This week’s leadership message comes from Dr James Thomas, Medical Director for NHS West Yorkshire Integrated Care Board (ICB) and Beverley Geary, the ICB's Director of Nursing

Posted on: 29 September 2023

This week’s leadership message comes from Dr James Thomas, Medical Director for NHS West Yorkshire Integrated Care Board (ICB) and Beverley Geary, the ICB's Director of Nursing. We also have blogs from Becky Malby, Non-Executive Member of West Yorskhire ICB and Haris Sultan, non-executive development placement, and from Caroline Andrews, Project Manager for the West Yorkshire Health and Care Partnership's Adversity, Trauma and Resilience Programme.

Beverley Geary Hello,

First, we want to start by saying a massive thank you to all our colleagues who continue to support and “step up” in the system, in adversity, as we face many different and ongoing challenges across our health and care system.

We are in a privileged position to work with many colleagues across all sectors, geographies and with people and communities in West Yorkshire, and we see first-hand the leadership that helps connect the system to itself and respond to the many demands we are all seeing. We continue to meet the challenges and drive innovation, despite the pressures, to ensure we deliver the best care for the people of West Yorkshire and ensure our staff feel valued. We are immensely proud of how many of you are leading, influencing and responding to the challenges of the impacts of the cost-of-living crisis, alongside the increasing needs for our services, the ongoing industrial action and the back log across health.

As the summer draws to a close, we are now looking to our preparations for winter, in order that we have a resilient and responsive service for people and communities. In March of this year, we started to prepare for this winter, when together, in partnership, we worked collectively to reflect on how we responded to, what was publicly documented as, ‘the worst winter on record for the NHS’. These reflections on the good response and where we feel we need to improve or change were the basis for our planning for this winter. A detailed plan has now been written and was submitted to the NHS West Yorkshire Integrated Care Board on 19 September.

Dr James Thomas In and amongst the current very busy times, we are dealing with not only the clinical challenges but with some very alarming issues in the national news, including the verdict into the investigation at Countess of Chester and the criminal conviction of neonatal nurse Lucy Letby. We know that a statutory inquiry is planned to identify lessons to be learned, and we hope you all read the immediate response from ourselves and Rob Webster; CEO for NHS West Yorkshire Integrated Care Board on 21 August 2023.

We have also all seen the recent shocking findings of the survey into sexual assault of women in surgery - A third of women working in surgery have been sexually assaulted by a colleague | University of Surrey. Following this publication, we are working to understand what this means for all our organisations in the system and, most importantly, for our female colleagues. Understanding what we can learn to ensure our culture in West Yorkshire prevents this happening and ensure the support is available for anyone at any time is really important to us. Given these recent incidents, we need to ask ourselves if the culture in our organisation enables people to feel open to raise concerns, escalate when appropriate, act when required and people feel supported when concerns are raised.

The scale and range of challenges across health and care can feel huge, especially when you look at the vast differences we see across West Yorkshire, the health inequalities and the impact of these for people and communities. At our last Partnership Board development session, we discussed how we measure that we are delivering improvements against our ambitions, and heard what these inequalities mean for us in West Yorkshire. The startling difference we saw across West Yorkshire was that 900 more people died from the most poorest 20% parts of the area than would have if the rate of death in these places had been the same as in the most affluent 20% of the region. It means that there were over 700 excess deaths from heart disease and strokes in the most deprived 20% in 2020-2021.

This is staggering, and as clinicians we see what this means for the individuals, their families and carers. As we challenge ourselves across all of our organisations to have a positive impact on these inequalities, we shouldn’t lose sight of all of the amazing work that is happening across the system and remain positive as we innovate and as we deliver care across our partnership and see the impact on these stark inequalities. Only last week we had the privilege to meet some of our new equity fellows, who are embarking on work across many sectors of health and care and wider, ensuring it is connecting the system to itself, doing real change in real work and focusing on our founding principles of embedding early help, and addressing inequalities in our Fellows programme.

Despite a busy summer, work to continually improve and on system leadership has continued at pace, focusing on partnership working, leadership development and communication of our system clinical and care professional leadership. Adopting a Jonkoping approach, participants at a recent event were made up from one-third clinical and care professional leaders, one-third members of the public, and one-third from the VCSE. The work was grounded in personalization and key foundations of health inequalities, co-production and understanding a trauma informed approach. There was even an opportunity to “know your numbers” as part of blood pressure testing week. Work is ongoing to summarize the richness of these conversations and will be highlighted later this year, but it highlights the importance of ensuring the process you use to get to the future is the future you get.

It was wonderful that we had a chance to meet Dr John Paul Bagala, Medical Adviser to the Ugandan Ministry of Health, in Wakefield earlier this month. It was great to hear about the learning through the Global partnership working that is taking place here in West Yorkshire and across Uganda. We discussed specifically the great collaboration being seen across our Local Maternity Neonatal Networks (LMNS) and the positive impact this is having for the women and families in Uganda but also the impact and opportunities of learning for clinicians in Uganda and also West Yorkshire. This enables us to learn and share as a system on the global stage and demonstrate the opportunities for others by working in the West Yorkshire system.

Finally, this week has seen the start of the wider roll out for COVID vaccinations alongside our regular flu vaccination campaign. The vaccination programme started for residents of adult care homes and people who are housebound last week. As in previous years, people will be notified when bookings open. Those eligible will be invited to book an appointment in priority order, starting with those at greatest risk, with the main programme expected to be completed by the end of October. We are encouraging people who are eligible to get both COVID and flu vaccinations as soon as possible ahead of the winter period and due to the risk of the new COVID-19 variant, in order that they can be as fully protected as possible. People will be aware that this has been brought forward following an announcement by the Department of Health and Social Care (DHSC) and the UK Health Security Agency (UKHSA) on the risks presented by the new BA.2.86 variant and pre-emptive measures the NHS has been asked to take. So once again we have seen how GPs, community pharmacists, community teams including the VCS and our hospitals have stepped up to ensure we can respond and deliver vaccinations and go faster sooner. There is no doubt this will present a challenge but as so often in West Yorkshire, we will come together as a system to do the right thing to ensure all communities can the care they need.

So, we end this message with sincere thanks to each one of you for the work that you do every day, and with a recognition of all of the hard work that every one of our teams are doing to meet the many challenges across our system as we start to face winter and the challenges this brings.

Thank you,
James and Beverley

Becky Malby and Harris Sultan

Hi we are Becky and Haris and we are the non-executive members for citizens and future generations on the Integrated Care Board.

What do we do?

Non-executive members are equal members of the Board with the executives (chief executive, medical director..). We are there as members of the community in West Yorkshire to share responsibility for the Board’s decisions, making sure that West Yorkshire does all it can to help people enjoy good health, and that we do this fairly, so that everyone in West Yorkshire has the same access to high quality healthcare, and no lives are cut short because of life circumstances. Becky is a Non Executive Member with governance roles, such as chairing the ICB Quality Committee and being the ICB’s Non Executive Maternity Safety Champion. Haris has a Non Executive placement with the ICB which provides him professional development opportunities and the opportunity to contribute in a Non Executive style role.

As critical friends, we help make decisions better by challenging ‘the way things are done round here’. With the best will in the world, if you are dealing with the issues facing the NHS every day, it's hard sometimes to see another way to solve the problem, or to challenge the assumptions on which the NHS provides services. Becky brings a career in evidence-based decision making, many years of working with primary care, her environmental leadership (in the national campaign to clean up rivers), her volunteering with young people, and her community activism to this role. Haris brings his perspective as a younger board member with both local and national leadership experience in children and young people’s health and social care working across sectors as well his experience looking into health inequalities, climate change and future workforce. It means both Haris and Becky understand the NHS dilemmas, but also provide challenge and critique to pervading views.

So what?

Some examples of what we have done as NEMs:

Becky has led the change to how the Board meets. Each Board meeting has an issue it focuses on, but now this is preceded by discussions with members of the public affected by that issue (for instance we have examined children and young people’s mental health, access to general practice, dentistry). Each of the issues comes to the Board with a track record of local involvement, but these pre-meetings with members of the public mean that members of the Board are acutely focused on people in West Yorkshire’s real experience. After these discussions we have lunch together and then the members of the public are invited to observe the Board meeting decisions in relation to that issue. This means the Board both listens before the decisions, but also makes those decisions in public with those who are affected in the room with us.

We also go and visit places to follow-through on these issues. Recently Becky visited Bradford to talk with all the organisations involved in supporting children, young people and their families with the huge increase in mental health needs. We all know that COVID-19 led to an increase in the number of children and young people experiencing anxiety and mental health distress, with doubling in referrals to MH services. This level of need is remaining high, in effect becoming a new normal. With children and adolescent mental health teams working with double the caseload on static staffing, across West Yorkshire places are rethinking how best to meet this need, collaborating with communities and the voluntary sector. We met young apprentices building children and young people’s confidence, school based children’s therapy teams helping children and young people manage their mental health, teams working proactively with families at the early stages of children’s lives. The demand is really significant and places are reaching out into communities to find the best way to support families.

Haris has led change on how the board focuses on prevention and public health. It can often feel as if we are “chasing the treasury” and not focusing on the future. Recently Haris visited a community centre in Wakefield to talk to members of staff and young people about what we can do differently particularly around mental health, suicide prevention and refuges. This then promoted a discussion at with the Associate Director of Public Health on how we classify public health risks on our risk register (this is a list of all the high level risks to the West Yorkshire system and what we are going to do to stop them from happening). This has also meant working with our WY Directors of Public Health to ask about what they believe we can do differently to ensure the best health for our population now but also in the future. Climate change is an essential part of public health, which is something both Haris and Becky advocate frequently for at Board level. Recently the ICB took on the commissioning of NHS dentistry, Haris asked whether dentists are going to come over to our amazing ambition of using greener gases in procedure and less single use plastics. it is really important we work collectively to reduce our impact on the environment and that climate change permeates every decision that we make.

Becky is actively encouraging a change to the Board’s performance dashboard (the measures that we look at to see how well we are doing in providing high quality and fair health services) so that we have measures that matter on general practice and primary care. We all know that you get more of what you pay attention too, so what you measure focuses our attention. The Board has not been required to measure the impact of general practice and yet it is a major concern to people living in West Yorkshire. We are putting in measures that not only tell us about how many appointments are available, but also the quality of general practice, and how appointments are provided so that everyone gets a fair service.

Haris has actively encouraged change to the recruitment of call handlers. When out in the community, Haris had a conversation with individuals who really wanted to work for the NHS but couldn’t . Previously 999 and 111 call handlers were required to have a Grade C in English and Maths GCSE which creates an initial barrier for people who haven’t done GCSEs or haven’t achieved those grades but have a wealth of experience that we need within our workforce! Therefore, after a discussion at our West Yorkshire Integrated Care Board Meeting the Chief People Officer, Kate Sims followed this up. The requirement is now Grade C in English and Maths or equivalent experience, allowing more people to apply for the roles removing the initial barrier allowing us to have a more diverse workforce that is representative of the population.

The NEMs all have link roles with places. Becky is linked to Calderdale. This means she can follow through on how decisions made at the Board are actually working in place, and can understand the differences in how people’s lives are affected by the NHS and its partners. She will be visiting the Healthy Minds group in Calderdale soon to see how our work across West Yorkshire on mental health and on supporting the voluntary and community sector is working.

Now what?

We do this work because we care about the future. As NEMs for Future Generations, we will question, scrutinise and make visible the experience of children and young people; we will champion measures to reduce our impact on the climate; and we will constantly seek to do all we can to mitigate the impact of poverty on health. We want to make sure no one life is cut short because of where they were born or live. We aim through our persistent focus on these issues, using them to judge how well we are doing as an ICB, to support decisions about funding and priorities in West Yorkshire.

In this blog, Caroline Andrews, Project Manager, Adversity, Trauma and Resilience (ATR) for the Improving Population Health Programme, talks about her passion for creating trauma informed organisations. She also describes her own personal development story and overcoming her fear about presenting.

Caroline Andrews Hello, my name is Caroline.

In West Yorkshire, we have an agreed ambition of “working together with people with lived experience and colleagues across all sectors and organisations to ensure West Yorkshire is a trauma informed and responsive system by 2030”. This is something that I am deeply passionate about, having lived experience.

When I joined this programme, I was in awe of the work that had progressed and the passion and commitment from Emmerline (Emm) Irving and Carrie Rae, who originally created the ATR programme. Whilst listening to their various presentations and chairing of different workstreams, I was very vocal that “I would never be able to do anything like this” and referred to myself as sounding like “Larry the Lamb” if I were to ever present.(If you are too young to know who Larry the Lamb is use this link).

As part of the ATR programme, we have included an NHSE pilot to reduce violence against staff in hospital trusts, along with six other areas across the UK. In West Yorkshire we put ATR delivery under the Improving Population Health Programme. When I attended monthly meetings I talked a lot about what we do in the ATR Programme, how important it was to be trauma informed, not only for patients but also for staff and providers. From these discussions a member from East Sussex asked if we could arrange a meeting to discuss the ATR work as this is a journey that they were looking to begin. Although I felt nervous and anxious, Emm assured me I could do it and supported me in creating a presentation.

I attended a senior leadership executive group and presented the West Yorkshire journey to date to become trauma informed. We are now working with East Sussex to support them on their journey. I really appreciated Kath Marginson, the project lead from NHSE on the pilot, telling me that she wished she could bottle up my enthusiasm and pass it on to other colleagues. As the pilot progressed, each area involved got together to present an update on the work being carried out to reduce violence against staff at a meeting in Leeds. Colleagues at the meeting were aware that I was a nervous about presenting face-to-face but made me feel at ease. In my update I talked about the trauma informed foundation training led by Dr Warren Larkin to trust leads. Warren has already provided training for over 3,000 people across West Yorkshire including housing and GP practice colleagues as well as front line police officers with some great feedback.

After the meeting I was delighted to receive an email from Claire Parker (Chartered MCIPD), Senior Programme Lead, Health and Wellbeing Team, People Directorate, NHS England, which said: “I just wanted to say that I thought your presentation to the group went great! There is so much work that’s happened in your ICS and this will absolutely be down to the management you have provided the programme. I know you were nervous about presenting so do take a moment to congratulate yourself on a successful day – and a successful programme!”

Caroline Andrew with students Dr Richard Baron, Lecturer in Mental Health, Programme Leader for MA in Mental Health of Children and Young People at Leeds Trinity University emailed and asked for a meeting about the work we are doing across West Yorkshire to become trauma informed. After talking to Richard about the work I was doing with NHSE around reducing violence against staff he said that his instincts were spot on and we were aligned in our goals around learning, knowledge development, cultural transformation, and professional growth.

Richard asked if I would be willing to be a guest lecturer at the university for his students who had spent a whole year critically analysing trauma-informed practices - if I had been in a room full of other people, I would have looked behind me to see who he was talking to! I felt overwhelmed but Richard assured me that I would be ideal due to my passion on this subject. When the day came, I drove there feeling very anxious and tense at the prospect of ‘lecturing’ at a university. On making my way to the lecture theatre I completely missed the exit to a glass revolving door and ‘face planted’ into the glass. At least the students in the nearby café waited until I’d walked on to share their amusement.

After presenting to the students about our ATR model we had an interactive session on trauma informed language. I felt able to draw on my own experiences, especially in supporting children in schools. Richard asked me to attend another session and do a follow up on the language work. Everyone made me feel very welcome and I feel very honoured to be able to put on my CV that I have been a guest lecturer at the university.

Feedback from Richard has been really welcome and the experience has opened up new forums and fortified the bond between Leeds Trinity University and the Partnership. Richard said that: “While Caroline might not regard herself as a foremost expert in trauma-informed practice, I saw her as the lifeblood of a system striving for cultural metamorphosis in our region. I recognised the immense value she could bring to our students—partly because some could see their future selves in Caroline and partly due to the breadth, personalisation, and sincerity of her knowledge.”

I feel extremely fortunate to work for such a fantastic team and organisation that give opportunities for all staff at any level. If you would like to know more about the amazing work that the ATR programme is doing please visit westyorkshiretraumainformed.co.uk.

I’ve never done a blog before so I hope that you found it interesting and maybe amusing and thank you for taking your time to read it.

Caroline

What else has been happening this week?

A young child enjoying the HRI A&E open day

First look inside 'world-class' Huddersfield's new A&E department

More than 350 people attended the public open day of the new, state-of-the-art A&E at Huddersfield Royal Infirmary on Thursday 21 September. Feedback from the day was overwhelmingly positive, and news of the open day was covered on Yorkshire Live.

Linda Pollard Phil Wood with ICB and WYAAT execs

New regional pathology lab opens

A new regional hub for diagnostic testing has opened at Leeds Teaching Hospitals NHS Trust. The new, state-of-the-art facility was officially opened on Tuesday 26 September by Minister of State for Health and Secondary Care, Will Quince MP.

The building marks a significant milestone in regional healthcare as the Trust will welcome staff from Mid Yorkshire Teaching NHS Trust and Calderdale and Huddersfield NHS Foundation Trust. In addition to Minister Quince, the opening event attracted a host of VIP guests including West Yorkshire Mayor, Tracy Brabin. Everyone had a tour of the building led by LTHT pathology staff and had the opportunity to meet pathology staff from Blood Sciences, Microbiology, Central Specimen Reception, Specialist Laboratory Medicine and LTHT’s Cat 3 lab.

This pioneering regional partnership with Calderdale and Mid Yorkshire, which has been forged in collaboration with the West Yorkshire Association of Acute Trusts (WYAAT), will drive innovation in testing and diagnostics. Equipped with advanced technology and state-of-the-art equipment, the laboratory will deliver faster results for patients, irrespective of their geographical location. Read the full story: Latest news from Leeds Teaching Hospitals NHS Trust (leedsth.nhs.uk)

Leeds Teaching Hospitals NHS Trust Pathology Lab

Black Maternal Mental Health Week

A new mum with her baby This week is Black Maternal Mental Health Week in the UK, an annual event dedicated to raising awareness about the mental health challenges faced by Black mothers. #BMMHW23

As part of our inclusion work underpinning the development of the West Yorkshire-wide maternal mental health service we have carried out a number of listening events across West Yorkshire with black women and birthing parents.

The events were set up to help women to see the value of and participate in wellbeing activities as well as engaging in conversations about accessing mental health and emotional wellbeing support and how our new service can be better shaped to be more accessible and inclusive to all. We have been delighted that groups around the district have welcomed us into their space. This has been a great learning opportunity for us to shape our service and develop training for our staff. Our aim is to ensure Black women and birthing parents feel welcomed and supported, that our offer is relevant to their experiences and they feel able to access support when needed. Look out for more on this work during Black History Month (October) – the theme this year is “Saluting Our Sisters” #WeMatter.

Your home, your choice

We have added a playlist comprising three videos to our You Tube channel as part of our your home, your choice campaign which urges everyone to think about rightsizing sooner rather than later.

Funded by West Yorkshire Health and Care Partnership, West Yorkshire Combined Authority, Wakefield District Housing and Together Housing Group, your home, your choice, has been developed to empower older people to find the right home for them. We are planning a fourth video to explain about extra care accommodation. Visit yourhome-yourchoice.co.uk to find more resources and support to rightsize.

Tackling climate change and delivering high quality care for all

In this animation you can find out how the actions that allied health professionals (AHPs) take every day can reduce health inequalities and improve the health of our planet. We developed the animation with frontline allied health professionals, with funding from the Healthier Futures Action Fund, run by NHS England’s Greener NHS Programme. With input and support from the Office for Health Improvement and Disparities and the Chief Allied Health Professions Office NHS England, this animation demonstrates the additional benefits that work by AHPs to reduce health inequalities has in also reducing climate change. For this and other resources including two handy infographics which aim to show why allied health professionals are acting to protect the planet see our tackling climate change and delivering high quality care for all resource page.

Let’s talk adversity, trauma and resilience - panel 4

In this one and half minute long video Dr Warren Larkin talks about how developing a trauma informed system means that people can get their needs met sooner and more effectively. Early intervention can help prevent a lot of trauma and addressing social determinants of health and social problems can help tackle the demand issue. The bite-sized video is part of a panel discussion recorded at our Adversity, Trauma and Resilience Knowledge Exchange.

Publication of research and report relating to sexual misconduct in the UK surgical workforce

We have been considering our response to the recent research into the extent of sexual misconduct within surgery in the UK NHS workforce in the last five years. Although this research focuses on the surgical workforce, we know that this behaviour affects other staff groups too. The research and reports make for difficult reading. They also present clear evidence of why we must act here in West Yorkshire. You can read the letter on our website.

Yorkshire and Humber National Healthcare Finance Awards (HFMA) success for the Partnership

Many congratulations to Robert Willis, Assistant Director of Financial Governance at Wakefield Health and Care Partnership, who won Finance Professional of the Year at the Yorkshire and Humber National Healthcare Finance Awards (HFMA) on Thursday 21 September.

The National Healthcare Finance Awards 2023 are an occasion for celebrating innovation and excellence in healthcare finance. Rob played a vital role in developing a newly established financial accounts and financial services team to ensure a smooth transition from five CCGs to one Integrated Care Board (ICB) and developed a new approach to working as a single entity. He supported the organisation hugely throughout this time and did an excellent job.

Cohort 3 fellowship fellows

Cohort 3 of The Fellowship launches

All the very best to the fellows who began their journey on West Yorkshire's leadership programme for colleagues from ethnically diverse communities this week. Cohort 3 of The Fellowship is for 'Aspiring Leaders' and came together for the first time on Monday 25 September.

The latest cohort of our award-winning Fellowship programme will help to cultivate talent within West Yorkshire and develop future diverse leadership. The Partnership’s system leadership development team and the Strategic Race Equality Network have been instrumental in this work taking place.

Alumni from cohort 1 were on hand to share their insights and experiences since graduating from the programme. Rob Webster, CEO for NHS West Yorkshire Integrated Care Board, and Fatima Khan-Shah, West Yorkshire Inclusivity Champion and Chair of the West Yorkshire Strategic Race Equality Network, welcomed the fellows to what is an integral programme for the Partnership and wished them all their very best on the exciting journey ahead of them.

Check in with your mate campaign on screen at Headingley Stadium

Check In With Your Mate campaign at Headingley Stadium

Our Check In With Your Mate suicide prevention campaign hit the big screens at the England vs Ireland cricket at Headingley Stadium on Wednesday. Thanks to funding from Bradford Council’s public health team, Yorkshire County Cricket arranged the promotion to help mark World Suicide Prevention Day. The match was eventually abandoned, due to rain, but not before the campaign’s graphics had been beamed to around 9,000 fans. The campaign’s messages also featured on tannoy announcements. It all follows similar promotions by sports clubs across the area, including Keighley Cougars, Bradford City AFC, Bradford Bulls and Leeds Rhinos Foundation.

Urgent and emergency care programme board update

The urgent and emergency care programme board (UEC) met on Tuesday 12 September, chaired by Clare Smith, Chief Operating Officer at Leeds Teaching Hospitals Trust and Senior Responsible Officer (SRO) for the programme.

Updates were provided on the UEC service transformation priorities. The Board heard that work is progressing on the West Yorkshire urgent care service review and that the Joint Health Overview and Scrutiny Committee has now been briefed on this work. Regular updates to them have been factored into the high-level timeline that has been produced. The Same Day Emergency Care task and finish group will be relaunched with a new focus and updated priorities. Yorkshire Ambulance Service (YAS) transformation noted that a gap analysis on falls started across all five places to provide a better understanding including prevention and levels 1 and 2. Slides were presented which outlined the WY ICS winter planning principles, the whole system approach to winter, and the roles and responsibilities required over the period which include delivery of the high-impact interventions, implementing the revised Operating Pressures Escalation Levels (OPEL) framework and implementing the revised System Coordination Centre (SCC) specification to ensure appropriate structures, systems and processes are in place to maintain 24/7 operational oversight and delivery.

The ICB winter plan has been submitted to NHS England (NHSE) and reflects both local need and partnership working across West Yorkshire. Individual feedback will be provided on place plans in the coming weeks. A ‘UEC recovery group’ has been set up by West Yorkshire Association of Acute Trusts (WYAAT). This will bring together leaders from across the Partnership and will focus on UEC recovery. For the third year the Partnership will run an area wide ‘Together We Can’ campaign this winter.