This week’s leadership message comes from Julian Hartley, CEO for Leeds Teaching Hospitals NHS Trust and CEO Lead for West Yorkshire Association of Acute Trusts

Six Years and Six Lessons that Define our Provider Collaborative

Hello, my name is Julian and I’m the Chief Executive of Leeds Teaching Hospitals NHS Trust. As our provider collaborative — the West Yorkshire Association of Acute Trusts (WYAAT) — enters its sixth year I would like to share six key lessons that continue to underpin the growth and success of WYAAT.

1. Form follows function. 

WYAAT works because the collaborative has always focused on what practical changes can be achieved together.  WYAAT defines itself not by being an organisation, but by what the six member trusts do together and the decisions they make together.  A dedicated Programme Management Office ensures the attention remains on function, not form.  This is evident in just a few examples of the tangible benefits that have been delivered for our patients.

• Through the Yorkshire Imaging Collaborative, we now have a single clinical viewer which enables any clinician to view, at an instant, any patient image taken across the Yorkshire Imaging Collaborative.  For patients this can mean a quicker and more accurate diagnosis and fewer trips to hospital.
• The West Yorkshire Vascular Service (WYVaS) was created within WYAAT and has reconfigured vascular services to deliver a sustainable service model with consistent consultant-led care and equitable access to all.  We are already starting to see clinical benefits through shared learning and new models of working - such as the creation of a ‘virtual ward’ to deliver more outpatient and local care, with the aim of improving patient safety, experience, and outcomes.
• The rapid establishment of the West Yorkshire Vaccination Programme and the response to COVID-19, which included mutual aid, personal protective equipment (PPE) logistics and shared capacity planning, was made practically possible through established relationships within WYAAT.

2. People own what they create. 

WYAAT is a collaborative, not an organisation in itself.  Changes are made by and with member trusts, not to and for.  Through collaboration we have achieved challenging tertiary service reconfiguration such as the consolidation from three to two arterial centres.  I believe the sense of ownership from the trusts was central to the successful public consultation and engagement process which, partnered with clinical expertise, enabled a major change in the way arterial services are delivered.

3. Clinical leadership is paramount.

Member trusts contribute significant senior clinical time to WYAAT programmes, Medical Directors and Chief Nurses meet regularly and there is an appointed WYAAT Clinical Lead.  All WYAAT programmes are clinically led, and management enabled, which maintains a focus on clinical benefits.  For example, the continuing rollout of over 200 specialised home working stations by the Yorkshire Imaging Collaborative (YIC) enables Consultant Radiologists and Reporting Radiographers to view and interpret patient scans from home.  Recently, this ensured a vital diagnostic service was maintained despite significant staff absences due to COVID-19.  In the longer term it means we can offer an improved service with capacity shared across the YIC network.

4. You cannot compel collaboration. 

All WYAAT decision making is based on consensus.  It is a collaboration of the willing and participation in WYAAT programmes is voluntary.  Decision making is made through a ‘Committee in Common’, which means Trust Boards retain ultimate authority.  Through this approach of collaboration and compromise, WYAAT has secured over £40 million in capital investment which funds many of our programmes, including pathology where we are completing the implementation of a single laboratory information system (LIMS).  This will improve laboratory productivity by simplifying, streamlining, and standardising many of the current processes and support delivery of a resilient and sustainable pathology service for patients in the future.

5. Foundations for the future. 

The development and growth of WYAAT continues to embed a joined-up approach across members.  Rather than comparing ourselves against each other we have developed a partnership which seeks improvement and innovation.  It is through this joint approach that we met the challenges of the pandemic together, mutual aid, the logistics of PPE supply and the establishment of the West Yorkshire Vaccination Programme.  Those shared experiences of the past stand us in good stead for the future, particularly the challenge to provide for the significant number of people whose elective care procedure has been delayed because of the pandemic.

6. Relationships trump governance. 

In West Yorkshire we have placed a priority on leaders meeting together regularly.  Chief Executives meet every month and there are equivalent groups for all executive colleagues.  These relationships are longstanding and have been invested in for over five years.  As a result, the acute sector in West Yorkshire has a set of leaders which recognise the future is less about direction and more about consensus, relationships, and influence.  The quality of collaboration is reliant not upon watertight governance frameworks, but shared commitment to delivery for patients.

Here’s to the next six years! 

Julian