, more equitable and more sustainable way. The intention is to keep you updated on these areas through these monthly newsletters.
As referenced above, the demand currently being placed on the system is significant and reinforces the need for us to “lock-in” the improved ways of working. The Queen’s Speech clarified the expectation of Integrated Care Systems (ICSs) becoming statutory organisations and the scale of the task ahead. The Health and Care Bill will, once it receives Royal Assent, set the foundation for a more integrated, efficient and accountable health and care system. The national emphasis on local flexibility is reassuring, as this will be essential if we are to design a system that delivers real change, reduces inequality and meets local needs. The challenge is being set in this regard and how much we want and are able to achieve, will be down to us and our collective ambition.
We are expecting the publication of the ICS Design Framework over the next few days. This will be an important piece of guidance as it will help to shape our plans and discussions across the system. It is also interesting to note that the Department of Health and Social Care will be releasing guidance on the ICS Health and Care Partnership – a clear message that this is genuinely about partnership working across sectors and that the ICS is much more than just an NHS construct or a CCG in a different guise.
We know there is a lot to do this year, subject to the legislation passing through Parliament, to prepare for a statutory ICS. However, despite these preparations, it is vital we don’t lose sight of our core objectives: improving health outcomes, tackling inequalities, enhancing productivity and value for money and supporting broader and economic development. These are the areas all ICSs will have the greatest impact in and should be our priority.
Influencing the national direction, will be key in giving us as much flexibility as possible in designing our local approach. In recognition of the work we have been undertaking together as a system to develop our ICS and Integrated Care Partnerships (ICPs), Simon Whitehouse, our ICS Director, has been asked to join the newly formed NHS Confederation ICS Network Advisorate. This small group of leaders, from health and social care, will help to develop the thinking and strategic approach towards the implementation of the forthcoming Health and Care Bill. As well as sharing any learning locally, it’s an opportunity to showcase the Staffordshire and Stoke-on-Trent voice into the national work.
The past year or so has demonstrated the importance of partnership working, and how far we have come locally. This was evident at the launch of the Stoke-on-Trent City Forum on 14 May, led by the City Council. Representatives from more than 150 organisations came together to discuss the ambitions for the city with the aim of securing partnership and investment in the city. Nadhim Zahawi MP, Minister for Business and Industry and Minister for COVID Vaccine Deployment opened the event and praised the work happening to open-up the city.
No one single organisation can tackle the challenges ahead alone. Never has there been a time where all sectors have been able to work together as efficiently as now, and events like that forum are extremely important for the future of Staffordshire and Stoke-on-Trent.
Finally, I wanted to highlight another significant launch for our system. The Staffordshire and Stoke-on-Trent ‘Staff Psychological Wellbeing Hub’ is now available to support any health and care staff across the system who are feeling overwhelmed, and you can read more about this below. We can only achieve incredible things, thanks to our amazing workforce. We know that demand on our services is high and that people may be weary. This is one way we can offer practical support. A lot of work has happened to make this happen and I’d like to thank everyone involved.
Prem Singh
ICS Independent Chair
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Health and care in Staffordshire and Stoke-on-Trent
Developing a future model of community engagement
The four core purposes of an ICS are:
- to improve outcomes in population heath and healthcare
- to tackle inequalities in outcomes, experiences and access,
- to enhance productivity and value for money and
- to help the NHS to support broader social and economic development.
We can only achieve these aims if we listen to our communities, understand the challenges and inequalities they face and actively involve them in the planning, development, and delivery of services at a system and local level.
We recognise that the changing landscape is an opportunity to review our approach to community involvement, building on best practice and learning from all partners. We want to create a system-wide model that enables us to involve a diverse and representative proportion of the population as an ICS, as well as in the work of our Integrated Care Partnerships (ICPs), including Primary Care Networks (PCNs).
To shape our future model of engagement, we have been working with partners and existing groups and networks to review what mechanisms we already have in place and who they involve. We want to understand what’s working well, what could be improved and how we could extend the reach of these groups to connect with the wider community and ensure a representative voice.
We also need to understand where the gaps are currently and are working with community champions who represent people who may not be willing or able to engage through traditional methods. A key focus of any future model of engagement will be to ensure we are capturing the views from seldom heard groups, building on lessons learnt and the networks that have been formed during COVID-19.
All the feedback we are collecting, through the on-line survey that was shared with partners and from focus groups with different community representatives, will be used to inform the future approach to patient and public engagement and governance arrangements. The aim is to have a robust involvement network at an ICS level, supported by networks in the place based ICPs, in place by 1 October 2021.
Transformation Programme
As previously mentioned, the system-wide transformation programme was paused in early 2020 to allow partners to respond to the COVID-19 pandemic. Throughout this time, we have continued to involve people through virtual events and focus groups, to keep service users and the workforce up to date where possible.
We are now in a position where the system is ready to restart involvement work for our programmes, starting with a focus on Maternity Transformation.
The ICS is seeking to improve midwifery services in Staffordshire by offering more personalised care around the needs of pregnant women and their families.
To help inform and shape future maternity services, a virtual event is being held on 16 July 2021 between 10am and 12pm. People who have accessed maternity services locally in the past three years, are currently pregnant, or are planning to start or expand their family in the near future, are invited to share their experiences and views. Partners and staff members working with maternity service users are also invited to attend.
We will be asking for feedback and views on our previous work and whether any changes will be needed, as a result of the COVID-19 pandemic.
The session will be held via Microsoft Teams and will include breaks. This will be an informal event, and so attendees do not need to worry about juggling childcare or children being present.
Anyone interested in attending the event should register online.
COVID-19
Whilst the latest easing of lockdown restrictions is great news, the experts are keeping a watchful eye on the COVID-19 variant from India and we must all remain vigilant. It is important to continue to follow the principles of ‘hands, face, space and fresh air’, get tested regularly and get vaccinated when offered. This will help minimise the risk of transmission of COVID-19 and keep the infection rate down. View the details of the current restrictions and guidelines on the GOV.UK coronavirus webpages.
On 14 May, the millionth COVID-19 vaccine dose in Staffordshire and Stoke-on-Trent was delivered and, of course, the teams are continuing to work incredibly hard to reach the target of 1.8 million doses total to protect our communities. The operational team has been working to ensure that under-40s are offered alternatives to the Oxford-AstraZeneca vaccine.
The national NHS-App has now been updated to display vaccination status. People without access to the app and who need to prove they have had both doses for international travel can request a letter by calling 119.
Locally we continue to lead the way in the vaccination programme, which is thanks to the efforts of the hundreds of volunteers, vaccinators and programme staff who help make the most of every vaccine we receive. You can read more, in the latest vaccination bulletin.
During the pandemic, the NHS has seen a decrease in people accessing services for a range of conditions that are not related to COVID-19. This includes adults and children attending Emergency Departments (EDs) for urgent and emergency issues (including serious conditions such as stroke and heart attacks), cancer patients attending their ongoing treatments, and expectant mothers attending for regular scans.
It is important to remember that the NHS is still here for you if you need help. You can still contact your GP either online, by an app or by phone to be assessed. If you need urgent medical help, you can contact NHS 111 online or by phone. If it’s a serious or life-threatening emergency, call 999. If you are told to go to hospital, it is important that you do so. You should continue to attend your appointments unless you have been told not to attend.
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News
Multi-million-pound programme to transform community mental health services
Ambitious plans to transform community mental health services in Staffordshire and Stoke-on-Trent have been given the green light after securing a £3.5 million investment. Mental health trusts will work in partnership with primary care, local authorities, the VCSE sector, service users, families and carers to create fully integrated teams of health, social care and voluntary and community staff. The teams will work in new ways, with the support of people with lived experience, to deliver services that more effectively meet the needs of local communities.
(Read more)
New non-emergency transport service to hit the road from August
The NEPT service delivers around 187,000 non-urgent and pre-booked journeys a year to hospitals and other health settings in Staffordshire and Stoke-on-Trent. They provide a lifeline for patients who qualify and do not have other transport options. Vehicles and crews will be provided by ERS Medical after the award of a five year contract following a routine re-tendering process. The service has been provided by E-zec Medical since 2016.
(Read more)
New partnership is driving forward plans for Stoke-on-Trent
The City Forum, which met for the first time on 14 May, brought together representatives from over 100 local organisations including government, regional agencies as well as a number of public and private sector partners. The partnership aims to deliver the ambitions set out in the Powering Up Stoke-on-Trent Prospectus, which focuses on securing partnership and investment in the city.
(Read more)
Hands-free device improves care for A&E patients at UHNM
The ‘Vocera’ communication system is worn as a badge on the front of a uniform and uses the hospital’s WiFi to give staff instant voice communication with each other. It was funded through a COVID-19 grant, and has improved patient flow, safety and satisfaction.
(Read more)
Focus on ICS programmes and priorities
Health inequalities
There are significant health inequalities across Staffordshire and Stoke-on-Trent, brought into even sharper focus by COVID-19. Deprived communities are at a greater risk of exposure and more likely to have poorer outcomes due to existing poor health and adverse lifestyle factors. Disadvantaged communities have had a greater economic, social and health impact resulting both due to the virus and the control measures put in place.
Staffordshire and Stoke-on-Trent’s approach to addressing health inequalities includes a multi-pronged approach which aims to:
- Reduce the risk of worsening health inequalities and ensure inclusive recovery of clinical services, taking into consideration population risk in terms of inequalities such as ethnicity and deprivation
- Improve understanding of population health needs and risk factors using the Population Health Management approach
- Accelerate existing preventative programmes in the community, which proactively reduce inequalities and support people with recovery post-COVID, particularly ‘seldom heard’ groups
- Address significant ongoing inequalities as outlined in the NHS Long Term Plan.
The local health and care system is trying to investigate and address the impact of COVID-19 on deprived and disadvantaged communities – in terms of COVID cases, hospital admissions, critical care admissions and deaths. We are communicating with people from a range of deprived communities, ethnic minority groups, faith groups, at-risk groups (e.g. homeless population) to understand any reasons for vaccine hesitancy and make appropriate efforts to improve health outcomes for everyone.
Enhanced NHS 111 service
We have recently seen increased demand for our EDs and other urgent care services. We’re continuing to encourage patients to phone NHS 111 for advice and a timeslot, rather than simply walking into these services. This will help manage demand and also reduce time spent in waiting rooms – particularly important as we strive to limit the transmission of COVID-19.
Thanks to the efforts of all partners, timeslots are now available in our EDs as well as the Haywood Walk-in-Centre, Samuel Johnson Community Hospital and will shortly go live at the Sir Robert Peel Community Hospital.
We continue to take a phased approach to communications and raising awareness of this service, and we carefully monitor patient feedback and identify future improvements.
At the moment, timeslots are only available by phoning NHS 111, but we are developing the online NHS 111 service to also offer timeslots, in line with the national ambition. We are working with NHS England and NHS Improvement to align the NHS 111 online service with our local service pathways and aiming to be ready by summer 2021.
We are also developing more pathways that allow patients to access more Same Day Emergency Care services – avoiding the need to be at an ED at all. You can read more in our latest update.
Finance
The NHS changed its funding arrangements for 2020/21 and the first half of 2021/22 in response to the COVID-19 pandemic. In these extraordinary times, Trusts and Clinical Commissioning Groups (CCGs) were funded at cost directly by NHS England to ensure service continuity. As a consequence of these changes, the NHS in Staffordshire and Stoke-on-Trent posted a small surplus last year and have also set balanced plans for the first half of 2021/22.
However, we are soon to return to more traditional funding arrangements, and back to a more difficult financial position. Finance directors have collectively been in detailed conversations with colleagues – regionally and nationally – about how we restore long-term financial balance. A strategy of managing the increase in both activity and expenditure has been agreed, in the hope of getting back into balance in the next four years. Once we’ve agreed these plans nationally, we will all be required to play a part in keeping the rise in expenditure down during a difficult period of post-pandemic recovery.
Organisational Development and Leadership
Staffordshire and Stoke-on-Trent Staff Psychological Wellbeing Hub
We recognise that the intensity of work during the pandemic has taken its toll on the health and wellbeing of the local health and care workforce. The Together We’re Better Staff Psychological Wellbeing Hub is a safe and confidential space for staff to get the support they need.
A team of qualified mental health professionals is on hand to offer help, support and give advice to staff working for any NHS or social care organisation in Staffordshire and Stoke-on-Trent.
Complete a short online questionnaire about how you’re feeling, and then the team will be in touch to offer support or direct you to a service that can help. The questionnaires do not ask for employer’s details, and information remains confidential.
Inclusion schools
The Together We’re Better summer ‘Inclusion School’ masterclasses are already underway, with a focus on developing greater understanding about some of the key concepts of inclusion that all leaders should be aware of. The remaining sessions are on Thursday 24 June (2pm until 3.30pm) and Thursday 29 July (3.30pm until 5pm).
The masterclasses are delivered through online webinar-style learning and are open to both existing and aspirant leaders at every level within health and care. Recordings of the sessions will also be available for anyone unable to attend or who wishes to watch again.
We will share the date/s for the autumn Inclusion School with you in this newsletter once confirmed, which will be a ‘pulling it all together’ session with a focus on taking action.
Cultural Education Programme – Comfortable Being Uncomfortable with Race
The Together We’re Better Organisation Development and Leadership programme has been working with a company called Enact to develop an immersive, experiential cultural development programme for leaders within the health and care workforce. This has focused on race inclusion as part of our programme to offer outstanding equality, diversity and inclusion as a system.
This programme is pivotal in ensuring our system progress on inclusion, particularly on the matter of race, recognising that, as a health and social care community, we have a specific responsibility to create a more inclusive society. The first cohort of attendees will be the very senior leaders from across the partnership, who are invited to attend one of the following three sessions:
- Monday 14 June, 1pm until 3.30pm
- Wednesday 23 June, 10am until 12.30pm
- Monday 12 July, 1pm until 3.30pm
For more information about the Inclusion Schools or the Cultural Education Programme, please email Diversity@combined.nhs.uk.
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