Posted on: 23 July 2021
Hello, my name is Catherine
I am the Programme Director for the West Yorkshire and Harrogate Planned Care Alliance and I know all too well how the pandemic has affected healthcare services and staff across the healthcare system. Although I was aware of the dreadful impact that long waits have on people’s lives, hearing this for myself from patients affected, and seeing their anguish and distress, is what really brought it home.
“I’ve been waiting over 16 months for a routine operation. I’ve had no communications from the hospital for nearly a year, so I don’t know if I’m still on the waiting list or not. The delay is having a big impact on my physical and mental health. I appreciate that it’s been an extremely difficult time for the NHS and I sympathise with the workload but I haven’t been kept in the loop. I just feel forgotten.”
This is what a member of our new Planned Care Citizens’ Panel told us at the very first panel meeting last month. Everyone on the call saw for themselves the despair on her face and heard the frustration in her voice. It’s heart-breaking and very difficult for us to hear because we know this will be the case for the thousands of patients across the region who are waiting for planned care. And because we also know this hasn’t come about through any lack of effort by the NHS and healthcare staff – quite the opposite in fact.
Throughout the second wave of the pandemic in October last year, and the third wave in January this year, our six hospital trusts across West Yorkshire and Harrogate continued to carry out emergency surgery and prioritise demand for tests to diagnose conditions that require urgent treatment, including cancer.
Our hospitals have never stopped carrying out elective surgery since the initial pause in non-emergency surgery at the very start of the pandemic, even though at times our ability to do so has been quite limited. We continued because we didn’t want people in the greatest need to have to wait any longer than was absolutely necessary. We knew it was possible to scale back some planned surgery, rather than stopping it altogether and then having theatres and beds available that could have been used to treat patients.
This all took place under extremely difficult conditions and in addition to the ongoing need to treat the thousands of patients seriously ill with Covid across the area. It made everything much harder for the clinical staff in the hospitals, but it was the right thing to do because otherwise, we’d be in an even worse position now, with even more people waiting for planned care.
The media recently reported that the number of people in England referred to treatment for consultant-led elective care at the end of May 2021 had exceeded 5 million. The national total given is now actually just over 5.3 million, the highest number since records began in August 2007. We know that in West Yorkshire and Harrogate, we have about 200,000 people waiting for some type of elective surgery or planned care procedure. Of those, around 10,000 have been waiting for more than a year.
As the numbers of cases of Covid in the community go up, we are once again seeing rises in our hospital admissions for the virus, although nowhere near as high as during the last wave. Other pressures in our system, including the ever-increasing demand for urgent and emergency care services, are also impacting on planned care. All healthcare services are under pressure which makes it extremely challenging for those people in our hospitals who are working incredibly hard to keep planned care going.
It is inevitable therefore that many patients will still have a long wait for planned care but we are working hard to make sure that those patients are able to manage their conditions whilst waiting and that they know when and how to seek medical help if their condition deteriorates. We’re helping patients make the best possible use of the time they are waiting by supporting them to prepare physically, mentally and practically for when they do have their procedure. By taking a holistic approach to patient care, we can talk to patients about alternative pathways and treatment options that are appropriate and available.
So, to get back to our panel member quoted earlier who is one of the 10,000 people in our region who have been waiting for more than a year, how did I respond to her comment? The first thing I needed to do was to say ‘sorry’. Sorry that she, and many others in the same position have had to wait so long, and sorry that people haven’t been told what’s happening and when they can expect to be treated. I could have talked about the immense pressure hospitals and other healthcare services have been under and how it has been almost impossible to give planned care patients any timescales for when they are likely to be seen but she knew all that. She now wants to know that she has not been forgotten.
The 200,000 people in West Yorkshire and Harrogate who are currently on the waiting list have most certainly not been forgotten. They are uppermost in the minds of the Planned Care Alliance, WYAAT, the elective recovery teams, hospital staff and many, many others as we carry out elective care for those in most urgent clinical need. And as we develop plans for addressing the backlog and shortening the waiting period for people in less urgent need but who still need treatment.
Good and timely communications with patients will be essential as we progress with elective recovery and as we move into a new way of working in an environment where Covid is always present. This is where the experiences and insight of our citizens’ panel is proving to be invaluable.
The Planned Care Citizens’ Panel was established in early June 2021 to give us a patient’s perspective on the restoration of elective surgery and planned care services. It’s a virtual panel, consisting of patient representatives from across the region, with different health conditions but who are all waiting for a planned care procedure. The panel’s input is really helping us to make sure that information around bringing back planned care services is relevant and clear, and that it gets to the people who need it at the right time.
At the two panel meetings we’ve had so far, we’ve talked to panel members about communications related to planned care – what’s not working right now, what we can do to improve communications and exactly how people want to be communicated with. Even though we all work in healthcare, we don’t necessarily know what the right things are we should be addressing around planned care - but those who are waiting for planned care do.
Feedback from the citizens’ panel is helping shape communications and is feeding into many different areas, not just elective recovery but things like personalised care, shared decision-making, digital healthcare and how we can promote self-care, prevention and healthy choices to help reduce the number of new referrals for planned care in the future.
The good news is that we are starting to see increased planned care activity in our hospitals week after week. The six trusts across West Yorkshire and Harrogate are working as a an ‘elective co-ordination group’ to think creatively about how resources can be pulled together to address some of the backlog and provide additional activity.
Members of our citizens’ panel know from first-hand experience the impact that waiting for treatment is having on their health, lifestyle, personal circumstances, and on their friends and families. It is because they know this that they are so determined to do all they can to help others in the same position. We have a long way to go but we will get there, and we’re privileged to have patient representatives who are so willing to support us along the way.
Have a good weekend,
Catherine
What else has been happening this week?
Doctor’s plea for people in to get jabbed, as hospital admissions increase
Dr Phil Wood, the Senior Responsible Officer for the COVID-19 vaccination programme in West Yorkshire is calling on those who haven't been vaccinated to get their jabs, as hospital admissions for the virus continue to rise sharply. With all remaining restrictions lifted earlier this week, people who are yet to be vaccinated or who had their first dose more than eight weeks ago, are being urged to visit one of the many walk-in vaccination clinics in the region or book an appointment at www.
It has never been easier to get your vaccine. Your local clinical commissioning group lists all the places within your local area where you can simply walk in without an appointment, get your jab and walk out.
Partnership drives towards improving health and care for people with learning disabilities
Our Partnership has announced a package of measures aimed at reducing the health inequalities faced by people with learning disabilities in the area. These inequalities start early in life and stem from barriers to accessing appropriate and effective health care as well as other services. The latest national Learning Disability Premature Mortality Review (LeDeR) programme report (University of Bristol June 2021) has highlighted that people with a learning disability still die much younger than the rest of the population (on average 20 years) and are three times more likely to die from causes that could have been avoided.
Learning disability is not, of itself, the reason for this inequality; instead, it is a result of services not always meeting people’s needs. For people with a learning disability, it can be difficult to stay well and get help when it is needed, and this has been further compounded by the pandemic where we saw numbers of people accessing health services reduce significantly. You can read more about the Partnership's drive towards improving health and care for people with learning disabilities here
Partnership People Board
The Partnership’s People Board met on Tuesday. Chaired by Brendan Brown, CEO for Airedale NHS Foundation Trust, and our Workforce CEO Lead. The group is made up of NHS, councils, universities, and voluntary community social enterprise sector colleagues.
Colleagues discussed support for all our health and social care workforce, the move towards becoming a statutory integrated care system; organisational development and the production of our new people plan.
Health and Care Bill Proposals
The first reading of the Health and Care Bill took place in the House of Commons on 7 July with the second reading on 14 July. The Bill follows on from the White Paper Integration and innovation: working together to improve health and social care for all and sets out legislation to establish Integrated Care Boards (formerly known as Integrated Care Systems) as statutory bodies.
NHS England and NHS Improvement (NHSEI) have previously published the Integrated Care System (ICS) Design Framework to guide next steps in developing ICS’ in line with the Bill and the White Paper. It should be noted that until the legislation is agreed by Parliament the move to create new statutory NHS bodies to replace clinical commissioning groups remains a proposal. You can read more about the work we are doing in our latest update here. You can also read more via the Guidance: Health and Care Bill: Integrated Care Boards and local health and care systems. This was published on the 19 July and Rob Webster our CEO Lead is quoted.
New digital solution in the UK called TytoCare
Staveley Birkleas Nursing Home and the Shipley Medical Practice are currently participating in a Yorkshire & Humber wide pilot of a new digital solution in the UK called TytoCare. The pilot is funded by NHSX until the end of April 2022 with the aim of understanding the impact of using TytoCare to provide virtual primary care to our residents.
TytoCare is a handheld examination device linked to a digital platform. Using the device makes it possible to capture enhanced clinical observations and carry out high-quality video consultations at the same time with a GP or another healthcare professional. The home looks after up to 61 adults with disabilities, from the ages of 18 to 64. The Shipley Medical Practice is the linked GP practice for Staveley Birkleas and provides both urgent care support and weekly virtual ward rounds.
Unpaid Carers Programme
The Unpaid Carers Programme Board met last week and heard about progress made on how as a system we can better support those with caring responsibilities living and working within West Yorkshire and Harrogate. The Programme has identified six priorities for 2021/2022 including:
- Increasing awareness and support for young carers
- Improving the lives of working carers
- Better recognition and support in primary and community care
- Working with our hospitals
- Recognising carers as experts in care
- Supporting the mental health of carers.
The Board discussed the need to involve lay people who can contribute as board members as well as bring their experience as patients and carers to our Board. To provide a parity of esteem, members agreed that it is essential that recruitment of all future lay members of the board receive fair renumeration that demonstrates how they are valued for their time and contributions. Following the launch of the Primary Care Quality Markers film the Board were in support of developing a task and finish group to better embed and spread the quality markers within primary care, and the important links with community care. The Board also reflected on the importance of linking in with Primary Care Networks closer to push the agenda. The purpose of the task and finish group is to create a compendium of resources tailored for primary care looking at benefits of support, clinical coding, processes for signposting, and embedding the working carers passport.
Yorkshire & Humber Academic Health Science Network (AHSN) helps to secure £140k of funding to support asthma sufferers
Access to asthma care for vulnerable and hard to reach groups across West Yorkshire and Harrogate is set to be improved, thanks to £140,000 funding that Yorkshire & Humber Academic Health Science Network (AHSN) has helped secure through the NHS Accelerated Access Collaborative’s Pathway Transformation Funding.
Mid Yorkshire Hospitals have been awarded funds to progress with an asthma project looking at the barriers that prevent people from ethnic minority communities from accessing the care they need. Amongst minority communities, there is still a high prevalence of asthma cases that are inadequately treated. For instance, for many, English is not their first language, and it is important to ensure people have access to information in a number of different languages. There are still many myths and misconceptions surrounding asthma such as the belief that it is infectious, or that it is a psychological disease.
Dr Llinos Jones, respiratory consultant at Mid Yorkshire Hospitals NHS Foundation Trust, said: “I’ve been working for years trying to address health inequalities for patients with asthma who struggle to read and write in English, and yet need to self-manage a chronic condition. “I was initially asked to help set up a branch of our Difficult Asthma service in Dewsbury, a service that provides assessment and treatment for asthmatics who need more than the standard asthma treatment. “While there, I quickly recognised that there were very few resources available for patients who didn’t speak English. With 1 in 6 people functionally illiterate in the country and large communities of people whose first language isn’t English, this wasn’t something I was willing to accept.
“Alongside the Yorkshire & Humber Academic Health Science Network who helped me tender the bid, we have set about addressing some of the communication inequalities that contribute to poorer outcomes for those from minority ethnic backgrounds and those with learning difficulties. It’s a fantastic development to have secured funding which will go some way in helping us tackle the communication barriers that cause these poor outcomes.”
Kathy Scott, Deputy CEO of Yorkshire & Humber AHSN, added: “The pandemic has exacerbated the health inequalities already existing in our region in particular for minority communities and people living in areas of high deprivation, and projects like this are vital to help reduce those inequalities. “Furthermore, local healthcare teams are better placed to understand the needs of their population and find the best solutions in their approaches to patient care”.
Over the last 12 months we have supported bids for funding that have resulted in over £5.3m of new healthcare investment coming into Yorkshire and the Humber, of which these two projects are just an example. If you would like to know more about how the Yorkshire & Humber AHSN can support your project, follow them on Twitter @YHAHSN or visit www.yhahsn.org.uk
Caring for COVID patients at home
One of the major challenges for the NHS during the pandemic was detecting early signs of deterioration in patients with confirmed or suspected COVID-19. Oximetry @home was commissioned by NHS England and NHS Improvement to provide ‘high risk’ COVID patients with pulse oximeters to support the use of home monitoring of blood oxygen levels.
The region’s Patient Safety Collaborative is hosted by the Yorkshire & Humber Academic Health Science Network (AHSN). They have been supporting the use of the oximeters in our local health and care system. Through regular meetings with dedicated oximetry project teams, all clinical commissioning groups across our area have successfully adopted and spread an Oximetry @home project. Oximeters were given to patients as part of the on-boarding process either by the GP practice or COVID 'hot hubs' that had been established in some areas.
If you would like more information about this project, please visit Oximetry @Home web page on the Yorkshire & Humber AHSN website or read their latest Impact Report.
The West Yorkshire Joint Health Scrutiny Committee writes to record thanks to all NHS staff over the course of the pandemic
"Our thanks cover everyone in the NHS. The nurses and doctors have, of course, been brilliant, but their work would not have been possible without medical ancillary staff, porters, cleaners, ambulance staff, receptionist and administrators and every other role in the service. All of you have gone way beyond the call of duty. Our thanks cover everyone in the NHS. The nurses and doctors have, of course, been brilliant, but their work would not have been possible without medical ancillary staff, porters, cleaners, ambulance staff, receptionist and administrators and every other role in the service. All of you have gone way beyond the call of duty. We are all very aware that many of the staff have protected the people of West Yorkshire at great personal cost to themselves and their families. And those colleagues who have sadly died from covid-19 while putting themselves in the front-line are never far from our thoughts. The NHS certainly deserves the George Cross that you have recently been awarded for your courage. Of course, millions of other key workers, such as care workers, supermarket staff, and refuse collection staff have also made a fantastic contribution, but as a health scrutiny committee we wanted to pay particular tribute to the NHS and its people".
‘Skin Snaps’ And Rapid Tests Among £20 Million NHS Push To Speed Cancer Diagnosis
‘Skin snaps’ and rapid tests for same day diagnosis are among a package of measures to get more people checked for cancer, the NHS said last week. The NHS is investing £20 million to speed up the rollout of these plans, so that thousands more people can get potentially lifesaving cancer checks. ‘Teledermatology’ is being used to diagnose skin cancer faster, with pictures taken by a medical photographer sent to hospitals so diagnosis and treatment can happen quickly. The technology has already been used in Leeds, York and Mid-Yorkshire NHS Trust Hospitals – with a doctor reviewing an image of the patient’s skin for diagnosis. New efforts to speed up diagnosis for prostate cancer are also seeing patients referred directly for an MRI scan by nurses, rather than having to wait for an appointment with a consultant. This has reduced multiple visits to a single visit, with all diagnostic tests carried out on the same day.
The difference communities are making with Partnership’s grants
Last year we allocated over £500,000 health inequalities funding to thirteen voluntary and community organisations across the area.
The funds are being used to support community two organisations, working together with health partners, to support those that have been disproportionately affected by COVID-19. On our new making a difference through funding website pages you can find out more about how organisations are using the funding to help make lives better.
See our latest case studies which include:
- Leeds GATE, who have recruited a Health Advocate to build links with Gypsy and Traveller groups in Bradford and Wakefield. Through collaboration and by providing mental health, welfare rights and healthcare registration support, Leeds Gate is making a real positive difference to people's lives
- a collaborative partnership between People’s Voice Media, local organisations in central and North Halifax, VAC and the Community Foundation for Calderdale helping to address health inequalities in those communities most affected by COVID-19.
- Solace, which helps people survive exile and persecution, extending their specialist therapeutic care approach to help alleviate emotional distress.
Urgent and emergency care programme board update
Representatives from the ICS Clinical Forum, Anthony Kealy from the Locality Team and Sarah Smith, Public Health Consultant from the Improving Population Health Management Programme joined the urgent and emergency programme board on 20 July to have a joint discussion about the Key Lines of Enquiry previously developed by the Clinical Forum and shared with the System Leadership Executive. The aim was to use our collective knowledge, think differently and identify if there was any further action which could be taken to address system pressures. Mental health, children and young people, data and communications were key themes and several actions were identified such revisiting the West Yorkshire and Harrogate Ethical Framework published in 2020 and the guiding principles to help guide the system over the next few months and modelling data in relation to child health and mental health needs over the coming months.
The safer transfer of care steering group recognised the contribution of robust community services and the work that will be need to done over the next 18 months within each place such as the mapping of groups they will engage with and will share the approach with the wider system. The pre-hospital working group asked the board to support the proposal they have made relating to the review of paediatric pathways, to identify gaps and opportunities for next steps. Increasing system pressures and representatives’ ability to contribute to the workstreams could potentially affect the overall delivery timescales that could impact upon the programme’s delivery programme.
Keir Shillaker, Director for the Mental Health, Learning Disability and Autism Programme updated the board on current pressures and access rates for mental health, noting that all areas are struggling to hit national targets and the position is similar for children’s access but West Yorkshire and Harrogate are doing better than most. The board heard about a new pilot overnight mental health crisis support line for children and young people called NightOWLS. The Board were updated on the approach that will be taken to launch phase 4 of the ‘Looking out for neighbours’ campaign that will target young people and is set to launch in mid-September.
Dr Owen Williams OBE leaving Calderdale and Huddersfield NHS Foundation Trust after serving nine years as Chief Executive
Owen is due to take up his new post this Autumn as the Chief Executive of The Northern Care Alliance NHS Group which provides services across Salford Royal NHS Foundation Trust and The Pennine Acute Hospitals NHS Trust, serving hospital and community healthcare in Salford, Oldham, Bury and Rochdale.
Owen said:
"It has been a huge privilege to have led Calderdale and Huddersfield NHS Foundation Trust since 2012. I have so many fond memories and so many reasons to be proud of the many achievements we have made together during my time here from our pioneering work on digital healthcare through to our more recent work in tackling health inequalities across our local communities. I know CHFT will go to on achieve so much more in the years ahead, because I leave behind friends and colleagues who have shown astounding levels of resilience during the pandemic, always striving to deliver compassionate care to our patients under the most challenging of conditions. It is this fighting spirit and sense of hope, despite adversity, that I will miss the most as I journey towards the other side of the Pennines”.
Starring role for West Yorkshire and Harrogate In National Lung Cancer Awareness Campaign Video
A video produced to support the Do It For Yourself lung cancer awareness campaign running across a number of Cancer Alliances nationally -including West Yorkshire and Harrogate - features a Yorkshire trio who are encouraging people concerned about signs and symptoms to seek medical attention. Dr Leanne Cheyne, Consultant Lung Physician at Bradford Teaching Hospitals, and Ric Myers, a lung cancer patient from near Leeds, join TV personality and Bradford GP Dr Amir Khan in the film, which will run alongside other elements of the campaign, including bus side advertising, supermarket digital screens and social media. View the film here.