July/August 2021
Recent weeks have the seen the lifting of restrictions across society. We will all have mixed feelings about this and will use our “freedom” in different ways. Congratulations must go to the vaccination programme - a fantastic partnership effort and one of the mains reasons why restrictions can ease. We all know though that the next few weeks and months will still be incredibly challenging.
COVID-19 restrictions might have eased, but the system is still facing significant demand, higher than normal staff absence, ongoing social distancing measures and colleagues taking well-earned leave. We will need an open and honest conversation with the public about what is realistic, as we continue to work differently for the foreseeable future. We also need to make sure that our road to recovery is as much about staff recovery and well-being, as it is about the waiting lists, backlogs, and meeting unmet demand. Demand on all of our services and across all of our areas is unprecedented, and colleagues are working hard to meet this need. Planning for winter is a thing of the past, with the current demand showing surge planning is needed all year-round.
Even without COVID-19 July was an eventful month, with Sajid Javid announced as the new health secretary and Amanda Pritchard as the new NHS Chief Executive. We look forward to working with both and in being able to demonstrate what the Staffordshire and Stoke-on-Trent system can deliver for local people. The Health and Social Care Bill also passed its second reading in Parliament ahead of the summer recess. It’s been covered widely, so I will not repeat it here and there is still a long way to go, as it works through the parliamentary process. Locally, we’re continuing to adapt and respond to guidance which is trickling through. The ICS Design Framework contained no real surprises, but gives us the permission to accelerate our local plans and priorities. In June, we submitted our ICS Development Plan to NHS England/Improvement (NHSE/I), which sets out our priorities for this transition year and beyond.
All of this is so much more than just guidance or governance though. If we get it right, it’s about making a tangible difference to local people’s care and long-term outcomes. We need to make sure that communities have the support and resilience to offer truly personalised care and help people stay independent for as local as possible. We need to keen an unremitting focus on our four priorities, and to do that in a way that’s about improving the health outcomes and tackles health inequalities that exist across our system.
Finally, we can’t achieve these priorities without our amazing staff. Our staff and partners continue to go above and beyond, and I offer my heartfelt thanks to each and every one of you for that continued effort.
Prem Singh, ICS Independent Chair
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We are pleased to confirm that, following a robust process, NHSEI have recommended, and the Secretary of State has agreed, that Prem Singh should be NHS ICB Chair Designate. Prem will therefore be ready to take up the post from April 2022, should Parliament confirm the current plans.
This follows the recent Second Reading of the Health and Care Bill, which contains a series of measures which would formally establish ICSs. It would also give their governing bodies – including an NHS Integrate Care Board (ICB) – a broader range of responsibilities empowering them to better join up health and care, improve population health and reduce health inequalities.
While we cannot pre-empt the decisions of Parliament, the Bill receiving a positive vote at the Second Reading means there is a degree of confidence that the measures relating to ICSs will become law.
This confirmation of Chair Designate is part of the local, regional and national NHS responsibility to prepare for when those measures are expected to come into effect.
ICS Core Priorities
Restoration and recovery
Most ‘essential services’ continued throughout the pandemic, but critical care and ‘green’ bed pressures relating to COVID-19 surges have impacted on the elective (planned operations/appointments) programme for many service areas. We continue to work with all our acute providers to restore and recover health and care services in Staffordshire and Stoke-on-Trent.
Three main risks to recovering services have been identified, and mitigations have been put in place:
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Frailty
The main priorities of the frailty programme are falls prevention and admissions avoidance. Jon Rouse from Stoke-on-Trent City Council has recently been announced as the executive sponsor of the programme.
There has been good clinical engagement recently with Place Based Partnerships in the North and East of Staffordshire, and engagement events with ethnic minority communities to understand their issues and experiences.
System savings
We continue to work with regional colleagues at NHS England about our future spending plans. Partners across the ICS have come together to agree on a number of transformation schemes which should improve patient care, and manage any future rises in demand better. By combining improved financial management and transformation of services, we hope to bring our system back into financial balance over a five-year period.
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Health inequalities
The disproportionate effect of COVID-19 on different communities and people has highlighted the importance of addressing health inequalities in Staffordshire and Stoke on Trent. Therefore, over the last year, across the two Upper Tier Local Authorities (UTLAs), the NHS and other partners, we have been concentrating on laying strong foundations for collective and collaborative action to reduce health inequalities.
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Funding to increase preventative services to reduce health inequalities
Staffordshire and Stoke-on-Trent ICS has been successful in securing £200,000 following a bid for increasing uptake of preventative services to reduce health inequalities within our population.
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Place-based Partnerships (PbPs)
The latest national guidance, emphasised the importance of place-based working, including a new name - Place Based Partnerships (formerly Integrated Care Partnerships). Regardless of the name change, and another new acronym, the guidance describes why Place is a key mechanism to ensure that local population need is addressed through co-design and development of services.
Our system Place Programme Board has been meeting monthly to move two key aspects of Place arrangements forward.
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Provider collaborative
From April 2022, all trusts providing acute, community and/or mental health services are expected to be part of one or more Provider Collaborative(s).
To date, we have completed the national self-assessment and recently concluded discussions with all system leaders regarding expectations.
Ongoing work includes a stocktake of current collaborative arrangements, developing draft Terms of Reference and discussing governance and reporting requirements.
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COVID-19 vaccination programme
Last month, the vaccination programme hit the national target for all first doses to be offered to adults. We’ve delivered an impressive 1,478,313 vaccines. This is an incredible achievement, and we’d like to thank the army of staff, vaccinators and volunteers it has taken to deliver this within only eight months.
It’s a fantastic example of partnership working, across the NHS, councils, Fire, Police, voluntary and private sector. Everyone has played a part.
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NHS 111
We are encouraging the public to use NHS 111.nhs.uk, download the NHS app or phone 111 to get the most appropriate medical help quickly.
Timeslots are now live at Sir Robert Peel Community Hospital Minor Injury Unit (MIU), following the success at Samuel Johnson and Haywood hospitals.
After a significant amount of work behind the scenes, timeslots are now available to book through 111.nhs.uk and the NHS app for the emergency departments (ED) at Royal Stoke University Hospital (for adults and children), County Hospital in Stafford (for adults only), and Queen's Hospital in Burton (for adults and children). Work is still underway to establish the appropriate pathways for minor injuries units (MIUs).
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GP access survey
General practice remains open and our teams of clinicians and staff continue to work extremely hard as they have since the start of the pandemic. Whilst continuing to care for their patients, our GP practices have played a significant role in the COVID-19 vaccination programme.
Although lockdown restrictions are lifting across England, social distancing remains in place across all healthcare settings and we must continue to work differently to keep the most vulnerable members of our community safe. This means that face to face appointments will continue to take place for those who need them alongside telephone and video consultations.
If you, or someone you know has recently tried to access care through their GP practice, please ask them to share their experience with us via our short survey.
People
Since the start of the pandemic, our People Function team have worked with system partners to implement significant changes across the health and social care workforce.
As a direct response to COVID-19 and the additional workforce demand, we created a People Hub. From local and national campaigns and a variety of other routes, we now have over 1,200 staff ready to support a variety of sectors and settings including testing, vaccination centres, intensive care, community, care homes and primary care. Career conversations are currently being offered to help inform their career choices in health and social are. Seminars are planned for September 2021, inviting key speakers from services such as nursing, phlebotomy, healthcare, midwifery and pharmacy.
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System transformation
In 2019 clinicians and staff from across the partnership were working on a number of priority areas, including urgent and emergency care, maternity, planned care (booked appointments and treatments), community hubs (southwest and southeast) and mental health (George Bryan Centre in Tamworth). Their work was informed by a large listening exercise, in summer 2019, where we captured the views of over 2,000 people. In March 2020, the work to develop proposals for future services was paused due to COVID-19.
With COVID-19 restrictions now easing, we feel it is the right time to recommence these important programmes. We recognise that the world may look different now and that we need to review our earlier assumptions and also take on board any learning or innovation that happened during COVID-19.
During 2021/22 clinicians and staff will once again be reviewing these priority areas and developing proposals for future ways of working. We will be encouraging people to share any new experiences during COVID-19 and help inform our future models of care.
The first programme to recommence is the maternity programme. We have already held one event on 16 July and will be holding a second online event on 12 August from 7pm until 8.30pm. At these events we are listening to the views of maternity service users, their partners, staff and people who support maternity users. There is still time to have your say in our survey which is available online here: https://www.twbstaffsandstoke.org.uk/get-involved/maternity-services-transformation or by phoning 0333 150 2155.
Digital
Our Digital Programme is being delivered in line with the Department of Health and Social Care (DHSC) Data Saves Lives Strategy.
- The One Health and Care (integrated care records programme) has been live for almost a year in Staffordshire and Stoke-on-Trent. This summer, we will be joined by health and care organisations and Shropshire, Telford and Wrekin.
- UHNM are launching the myhealthandcare application to enable patients to view their appointment letters through their smartphone, tablet or computer.
- Both the public and health and social care professionals embraced virtual appointments during the COVID-19 pandemic. The uptake of Patient Online and NHSApp increased to manage requests such as prescriptions and booking consultations. We are working with NHS Digital to integrate patient-facing apps to develop a digital gateway for patients.
- The Remote Care Programme has been developed to enable the use of remote monitoring tools such as pulse oximeters, blood pressure and glucose monitors to bring about an ICS-wide common remote care service. Work is already underway in this space in the form of a number of pilot projects for small cohorts of patients, with the overall objective to reduce A&E admissions/readmissions and have patients monitored and treated at home.
Community Diagnostic Hubs (CDHs) - please give us your views
Across Staffordshire and Stoke-on-Trent, we are working to improve diagnostic services (tests to work out what is causing a person’s illness or symptoms), by creating Community Diagnostic Hubs (CDHs). At the moment, most of these tests are done in larger acute hospitals, but it is now recommended, as part of national guidance, that NHS organisations across England move to providing these in Community Diagnostic Hubs. This aims to support patients to get the tests they need closer to home.
Further information, along with the link to the survey, can be found here. The survey is open until midnight on Monday 23 August. If you have any questions or require support completing the survey, call 0333 250 2155 between 8am and 4pm, Monday to Friday.
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Mental Health Transformation Programme
Ambitious plans to transform the way community mental health care and support is provided in Staffordshire and Stoke-on-Trent are underway.
This three-year transformation supports the priorities set out within the NHS Long Term Plan and is being bolstered with the help of multi-million pound national funding.
The new funding will help to create a new proactive model of community-based mental health care, based within Primary Care Networks (PCNs), with mental health NHS trusts working in partnership with GPs, commissioners, local authorities and voluntary and community organisations – alongside people with lived experience, their families and carers.
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News
Autism toolbox extended to support more families
Midlands Partnership NHS Foundation Trust’s children and young people’s autism service (south Staffordshire) have had huge success with their 'Autism toolbox’. This 10-week programme of interactive online sessions supports families in a range of areas. Feedback from users has helped further develop the toolbox to be as adaptable and accessible as possible.
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UHNM appoints new Executive Medical Director
Dr Matthew Lewis has been appointed as the new medical director at University Hospitals of North Midlands NHS Trust, and is expected to start his role around late September. Matthew joins the Trust from Walsall Healthcare NHS Trust, and is also a part-time Visiting Fellow at the King’s Fund.
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Parents encouraged to choose alternative urgent care services for their children
A ‘real increase’ in patients visiting the Children’s Emergency Department at Royal Derby Hospital has been noted recently, averaging at 139 patients per day in comparison to June 2020, where an average of 59 patients were attending per day. Parents are asked to consider the most appropriate option when seeking care and treatment for their children.
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