This week’s leadership message is from Carrie Rae, Children, Young People and Families Senior Programme Manager, NHS West Yorkshire Integrated Care Board

Posted on: 1 November 2024

This week’s leadership message is from Carrie Rae, Children, Young People and Families Senior Programme Manager, NHS West Yorkshire Integrated Care Board (ICB). We also have a blog from Charlotte Watkinson, Therapy Clinical Lead for Patient Flow at Airedale NHS Foundation Trust and Mark Jones, Service Manager for Operation Services within Adult Social Care at City of Bradford Metropolitan District Council.

Project Hope

Carrie Rae As this week is National Care Leavers Week and nearly a year on from our system launch of Project Hope, we wanted to share our journey to date, demonstrating how true partnership and collaborative working across our system has brought additional opportunities to our care experienced young people living in West Yorkshire.

In January 2023, the ICB successfully secured an NHS England bid to become one of ten ICB pathfinders as part of the national Universal Families Programme. In becoming a pathfinder, we aimed to build on existing practice to enable care leavers between the ages of 16 to 25 in West Yorkshire to access wholesome career development opportunities tailored to individual needs and to harness the young talent and potential that lies within our care experienced community. In West Yorkshire, we call this programme of work Project Hope.

We know that care experienced young people face stark inequalities that impact their health and wellbeing, experiences and outcomes. National data tells us that compared to others their age, care experienced young people are seven times more likely to die before the age of 25, and 25 times more likely to be homeless. 40% of all care leavers aged 19-21 (in 2016) were not in employment, education or training compared to 14% of all 19-21 year olds.

When developing Project Hope, it was important that for this to be a success, it needed to be developed in collaboration with partner organisations across the West Yorkshire Health and Care Partnership and with young people themselves to ensure it met their needs.

The collective approach that we have taken for Project Hope is to work with organisations across our system to provide entry level paid placements for at least six months for our young people. This work started out with opportunities within the NHS, local authorities and the voluntary, community and social enterprise (VCSE) sector. It has expanded to roles within the commercial sector, including Lloyds Banking Group, who in collaboration with Project Hope, have been able to offer permanent roles to a number of our young people. Taking a whole sector approach has been vitally important to being able to give young people choice around roles of interest and roles which suit their skills.

Reducing barriers to employment has been at the forefront of this programme of work. A key partner has been the West Yorkshire Combined Authority which has provided six-month travel cards for our young people in placements to reduce the barrier of paying for travel to work.

Taking a trauma-informed approach is key to the work we do across West Yorkshire and working in partnership with our Adversity, Trauma and Resilience Programme, bespoke trauma-informed foundation level training has been delivered to managers and teams offering placements to ensure that our care experienced young people and their teams are supported while in their roles.

Project Hope - giving young people in West Yorkshire hope for a better future A key part of Project Hope has been ensuring that our young people receive a wrap-around support and developmental offer, which, along with their individual organisational support, will help them to grow and succeed within their placements, providing them with both professional and personal skills.

Our wrap around support offer has been developed and delivered in partnership with the King’s Trust (formerly the Prince’s Trust) and Flourished Minds, a coaching organisation which specialises in supporting children and young people. This has included pre-placement inductions to prepare our young people to start in their roles, monthly workshops which have included confidence building, money management, CV writing and interview skills, weekly check ins and a coaching offer.

“It has been a pleasure to work alongside the ICB on Project Hope. I have had the honour of working with our young people under the banner of The Prince’s Trust, offering the young people with a pre-placement week to get them ready for work and then monthly follow on sessions to ensure their transition into the working world is as smooth as possible. It has been wonderful to get to know all the Project Hope young people and to see their confidence grow each month as they thrive in their new positions” Sara Liptrot, The King’s Trust

“Being part of this programme is an absolute privilege. Witnessing the young people step into their own, despite their personal challenges, is exceptionally inspirational. Seeing them realise just how much resilience and ability they possess is joyful.” Karen Cruise, Flourished Minds.

Whilst we have had many successes with Project Hope, it has also not been without challenges, with many wider factors such as housing and financial worries having an impact on our young people’s emotional wellbeing. Over the coming months we will be undertaking an evaluation of Project Hope with our partners, organisations and young people for learning and to inform future models and approaches.

We would like to thank everyone who has worked with us and been involved with Project Hope. We would not have been able to take forward this programme of work without the joint working, commitment and collective approach to this.

We wanted to end with a quote from one of our young people about their experiences, which truly demonstrates the impact that opportunities, reduction of barriers and support has been able to provide.

“Project Hope is the best thing to happen to me this year and has really been lifesaving. I feel much more motivated and ready to work and I’m developing new skills I never thought I would, which is helping me plan out my career and where I want to be within the future.”

If you would like to learn more about Project Hope or if you have a potential opportunity within your organisation for a Project Hope placement, please contact chloe.yates3@nhs.net.

Working in partnership to get people Home FAST!

Charlotte, Mark and the award winning Home FAST team

Hello, our names are Charlotte Watkinson and Mark Jones. We’d like to share our experience of working in collaboration across health and social care to deliver our Home First Assessment Support Team (Home FAST) service.

Our ethos across Bradford District and Craven is to ‘Act as One’ to ensure our population remain happy and healthy at home. Once people no longer require care in a hospital setting it’s important that we work together to ensure they don’t remain in an acute bed for any longer than needed. Long lengths of stay in hospital can result in risks of infection, deconditioning and impacts on wellbeing and mental health.

As part of our system wide implementation of the Intermediate Care Blueprint, we have been focusing on those people who no longer meet the criteria to reside in a hospital bed but require an assessment to determine any further care and support they may need to regain a level of independence and confidence to remain at home.

Colleagues from Airedale NHS Foundation Trust Flow Team and Bradford Council’s Adult Social Care Team have been working together to deliver a Home First Assessment Support Team (Home FAST) pilot.

Taking learning from and adapting using the principles from the East Lancs Home First model, Home FAST aims to discharge people within 24 hours of them no longer requiring acute medical care and undertaking an assessment (over a period of up to three days) within the person’s own home to determine their ongoing care and support needs.

Acute therapists working on the wards identify people who may be suitable for Home FAST. Referrals are sent through to the Airedale Flow Team who triage and confirm who is eligible. A multi-disciplinary team of discharge nurses, therapists and local authority trusted assessors then work together to ensure everything is in place (equipment, medication, transport) in time for the 11am discharge slot the next day.

Home FAST consists of a trusted assessor and a physiotherapist or occupational therapist who will meet the person back at their home to assess them in a familiar environment to determine their ongoing needs. This could be a package of care from an independent provider or a period of reablement from the Bradford Enablement Support Team (BEST). In some cases, people regain a level of independence where they require no further support and may need some lower-level input or signposting to VCSE organisations or local community groups.

We launched the pilot early March 2024 and aim to discharge up to three people per day with Home FAST. The team were recognised for their innovative and collaborative work, and we were delighted to win a Pride of Airedale award in June 2024.

From 19 March to 31 August there have been 190 discharges, approximately 1,000 bed days saved with an estimated saving of £500,000. Patients remaining in hospital who are not criteria to reside (do not require acute medical care) has dropped from 27% to 14%.

Home FAST is having a positive effect on people who are receiving enablement services once home. Bradford’s enablement service BEST (Bradford Enablement Support Team) have seen the positive outcomes for the pilot area increase from 58.8% in September 2023 to 76.42% in September 2024. 97 people who have been discharged were able to manage independently following input from Home FAST.

We have also seen a reduction in length of stay in the BEST service from an average of 4.2 weeks in September 2023 to 3.1 weeks in September 2024. We believe this is due to people being discharged as soon as they are medically optimised and are more able to engage in the enablement service.

As a social care professional, I was involved from the very beginning of the Home FAST project. I personally found the collaboration of both health and social care professionals working together to develop and implement the model extremely uplifting, with colleagues from both sides learning about each other and how their own knowledge and skills could enhance the Home FAST pathway. We did not have extra resource and had to look at working smarter with what we had to achieve the outcomes we wanted.

Not everyone embraces change and there were barriers. We started small and built on the positives and these positives were shared with the teams. I have seen the team now develop and know they feel valued and are enjoying working with people within their own homes. The team take pride in the continued positive outcomes they are achieving, and we all look forward to further developing the Home FAST service within our district.

Assessing patients in their own environment has allowed therapists to deliver better patient centred care in comparison to assessing in a clinical environment. As a whole we are finding that once patients return home, they present much better and are often able to safely complete functional activities in which they may not have been assessed for in the hospital. This in turn provides better job satisfaction for the therapy teams and better outcomes for patients who are supported to maintain their independence at home.

Following the successful implementation at Airedale, local authority teams are also working closely with the Multi Agency Integrated Discharge Team (MAIDT) at Bradford Teaching Hospital Foundation Trust to adopt and adapt the model over there.

If you’d like to understand more about Home FAST, we’d love to share our experiences and learning so please feel free to contact us at charlotte.watkinson2@nhs.net and mark.jones@bradford.gov.uk.

Thanks for reading,
Charlotte and Mark

What else has been happening this week?

Bradford Royal Infirmary endoscopy unit groundbreaking ceremony

Breaking ground on a new era of endoscopy care

A ground-breaking event took place at Bradford Royal Infirmary on Wednesday 23 October to mark the start of building work to create a new, state-of-the-art endoscopy unit which will provide more appointments for patients and reduce waiting lists.

Building the £25m endoscopy unit is a two-year project, due for completion in late 2025, which will see the introduction of an eight-roomed unit connected to the main hospital building. It is one of the largest NHS schemes of its kind in the country, with most funding coming from NHS England and the rest from Bradford Teaching Hospitals NHS Foundation Trust. Find out more on the BTHT website.

Endoscopy Unit (artist's impression)

New podcasts launched

‘In Safe Hands’ is a new series of inspiring stories from patients, their families and staff from the pioneering hand transplant team in Leeds, home to the UK’s first hand transplant programme.

The podcast sheds light on the incredible physical and psychological complexities faced by people who have lost their hands and how this remarkable procedure has changed their lives.

Also out this week is the latest in the West Yorkshire and Harrogate Cancer Alliance’s popular series of podcasts. You can hear how they teamed up with Appt Health, an innovative patient engagement service and Imperial College London in an initiative to increase uptake of cervical cancer screening in West Yorkshire.

Public feedback to help shape new hospital multi-storey car park plans

More than a thousand people have given their views about plans for a new multi-storey car park at Airedale General Hospital. The Trust was keen to gather the views of visitors, patients and staff as part of the process to develop the new car park which is a key milestone on the journey to a new hospital for Airedale. Full story.

Airedale Hospital car park

New legislation to ban the sale of single use vapes

On 24 October, new legislation was laid in Parliament to ban the sale of single use vapes from 1 June 2025. This move aims to protect the environment and reduce the appeal of vapes to children. However, additional regulations on product and branding are needed to address the rising popularity of vapes among teenagers. We urge the government to introduce the Tobacco and Vapes Bill to tackle these issues comprehensively.

Future policies should be evidence-based to prevent vapes from attracting young people and support long-term smokefree goals. Disposable vapes have been an important tool in helping people quit smoking, particularly for those who need a simple, effective alternative that is less harmful than cigarettes. Alternatives like refillable and rechargeable vapes are available and we need to increase awareness of all the available options among smokers and healthcare workers.

The key message is that vaping can help adults quit smoking but is not intended for non-smokers, particularly children and young people.

Leeds and York Partnership NHS Foundation Trust is restructuring its crisis resolution intensive support service

CRISS - two men talking The structure and location of Leeds and York Partnership NHS Foundation Trust’s Crisis Resolution Intensive Support Service will change from 4 November, resulting in a clearer care pathway for people experiencing a mental health crisis.

The service will transition from having one crisis service and three home treatment teams to having three crisis and home treatment teams covering Leeds. These three teams will each carry out crisis assessments as well as intensive support. The change represents an opportunity to improve services and meet the high standards in care service users expect. Structuring its service in this way will ensure a clearer pathway for people experiencing a mental health crisis, including those who need enhanced support when a hospital admission is being considered.