Using digital and innovation to support delivery

Our strategy for digital

Our digital strategy sets out an approach to how digital innovation can support the delivery of our Integrated Care strategy. Harnessing digital so that we can work together to promote health and wellness, reduce inequalities, and ensure high quality care for all. The plans arising out of the digital strategy will flex and evolve as we move through the lifetime of our Joint Forward Plan, reviewing each year with the refresh of our plans.

• See our 'plan on a page' illustrating the West Yorkshire digital strategy (pdf)

Our digital priorities

With the West Yorkshire Digital Strategy, the Yorkshire and Humber (YH) Health and Wellbeing Charter, and the recently published NHS England “What Good Looks Like” framework, the direction and ambition of digital in the region is clear and has the commitment from all stakeholders. The changing role of the Integrated Care System (ICS) and greater accountability as the Integrated Care Board (ICB) requires the leaders within the wider digital team to be responsible for turning this desire and ambition into a reality, working together to provide inclusive access to digital and information tools and services to deliver the quadruple aim of health and social care.

Recognising the ambition within the West Yorkshire Digital Strategy and its associated Charter will need multi-year work and clarity around investment to ensure the steps on this journey are clear.

The ICS appreciates the value of the transformation digital can bring and have agreed to recruit a Chief Digital Information Officer (CDIO) and Chief Clinical Information Officer (CCIO), who will work together to steer the region to meet its digital ambitions with support from their peers from our partner organisations.

As part of our ongoing plans to deliver the strategy, our seven proposed ICS Digital Priorities for collaboration are as follows:

Shared care records

• That each Place has a shared care record available across most care settings.
• That each Place has an agreed strategy and plan for moving to increased use of the regional shared care record and the removal of local solutions.
• That each Place has an agreed data strategy and plan that aligns with the WY Data Strategy to support improved use of data across the ICS.
• That each Place shared care record strategy considers the empowerment of patients through patient held records, patient instigated follow up and digitally connected patients and that these approaches are considered within the ICS framework. Ensuring we utilise digital to reduce health inequalities where possible and offering access and preference to different approaches where digital isn’t appropriate.

Our regional shared care record is the Yorkshire and Humber Care Record (YHCR), now known as Interweave. We have live services as follows: -

• GP Connect data is available in the portal for organisations to view.
• Airedale Hospitals NHS Trust (AFT) are live with sharing their maternity documents into the portal for other organisations to view.
• Bradford Teaching Hospitals NHS Foundation Trust (BTHT) are live with sharing their core hospital data into the portal for other organisations to view.
• Calderdale and Huddersfield NHS Foundation Trust (CHFT) are live with sharing their maternity documents into the portal for other organisations to view. They have also implemented the maternity viewing portal, so they can view maternity documents from other Trusts once they have gone live.
• Leeds Teaching Hospitals NHS Trust (LTHT) are live with the regional tab in their Leeds Care Record. This allows clinicians in Leeds to view information from YHCR that other organisations have shared.

All the provider Trusts are progressing to make a core set of data available in the portal for other organisations to view. We are also engaging with primary and social care colleagues to provide visibility of the data.

Cyber secure infrastructure

• That each Place/organisation has a clear understanding of its cyber security position
• That each Place/organisation has a plan to remediate any weaknesses
• To assess the role of the ICS in supporting Place and organisations, including but not limited to:
  • i.    Processes to support mutual aid
  • ii.    Virtual WY Operations Centre (SOC)
  • iii.    Shared resources

We have recently held the first West Yorkshire wide “war games” cyber event in May 2023 to simulate the process of one of our strategic IT systems being unavailable.

Linking in to the existing team who run the Y&H Warning Advice Reporting Point (WARP), who already run annual war games events and our regional cyber security lead from NHS England. There are a small number of organisations who aren’t currently members of WARP, but they have agreed to join. This will become an annual event as part of business continuity planning and organisations will be updating their business continuity plans in preparation for the event of a prolonged period of system outage. A West Yorkshire wide cyber plan is also in development, along with a cyber network for interested parties to come together and share best practice examples.

Staff capacity and capability

• For the ICS to understand the digital staff capacity and capability across the region and work with Place leads to agree approaches to strengthen capacity and capability where needed. Also working with the West Yorkshire Workforce Observatory to understand some of the barriers with the digital workforce.

Legacy remediation

• Across most of our organisations there are areas of IT legacy that create risks for both service provision and for the cyber position. The ICS should be aware of these areas, the plans Place and organisations have for remediation and the associated funding, capacity, and capability challenges.

Maintaining the digital networked relationships and collaborative ways of working

• The WY CIO and CCIO meetings have proved valuable in many ways, the relationships and connections forged there allow effective sharing of knowledge, experience and increase opportunities for mutual support. Without the collaborative nature of these networks the ICS would be more siloed and our chance of delivering to the Strategy and Charter would be much more difficult. It is essential that these networks are retained and enhanced.

We also have established networks for WY digital programme managers and WY clinical safety officer to gain peer support and work collaboratively together.

Embed the engagement between the digital teams, ICS programmes and workstreams (particularly business intelligence, population health management, innovation, and improvement), councils, voluntary sector, other qualified providers, industry partners, AHSN, ABHI, NHS E/X/Digital (now DH Transformation Directorate) and regional innovation partners. Aligning a Chief Information Officer (CIO) to each of the priority programmes to ensure digital is at the heart of any transformation considerations.

Using the strength and size of the West Yorkshire region to exploit and influence our strategic suppliers. Ensuring we gain economies of scale for our partner organisations and utilising or relationships with our strategic suppliers to drive forward the vision for WY.

Whilst these seven collaborative priorities are core to the work we deliver, we also support the ICS programmes with their individual priorities that are digital in nature and also the provider collaboratives, where they agree single schemes to progress, such as the single laboratory information management system (LIMS) that is currently progressing across WYAAT. The digital portfolio of delivery is ever changing to meet the needs of our services.

Using research to make a difference

Research leadership

All ICBs have statutory responsibilities to facilitate and promote research about health and to use evidence obtained from research in the health services it provides. We are committed to making sure that we use research to drive positive changes for everyone. In West Yorkshire, as a Partnership, we are committed to our four purposes to: reduce health inequalities; manage unwarranted variations in care; secure the wider benefits of investing in health and care; and use our collective resources wisely. Research has a crucial role to play in understanding these issues and how we can best work together to tackle them across our region.

In May 2022 we established the Research Leadership Working Group. With leadership from regional research bodies NIHR Yorkshire and Humber Applied Research Collaboration and NIHR Clinical Research Network Yorkshire and Humber, and membership from places and providers across West Yorkshire, we are working together to identify opportunities and mechanisms to ensure research is embedded into our Partnership.

Our research strategy

We are currently developing our research strategy. The strategy plays an important part in setting out our vision for research and provides the basis for a plan of action to deliver this. The strategy outlines the work we will do at a system level which will support work at the place and organisation level within our Partnership.

Our draft research strategy has five ambitions:

1. Make research everyone’s business

This ambition sets out our vision for our workforce to encourage a positive research culture and with a workforce who are interested in research, and how it can improve outcomes for our communities. We want everyone to understand how research fits in to their job and inspire a curious workforce that looks to research and other evidence to solve problems and improve things.

2. Give everyone the opportunity to be involved

This ambition sets out our vision for people who live in West Yorkshire. We will communicate opportunities about research widely and inclusively in our communities to ensure that everyone can take part and feels empowered to do so.

3. Use evidence to make a difference

This ambition sets out our vision to develop pathways at a system level for appraising and sharing evidence that help speed up the translation of research into practice. We will also work to embed research evidence in decision making, and make sure that that changes we make are evaluated so that we can understand the difference they make.

4. Build research capacity

This ambition sets out our vision to provide staff with the skills and training they need to appraise and use research. We will link with key partners in our region to provide development opportunities for staff to become research active and build capacity along the whole research pathway, from idea generation through to research delivery and implementation of findings.

5. Nurture collaborative networks for research

This ambition sets out our vision to support a network of our five places to share learning, identifying best practice in research delivery and work together to promote this across the system. We will also link with colleagues in other areas of the ICS like innovation and digital to work together on areas of shared interest and plan the spread and adoption of promising innovations from research that could make a real difference to people’s lives.

Our future plans

Our current priority is to finalise our research strategy and move on to develop a clear operational plan to deliver our ambitions. We will work closely with our five places and with organisations and partners across the region as part of this work, mapping our strengths and connecting people as we go. We will focus our work around the 10 big ambitions to ensure that the work we are doing is aligned to the priorities in our Partnership and that we are all doing our bit to achieve these together.

Our approach and priorities for innovation

The role of the West Yorkshire Innovation Hub

Our Partnership has a vision for everyone in their diverse communities to live a happy, healthier life for longer. This vision is supported by The Hub’s commitment to creating a culture of learning and innovation, recognising that achieving the scale of ambition set out in the Integrated Care Strategy and this Joint Forward Plan will require doing things differently and bringing into practice the best evidence-based ideas from across the region and beyond.

The Partnership has a strong and long-standing partnership with the Yorkshire and Humber Academic Health Science Network (AHSN), a core delivery partner within the system who are committed to supporting WY HCP in the delivery of three core innovation themes:

• Spread and adoption of innovation
• Discovery
• Improvement

To deliver system innovation, an understanding of process and priorities is essential, at system, place, and provider level. The Hub enables innovative ways of working to tackle the biggest challenges facing the health and care system. The connections and networks made by The Hub position it as the first port of call for anyone seeking support or exploring opportunities for innovation and improvement against WY HCP priorities across the health and care system. It is a centralised resource for other innovation infrastructures (for example the Digital Programme) to access support, such as network establishment and innovation proposals and is seen as a vital partner in the success and growth of the region and its commitment to system economic growth to drive down health inequalities.

The Partnership’s Inclusive Innovation and Improvement Programme Board (IIIPB) supports The Hub by acting as the conduit for sharing innovation and best practice, removing barriers and blockages, and ensuring inclusive design of innovation programmes. This will be supported further by the Research, Innovation and Digital Collaborative (RID), which brings the three interlinked disciplines together to offer assurance and governance on opportunities presented to the WY HCP.

By embedding Y&H AHSN staff into the Partnership’s Hub has the ability to evolve and adapt to system needs, to help identify the system’s innovation requirements, act as a front door for innovators and support the development of networks which promote the spread and adoption of best practice.

The role of The Hub within the system:

Overview of 2022/2023

As The Hub was only established in April 2022, a lot of activity has been focussed on improving connections, building strong relationships with key stakeholders, and understanding the WYHCP landscape. These key activities have provided a strong backbone to enable The Hub’s delivery in future years. Alongside these activities, The Hub has delivered activities which support WYHCP to deliver on their programmes and priorities. Key items to note are:

• Direct support provided to place-based innovation hubs/directorates linked priorities with innovators, provided peer support and the development of innovation showcases. Supporting these groups enabled The Hub to raise the profile of the Y&H AHSN and demonstrate the expansive landscape of innovation in which the AHSN works in.
• The Hub was a key contributor to multi-million-pound innovation bids. These are still undergoing review but if won, The Hub will act as the innovation expertise for WYHCP and the West Yorkshire Combined Authority.
• The Hub’s ability to act as a trusted and neutral partner has facilitated increased relationships between healthcare and industry. These relationships improve outcomes for patients and the prosperity of the region. For example, the Mid-Yorkshire Hospital Knowledge Asset Grant Funding application utilising the Pulse Health innovation platform relied upon The Hub to facilitate conversations and bring the right partners together.
• The triage of innovations for the West Yorkshire Cancer Alliance has been highlighted as an area of best practice in collaboration between an ICS, Cancer

Alliance and local AHSN provider and are being showcased to NHS England in view of potential spread and adoption of this approach.

• The Primary Care Innovation Collaborative (PCIC) has worked with the ICB Digital Programme to identify primary care digital solutions and has been instrumental in the roll out of PATCHS (online consultation tool) to GPs across West Yorkshire. The approach used by the PCIC to understand the unmet needs within primary care has been utilised by other Digital Primary Care Innovation Hubs as best practice.
• The Serious Mental Illness (SMI) programme brought together mental health leads in all five places to identify ways to share good practice and improve health equity across West Yorkshire for their SMI populations. Interviews and a thematic analysis report has been completed to identify areas for collaboration in 23/24.
• The Inclusive Innovation and Improvement Programme Board have refreshed how the group and the overarching programme will work moving forward. Some of the agreed changes involve face to face meetings to showcase innovations in each of the five places and bring the wider innovation community together, and the development of the RID.
• Outside of The Hub, Y&H AHSN has been working with WY HCP to deliver numerous innovative programmes. These programmes were developed from working with regional and national stakeholders to understand priority areas and challenges. Impacts include:
• Coordination of a West Yorkshire wide pre-eclampsia testing service and support to the development of regional clinical guidance. This collaborative approach is rare and is being seen very positively by regional and national stakeholders.
• As part of the Asthma Biologics Rapid Uptake Project (RUP), Y&H AHSN funded the Straight Talking Project in Mid-Yorkshire whose aims were to combat some of the myths and stigma surrounding asthma. This collaborative project has been shortlisted for a HSJ Partnership Award.
• Delivery of the Propel@YH programme and intensive international bootcamps has led to multiple innovators (including overseas organisations) locating their UK Main Office in West Yorkshire.
• Leeds Teaching Hospitals were the first Trust in Yorkshire & Humber to adopt XprESS, a minimally invasive treatment to treat chronic sinusitis as part of the MedTech Funding Mandate. Bradford Teaching Hospitals are fast followers and are close to adoption.
• 13 Innovation Exchange Events for over 450 innovators has taken place throughout 22/23. These events link innovations to unmet needs, support them to improve their offer to the NHS and facilitate conversations between innovators and healthcare to improve the health and wealth of the region.
• The NHSx funded Virtual Wards programme led to 1400 patients benefitting in West Yorkshire across its 2-year delivery. A series of resources have been produced to support Trusts to implement virtual wards now the project has finished.
• Y&H AHSN alongside the Improvement Academy are leading nationally on the Medicines Safety Workstream to reduce harm from opioid prescribing in non- cancer patients as part of the Patient Safety Collaboratives. This is utilising the expertise in Yorkshire to enable the national delivery.
• Y&H AHSN support to the WY Cancer Alliance has enabled the collection of blood samples from over 7000 patients for processing through the Pinpoint project, which is an NHS England funded scheme involving a real-world evaluation.
• SWYPFT and Creative Minds have led on the development of Create & Bloom, a creative health app which (like a creative version of Couch to 5k) guides users through artist designed content in drawing, creative writing, movement etc. all with a focus on improving wellbeing and measuring impact through the NAPC patient activation model.

Plans which have been identified to support upcoming programmes of work across the Partnership for 2023/24 include:

The Hub’s core activities

As identified in Figure 1, core priorities and activities of The Hub are extensive and will adapt appropriately to system need, providing core innovation leadership to the system. There are a number of continuing programmes as part of The Hub’s core delivery which include:

• Continued delivery of the IIIPB and development of the innovation strategy to enhance innovation collaboration across WYHCP, and delivery of the RID.
• Second year delivery of the PCIC alongside the WY Digital Programme. The PCIC will continue to support the roll out of PATCHS into GP practices across WY as well as development and delivery of a digital champion approach for the region.

23/24 Innovation Hub projects

Alongside these core activities, priority programmes have been identified through conversations with key stakeholders in WY HCP and a portfolio of work for 23/24 has been designed to reflect system need. These are:

• Understanding the correlation between Ambulance Conveyance and Deprivation to assess what can be utilised in the community to reduce impact on emergency services. This will be a proof of concept with the aim of spreading across the rest of West Yorkshire in the following years. It has gained interest from the Leeds DHSC Health and Wellbeing hub, as well as the Regional Office for Health Improvement and Disparities.
• The development of a central resource for training needs in research, innovation, and improvement alongside the creation of a research ambassadors programme. Be Curious aims to upskill all staff in WYHCP and help them understand that research is available for all not the select few. This has gained interest from the NHS England Research Team who recently have released guidance around research in ICBs.
• Delivery of roundtable discussions around the delivery of physical health checks for people with Serious Mental Illness (SMI); sharing best practice and innovative solutions to improve access and equity across West Yorkshire.
• Continuing the support to WY Cancer Alliance with their core strategic aims and ambitions with innovation as well as the identification and implementation of a Clinical Diagnostic Support Tool.
• Continued delivery of the West Yorkshire Healthy Hearts Programme to improve cardiovascular disease (CVD) care and recording and reduce the life expectancy gap between our least and most deprived areas in WY.

Additional AHSN delivered projects within West Yorkshire

The Y&H AHSN are funded by NHS England to deliver programmes based on national and regional priorities to improve the health and wealth of our region. The delivery of these projects are at no additional cost to WY HCP but can have significant impacts to patients and the system as a whole. Examples of our national and regional projects include:

• Supporting the implementation 11 products as part of the MedTech Funding Mandate. Products include treatments for Chronic Sinusitis, Benign Prostatic Hyperplasia and Sickle Cell Anaemia. These products are mandated by NHS England for organisations to adopt, have all been NICE approved and demonstrate significant ROI to providers.
• Working closely with Leeds Teaching Hospitals to combat regional inequalities in automated red cell exchange access for Sickle Cell sufferers. Y&H AHSN are leading the delivery of this programme nationally across the AHSN Network.
• Supporting an innovation in health improvement project which is looking at the most deprived areas alongside underserved populations to provide health education around CVD, and to identify and treat individuals with NICE approved medication in these underserved communities.
• Support the West Yorkshire Virtual Wards. Tender for 2023-2025 including innovator and implementation support once an innovation has been selected. The Y&H AHSN team are also exploring evaluation opportunities with the Leeds City Council led virtual ward to support people with long term conditions.
• Working across North East and Yorkshire to develop a regional approach and methodology to deliver workforce transformation, including training, promotions of assets and tools such as the Calderdale Framework and development of a network to improve workforce transformation.
• Identification and active engagement of GP practices to refer potential cancer patients through the Pinpoint pathway. This diagnostic tool is able to stratify a patients risk of cancer and identify biomarkers in the blood to assist in reducing the 2-week wait list burden.
• Working with Partners across WY, including Huddersfield University, the development of a Community Engagement Framework to support better connections with underserved communities by providing guidance and structure which can be adapted to all health areas and population groups.