This week's leadership message is from Rob Webster, lead CEO for our partnership and includes COVID-19 updates

Posted on: 20 March 2020

Hello my name is Rob

During the Coronavirus pandemic we should be more confident of our capacity to cope because of the strength of our Partnership. Over the last four years we have developed arrangements which have brought real change for specific programmes of work, for specific places and for specific sectors. We must now use these during the biggest public health crisis in our lifetimes.

The pandemic is affecting every part of public life and resulted in daily action, from the Cabinet and Prime Minster. It’s been heartening to see the reliance on scientific and medical advice in our government’s response. This has cascaded through the national and local resilience arrangements, using a long established command and control approach backed by strong emergency planning and resilience arrangements. These are necessary in maintaining control over a fast moving set of circumstances.

The delivery of the actions that follow for all of us require change in every neighbourhood, every place and across West Yorkshire and Harrogate. As a consequence, we are working to refocus our Partnership’s efforts so that they support actions arising from the COVID-19 pandemic. We should be grateful that:

We have a Partnership of local government, the NHS, third sector and communities. We all have a role in tackling the impact of the virus
We look at things beyond health as we consider the impact on people’s lives, for example jobs, housing, the environment and the economy
We have a West Yorkshire Association of Acute Trusts that can consider mutual action and mutual aid as we pause all none essential elective activity and build intensive care capacity
Our Mental Health, Learning Disability and Autism Collaborative can ensure that specialist services for people are maintained and changes to Mental Health Act legislation are implemented safely
We have a West Yorkshire Combined Authority and good council leadership that can enhance the support that will be required for people in vulnerable groups that we will have to ‘shield’ from the virus for 12 weeks
That local authorities can work closely with their 56 primary care networks and their associated community, voluntary and independent sector partners to deliver joined up care and ensure we have resilient groups of general practices
We actively harness the power of communities and support carers in every one of our six local places (Bradford district and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield)
The Local Health and Care Record Exemplar and Digital Board give us an opportunity to operate digital solutions at scale in a context where this is about to become mainstream
We have a Workforce Board that can make sure we respond to changes in training, the re-appointment of retired staff, the need to flex people across organisations and we need to ensure we have a maximum number of staff available over a sustained period
We have a Joint Committee of Clinical Commissioning Groups (CCGs) that can make decisions for us all and that this is supplemented by decision making arrangements between Councils and CCGs in each of our six local places.

All of this is backed by work in each of our six places that draws on collaboration in interests of people. The communities and places we live are where we will take care of #ourneighbours.

If we stick to the principles of our Partnership, then we will be ambitious in ensuring that we get through this period; we will do this together; we will use the best evidence and analysis; we will use the governance that exists to make good decisions and choices; and we will apply the principles of subsidiarity always. In doing so we will only work at West Yorkshire and Harrogate level where there are scale benefits, where there is good practice to share, or where there are wicked issues to tackle.

Maintaining this discipline and changing the emphasis of what we do will help us to transform care forever. It will also save lives right across West Yorkshire and Harrogate. Our sessions with Myron Rogers (system leadership) taught us that real change happens in real work. Our session with Cormac Russell taught us that we need to get as much done by and with people as possible. And our session with Donna Hall taught us that we need a different deal with the public. All three of these lessons are playing out right now.

Over the coming days we are refining the work that we do together to ensure we are successful, in the meantime I believe we have the leadership and the capacity to get through these challenging times. Thank you for what you do every day for people across West Yorkshire and Harrogate. Take care of yourselves, your families and each other.

Rob

Coronavirus (COVID-19) update, 20 March 2020

Thank you to all colleagues, across all sectors, who are working exceptionally hard around the clock to keep people safe and well during these uncertain times. All information is hosted on the following websites:

Info for public (health advice): www.nhs.uk/coronavirus
Info for healthcare professionals www.england.nhs.uk/coronavirus

Impact on West Yorkshire and Harrogate Health and Care Partnership meetings and events

In the light of the Government's response to the COVID 19 incident, and as clinical and other staff are deployed to support clinical cases and other support services, decisions will be made to cancel various meetings and events. Viability of all meetings will be kept under review and wherever appropriate, will be used to support the wider COVID 19 incident and held by conference call. This page will be updated regularly to reflect the latest position.

Health Education England (HEE) COVID 19 (Yorkshire and Humber)

Technology Enhanced Learning contribution to COVID19 workforce response

The HEE TEL team have been working on a range of activities to contribute to the system wide programmes of activity in preparation for the anticipated impact of COVID-19 on the workforce. We are now providing support into two major national initiatives: the NHS England campaign to mobilise the existing NHS workforce, as well as the initiatives to bring retired nurses and doctors back to practice and to accelerate students into practice. Activity has started within two work streams, simulation based education and e-learning.

Nursing and Midwifery Council e-Learning for Healthcare The e-Learning for Healthcare Hub is the primary learning platform for the NHS. An e-LfH COVID-19 web page has been launched, providing an updated summary of the content available on the e-LfH Hub about COVID-19, as well as links to external content. A new programme has been launched on the e-LfH Hub which contains a grow list of relevant content and learning pathways. Access to learning pathways will be set as 'open' so you can register with any email address. There is increasing demand for learning across a wide range of topics, with the most urgent being prioritised.

Apprentice pay and breaks in learning guidance during COVID-19

It is likely that apprentices will be asked to increase substantive clinical duties during Covid-19 operations. If empoyment continues on an apprenticeship basis (with a "break in learning"), clear proceedures must be put in place. Health Education England guidance is available.

Digital programme update

In response to the coronavirus (COVID-19) pandemic, the digital teams across the region are working together to expedite work for digital first offerings for both patients and staff.

Digital First for patients

Many of our GP practices are already offering online triage tools for patients to receive an online consultation, without taking up an appointment slot. We are working to ensure all practices offer this functionality. Many GP practices and hospital services are telephoning patients for their appointments, rather than undertaking face to face appointments. There will be some instances where appointments will be undertaken by video, should there be a clinical need to do so, and we will ensure tools are available to provide this service.

Tips to help you with video consultations

You may find these resources helpful if you’re planning to move to video consultations and have not previously done this. GMC remote consultation tips. Telephone consultation tips for GPs and Primary care and video consultation tips for GPs.

Remote working for staff

The digital teams are working to increase capacity to enable more staff to work remotely. Additional devices are being sourced, virtual desktops are being created to ensure staff can access tools and applications remotely to maintain delivery of core services.

Tips for remote working

Find a comfortable space with adequate lighting. Take regular breaks and take your lunch away from your workspace, consider going for a walk - your health and wellbeing is very important. Keeping confidential data secure is vitally important. Consider who can view the data you are working on.

Twitter or Facebook page or from the Department of Health on Twitter or Facebook

Attend Anywhere Video Platform

For the last ten months the National Outpatient Improvement team has been working with 40 trusts to pilot the scaling up of video consulting in outpatients across multiple specialties. Our six acute Trusts in West Yorkshire and Harrogate have been involved in this pilot. Although still early, evaluation results have been positive and clinical engagement good. A national procurement has now been completed to enable access to the Attend Anywhere platform to be made available to all Trusts to support Trust in their response to COVID19 where they do not already have a video platform. Trusts will be free to use the capability beyond outpatients if required. The decision to use video with patients will first and foremost be made locally by Trusts and clinicians and should be considered as one tool of many to manage care delivery during this period and beyond. A regional team has been set up to support delivery of this offer and will be rapidly contacting all Trusts who wish to take it up.

Empowering care teams with new tools

Both patients and clinicians need greater flexibility and convenience when it comes to being able to connect with each other across locations during events such as the spread of COVID-19. IT solutions such as Microsoft 365 empower care teams to securely collaborate and communicate, helping clinicians and administrators perform their jobs more effectively. For example, once a visit is scheduled within teams, the patient receives an email with appointment details and a link where they can join the virtual appointment from their web browser or app. "It’s very easy to set up the virtual appointments. I can schedule an appointment. An email goes out to the parent with the appointment date and time," says Judith Vincent, Specialist Nurse, Epilepsy Clinic at Calderdale and Huddersfield NHS Foundation Trust. You can read more here.

Schools to remain open for children of key worker staff

On Thursday evening the Government provided further clarity on its pledge to ensure that schools remain open for the children of ‘key workers’. This includes but is not limited to doctors, nurses, midwives, paramedics, social workers, care workers, and other frontline health and social care staff including volunteers, the support and specialist staff required to maintain the UK’s health and social care sector and those working as part of the health and social care supply chain, including producers and distributers of medicines and medical and personal protective equipment.

If your child’s school is closed then please contact your local authority, who will seek to redirect you to a local school in your area that your child, or children, can attend. For further information, please read the full guidance here.

What else has been happening this week?

Urgent and Emergency Care Programme Board

The UEC PB met on Tuesday. The meeting was focused on the coordination and regional response to the current Covid-19 crisis. The meeting was chaired by Anthony Kealy, Regional Locality Director for NHS England/Improvement, who updated the group from a national point of view, and then outlined the formal chain of command developed in response to the declaration of a national level 4 incidents. This includes the establishment of the National NHS England/Improvement Incident Management Team and the Operational Incident Coordination Centre operating 12 hours a day, 7 days a week, working closely with the Department of Health and Social Care (DHSC), Public Health England (PHE) and the wider health and social care leadership system. Reporting to this team at a regional level is the NHS England/Improvement North East and Yorkshire Incident Control Centre, operating within the same hours and supported by the Emergency Preparedness, Resilience and Response (EPRR) team. The official channel of communication between local frontline organisations and the regional team is via a single point of contact, and via daily SitReps.

Representatives from place and system providers then shared the measures that they had put into place, which included mutual aid and activating Gold, Silver and Bronze Command Meetings, working in partnership with the local authorities, community and primary care and acute trusts in a multiagency health and social care approach. Places have their own system resilience and business continuity plans which outline their escalation processes. The group discussed actions around the need for Community Pharmacy West Yorkshire to be more involved by places in the resilience planning for primary care, NHS England /Improvement to re-circulate communications to provide further clarity regarding the management of symptomatic patients during GP core in-hours and early testing for symptomatic healthcare workers (and their household members) to avoid the need for unnecessary self-isolation and the impact that this would have on the workforce.

Working carers passport

We are working together as part of the carers programme to introduce a flexible working arrangement via the working carers’ passport. This is an agreement between the carer and their manager, on behalf of the organisation. The intention is for the carer to be able to manage their working role alongside their caring responsibilities. Supporting working carers is highlighted in our ‘Better health and wellbeing for everyone: Our five year plan’. Leeds Teaching Hospitals NHS Trust launched the working carers passport across their hospitals last Friday.

Humber, Coast and Vale Health and Care Partnership – Five Year Plan

Humber, Coast and Vale launched their Five Year Plan this week. This is the culmination of 12 months of engagement with partners, stakeholders, voluntary sector representatives, patient groups and the wider public. It describes their vision to support people to live healthier, happier lives.

The healthier you’ NHS Diabetes Prevention Programme

Due to the emerging coronavirus (COVID-19) it has been decided that the NHS Diabetes Prevention Programme face to face sessions are stopped and participants given the option of digital or remote delivery for the foreseeable future. Please continue with referrals into the programme from your normal referral processes. For example mailshots that promote the referral process are to be encouraged for support via digital and teleconference. Conversations are ongoing with colleagues on how best to ensure we are still supporting those at risk of developing type 2 diabetes. The Healthy Living Pilot and the Diabetes Type 2 Prevention week will be cancelled. We will keep you updated when we know more.

Making Every Contact Count (MECC)

The MECC scheduled for 31 March 2020 has been postponed. There is clearly a massive community response to the coronavirus crisis taking place, and new resources are available for sharing via MECC Link on public mental health support and loneliness, including community contacts cards (easy read in production) and short videos on how to set up What’sApp groups etc. There is more new content to come shortly.

Two other resources have launched this week to support behaviour change as part of everyday practice. MECC Evaluation Guide is a step-wise practical resource developed by Public Health England, Health Education England and London South Bank University, and based on insights from local MECC leads, gathered during the planning and running of their own project evaluations.

‘Everyday Interactions’ toolkit provides clear and concise guidance for health and care professionals wishing to record and measure their public health impact based on a Making Every Contact Count (MECC) framework. This work has been undertaken by the Royal Society for Public Health, Public Health England and partners including the Royal College of Nursing.