Our Integrated Care Strategy

Our West Yorkshire Integrated Care system - our strategy and vision

Our Partnership has existed since 2016. It was established on the belief that working together towards common goals rather than competition is the best way to join up services to meet people’s needs, tackle inequalities and improve outcomes.

Over this time, we have built close working relationships with partners such as the voluntary and community social enterprise sector (VCSE), NHS England (NHSE), the Academic Health Science Network (AHSN) universities, the West Yorkshire Police, the West Yorkshire Combined Authority, and the housing sector. These partnerships allow us work together on the things that matter for people’s health and wellbeing.

During the COVID-19 pandemic we witnessed the best of the health and care service. We rapidly changed working practices so that we could safely treat people with COVID-19 whilst supporting peoples ongoing health and care needs. We significantly increased capacity, such as XXX to deal with the peaks of infection and severe illness; and we delivered the biggest vaccine roll out in our country’s history. All our teams across the health, care and voluntary and community sector pulled out all of the stops to keep people safe and well.

The demand for health and care has been rising over time. It’s good news that people are living longer. However, for some people they are living a longer life with multiple long-term health conditions. The pandemic further increased demand for health and care services, this now means the pressure on services is higher than ever. People who need an operation are waiting longer, and accessibility to services such as primary care, which includes GPs, dental care and urgent care is not as good as we would like it to be. These challenges will increase further because of the significant pressure on funding and workforce pressure on the social care sector.

We know from listening to the people of West Yorkshire that these are the things which are most important to them. As part of our consultation with them in the development of this plan, they highlighted six themes which are central to what they feel we need to improve, they are:

• Access to services, in particular access to GP and Dentistry services
• Tackling inequalities
• Co-ordination of services, truly integrated joined up care
• Having the workforce needed to deliver the services for our people
• Poverty and the cost of living and the impact of this on health and wellbeing and access to health services
• Getting the basics right in our delivery of health and care services.

This is the challenge that our integrated care system (ICS) must now address, and we will centre our work around addressing these six areas. We will do this by focusing on preventing ill health and proactively supporting people to stay well at home; and secondly by arranging services in a way so that they receive care from the right people in the most appropriate setting. This will mean teams working together to organise care around people and their families, and professional and organisational barriers being broken down.

Whilst these challenges are significant, we believe that working together at all levels in the system is the best way of tackling them.

Our Partnership acts as an influencing voice at regional and national levels for the 2.4million people who live, work or study in West Yorkshire. Our new five-year strategy (which is owned by our Partnership Board – the West Yorkshire Integrated Care Partnership) describes how we will do this, and the ambitions we hope to achieve. A summary of our strategy is outlined in the plan on a page. This information is available in alternative formats on our website.

At the heart of our strategy is our agreed vision for the future of health, care, and wellbeing in West Yorkshire. To achieve this requires all partners working together so people can thrive in a trauma informed, healthy, equitable, safe, and sustainable society. We want to help people live well and stay healthy for as long as possible. If they have mental health or physical problems, we want them to be able to easily access services that meet their needs.

Our vision

Places will be healthy. We will work in partnership to prevent ill health by improving the physical environment where people live and work. This includes having access to healthy green and blue spaces (areas with access to watercourses such as lakes and rivers) that provide safe spaces for outdoor activities and exercise and have good air quality. We want this to be the case for now and future generations.

You will have the best start in life so you can live and age well and die in the place of your choosing. We will work to make sure people are not disadvantaged by where they live, their background, gender, or ethnicity. We will focus on supporting people to stay healthy and prioritise approaches of preventing trauma, adversity, and ill health, delaying onset of disease, and reducing the impact of long term-conditions.

There will be a culture of preventing ill health across the partnership, making this everyone’s business. This will include; improving access to the things that keep people healthy; earlier diagnosis of ill health and supporting self-management of long term conditions to improve health outcomes. These approaches will be targeted to ensure they reach the people that need support the most.

We will focus on reducing inequalities in people’s experience of health and care services and associated health outcomes. We will also focus on equity for our staff making West Yorkshire a fair and inclusive place to work.

Climate change and sustainability will be key considerations in how we plan and deliver services. We will seek sustainable options and support innovations that reduce the impact of our health and care services on the local environment.

If you have a long-term health condition you will be offered trauma informed personalised support to self-care. This will include peer support, technology, and communities of support from people like you.

If you have multiple health conditions, you will be in a team with your GP, community health services, social services and VCSE including community pharmacy working together. This will involve you, your family and carers, the NHS, social care, and community organisations. All working on what matters to you.

If you need hospital care, it will usually mean that your local hospital, which will work closely with others, will give you the best care possible.

Local hospitals will be supported by centres of excellence for services such as cancer, vascular (arteries and veins), stroke and complex mental health. They will deliver world class care and push the boundaries of research and innovation.

All of this will be planned and paid for once between the NHS, local councils and community organisations working together and removing artificial barriers to care.

Our people and communities will be involved in the design, delivery, and assurance of services so that everyone truly owns their healthcare.

As a Partnership we intend to deliver our five-year strategy through this Joint Forward Plan.

Our Integrated Care Board (ICB)

The ICB is a statutory body responsible for planning and funding local NHS services and is directly accountable to NHS England for NHS money and performance. Our West Yorkshire ICB reflects the way in which we work collaboratively, with a membership including representatives from NHS providers, such as hospitals and mental health service, primary care, local authorities and the VCSE, led by our Independent Chair, Cathy Elliott, and supported by independent members.

Whilst our strategy is owned and overseen by our Partnership Board, our plans to deliver it and, the NHS elements of it, will be owned and overseen by our ICB. We will continue to do this with our wider partners given that our long history as a partnership shows us that we can only achieve the best health and care outcomes for people by working together. Our Partnership Board and ICB will continue to work together to deliver our vision for the people of West Yorkshire.

The way in which we work together

Our partnership has a long history of working together with strong foundations and good relationships which have helped us make a positive in our work to date. These foundations are rooted in making sure that we make decisions as close to the person as possible. We make sure we do this by focusing our work in neighborhoods and local places in everything we do unless there is value in working together across a greater footprint. Our five local places in West Yorkshire are Bradford District and Craven, Calderdale, Kirklees, Leeds, and Wakefield.

As an ICB we delegate most functions to our five places to plan and deliver services in response to local people’s needs and to ensure that health and care is joined up at the local level. We choose to work at a West Yorkshire footprint where there is a need or a benefit to:

• achieve a critical mass beyond local population level to achieve the best outcomes;
• share best practice and reduce variation; and
• achieve better outcomes for people overall by tackling ‘challenging / difficult issues’ (i.e., complex, intractable problems).

Whilst most of our work happens in our local places, communities, and neighborhoods, taking decisions and delivering joined up services as close to people and families. Sometimes however, there is real benefit in providers of services coming together (we call these provider collaboratives) across West Yorkshire to collaborate on agreed programmes of work. This work is in addition to working together with other partners within their local places.

Across West Yorkshire we have several provider collaboratives including:

• Our West Yorkshire Association of Acute Trusts Provider Collaborative (WYAAT) which has a vision to deliver outstanding, high quality acute and specialist healthcare for the whole population of West Yorkshire. WYAAT has a developing strategy which is aligned to the WY Integrated Care Strategy, formed around five pillars of workforce, service delivery, ways of working, recognising, and reducing variation and estates.
• Our Mental Health Learning Disabilities and Autism (MHLDA) collaborative which consists of our four mental health/learning disability trusts across West Yorkshire. The MHLDA is designed to help drive forward the system changes that need to be made, remove barriers to integration and ultimately ensure that our resident population receive the best care and support that can be offered within finite resources. We know that the pandemic has had a significant impact on mental health, and this is now compounded by the cost of living crisis. As a collaborative much work has been undertaken over recent years to transform services and this will continue through the delivery of our strategy.
• Our Community Health Services Provider collaborative which formed in 2021, has come together work collectively on shared issues that of common interest to the sector, such as enabling more healthcare to happen close to home, and where joint approaches or shared learning, such as in workforce development and service redesign, can add collective value. The collaborative has an important contribution in delivery the strategy through both working together and with other partners, ensuring that community health services has a clear and engaged stake in the direction and decisions.
• Our Hospice Collaborative which is built from a powerful basis of trust and has strong relationships through which, it delivers a manifesto for palliative and end of life care. We plan to provide the very best palliative and end of life care for the population of West Yorkshire, which will be personalised, holistic, accessible, a good life to the end of life and a good death. We want to make sure that hospices are working in a seamless way with the NHS and palliative end of life care system, to meet the needs of patients, reduce unnecessary hospital admissions and enable patients to be discharged home or to the setting of their choice.

As a Partnership we work closely with NHS England (NHSE) on a number of areas, to make sure that we can provide the best seamless care for people and communities. NHSE currently plan and deliver those services which are only needed by a small number of people across West Yorkshire, which we call specialised services. We work closely with NHSE to ensure that those services are integrated across a whole pathway of care and to ensure that the needs of our population are met. Over the coming years some of these services will be delegated to our ICB to plan and deliver. Until this happens, we will continue to work collaboratively through formalised arrangements to make decisions on these services.

Quality Improvement

West Yorkshire ICB has a duty under the Health and Social Care Act 2022 to exercise its functions with a view to securing continuous improvement in the quality of services provided to individuals for or in connection with the prevention, diagnosis or treatment of illness, and in particular, act with a view to securing continuous improvement in the outcomes that are achieved from the provision of the services – the effectiveness, the safety and the quality of the experience of the service. 

The National Quality Board (NQB) refreshed its Shared Commitment to Quality to support those working in health and care systems. The publication provides a nationally agreed definition of quality and a vision for how quality can be effectively delivered through Integrated Care Systems (ICSs) at all levels.  The refresh has been developed in collaboration with systems and people with lived experience and has a stronger focus on population health and health inequalities. NHS England » National Quality Board: Shared Commitment to Quality

Our values and behaviours

As a large Partnership, agreeing the way we work together is an important part of building on the strong foundations established since 2016. This involves building on our common purpose and vision, agreeing values through which we work and the behaviours that when demonstrated ensure that we deliver. It is important that we get this right to deliver our strategy.

We have a long history of working together in West Yorkshire to improve outcomes for our population which means that the new statutory arrangements are already building on a successful way of working. This is demonstrated through some of the West Yorkshire work we have undertaken together across the Partnership, for example national award winning campaigns such as ‘Root out Racism’, ‘Looking out for our Neighbours’ and the ‘Check-in Staff Suicide Prevention’ Campaign.

We have agreed as a Partnership that:

• we will be ambitious for the populations we serve and the staff we employ
• the Partnership belongs to us all, local government, NHS, VCSE and communities
• we will do the work once – duplication of systems, processes and work should be avoided as wasteful and potential source of conflict
• we will undertake shared analysis of problems and issues as the basis of taking action
• we will make decisions as close to individuals as possible – with work taking place at the appropriate level and as near to local people and communities as possible

The way in which our Partnership will put these principles into action is set out in our mission, values and behaviours.

The way we work has been demonstrated in being the Health Service Journal Integrated Care System of the year in 2021 and 2022, where leadership values across all health and care sectors was highlighted as a success of how we improve care for people and communities.