Our approach to involving people and communities
Since West Yorkshire Health and Care Partnership began in 2016, we have been passionate about ensuring that our approach to involvement, in all forms meets the needs of people living, working, caring, and volunteering in West Yorkshire. This includes making sure that people remain at the centre of all planning and decisions, and that we listen to and talk with them, their families and carers, and local communities. We are also accountable to people living in West Yorkshire for their NHS services.
Governance and assurance about involvement supports how we work. This includes how we make sure people and communities in West Yorkshire are involved in our decision-making and can have confidence in our approach.
We work hard in West Yorkshire to build the relationships needed to deliver better health and care locally. These relationships have enabled us to use our collective resources to tackle health inequalities, to innovate and to build partnerships that make sense locally to us. In our new statutory arrangements, we continue to need the freedom and flexibilities for us to innovate and to deliver in the right way for the people of West Yorkshire. At the centre of this is listening to people and communities ‘we care, we listen, we act.’ Engaging with partners, stakeholders and the public in the planning, design and delivery of services is essential if we are to get this right. You can find out more on our website. There is also our engagement and consultation annual mapping report which sets out what people have told us and what is important to them.
We know that many people are often not heard in our health and care system. To ensure our services meet the needs of all people we work creatively and accessibly to reach those whose voices and views / feedback are too often ignored or not sought. We have agreed principles of how we work together and with people and communities.
Our involvement framework describes our approach. Through this approach we can ensure that we are putting the people of West Yorkshire at the heart of everything we do. We have used the involvement framework to guide us in the development of this strategy and this will be especially important in the development of our plans set out here.
The way in which the people voice is heard in our system is outlined in our people and communities voice diagram which you can view on the West Yorkshire ICB involvement page.
What people have told us through our Joint Forward Plan consultation
The guidance on developing this plan reminds us of our duty to consult with the public in the development of our plans as set out in the Health and Care Act 2022. The consultation on delivering our five-year integrated care strategy consultation began in January for a period of six weeks. Details of this consultation process and importantly the findings are available on our website. This plan aims to address these findings.
Throughout the consultation period 203 people responded to the survey. Of these 67.9 % were members of the public and 32.1 % were colleagues from health and care settings. Responses were also received from organisations and are attached to the final consultation report which is available at Appendix B. It’s important to note, that we also have delivered many other involvement activities around many areas of care, such as autism, climate change and young people services – and this insight is evidenced in our annual mapping report alongside local place involvement work.
Themes arising out of the report align well to the engagement feedback we received as part of the development of the strategy. These are:
- Access to services, in particular access to GP and Dentistry services
- 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.
The consultation report provides us with valuable information to support the development of our plans to deliver both the five-year integrated care strategy, via this plan. We will continue to identify any gaps and new areas for involvement as part of ongoing involvement work. Building experience of care into the monitoring and evaluation of our plans will be important to ensure when reviewing our plans annually, we can measure the impact it is having on people and communities.
You can also read our ICB involvement report on our website as well as the engagement and consultation mapping report, which provides insight on involvement work undertaken in 2022/23.
What people have told us
As part of the development of the West Yorkshire Integrated Care Strategy, several reports summarising what people are telling us is their experience of health and care have been produced. This includes a Healthwatch Insight Report published in August 2022, a mapping report published in May 2022 setting out involvement and consultation activity across West Yorkshire and lastly a further mapping report from across the Partnership which provides oversight of engagement in all other areas of work. We also publish a short involvement report setting out recent examples of involvement activity across West Yorkshire.
There are a number of themes which have been raised over the last year (2022) as a result of these discussions in relation to healthcare across West Yorkshire. The changing context has in many cases placed a new emphasis on some of the themes and more recently the cost-of-living crisis has been an escalating issue.
Access to primary care remains a key area of concern. Primary care is considered the front door to the wider health and care service and many feel let down when they can’t access their GP in a way that works for them. There is a deep concern that this has a detrimental impact on their health and wellbeing. Recent work has included campaigns to support people get the right care at the right place, for example ‘Together we can’ and It’s a GP practice thing’.
Access to dentistry services continues to be an issue raised for both children and adults. This is both in terms of being able to register with an NHS dentist and access to appointments and treatment when registered. It was also raised that access to urgent dental care was not as responsive as needed.
Of increasing concern is the cost-of-living crisis which continues to escalate and impact on peoples’ lives. This impacts significantly on the ability to make choices that positively impact their wellbeing, such as accessing healthcare, undertaking activities that support mental wellbeing, eating healthy nutritious food and being able to live in warm, safe housing. These challenges are having a particular impact on those who are living with social disadvantage, serious illness, addictions, and those people who are carers. This has led us to join forces with West Yorkshire Combined Authority and West Yorkshire Mayor to tackle this important issue together.
We also know that suicide rates rise during times of economic recessions and financial exclusion is a significant risk factor in suicide deaths.
We have award winning campaigns, and a website with resources for wider support – all coproduced with people impacted by suicide.
There continues to be concern around accessing support for mental health in a timely manner, an issue which has increased with the impact of the pandemic. Of significant concern is access to support for our children and young people and the level of support for children who are waiting for assessment for, or have been diagnosed with, autism. Self-harm rates for both adults and children are rising, and the people we are supporting with mental health issues are becoming more unwell, more quickly than they have previously.
We know that the pandemic has led to significant delays in treatment, particularly for planned care services. People are telling us that this is causing a deterioration in their physical, mental, and emotional health. The impact of this is also extending to family members and carers who are concerned about their loved ones.
The choice people have in accessing care that is right for them highlighted concerns about digital exclusion with many appointments and support moving to online services. Many of our population do not have access to digital technology or have additional challenges in using it. This was particularly a challenge for people with learning disabilities
Poorer experiences of quality of care are starting to emerge in some care settings. Whilst it is acknowledged that this is in part due to challenges arising from the pandemic in terms of staff shortages, we know it is important to be treated with care and compassion. For example, we know that children and young people from ethnic minority communities and those in poorer areas with diabetes have consistently poorer blood sugar control. We also recognise that there is a variation in access to digital technology such as continuous glucose monitoring.
What our Health and Wellbeing Boards (HWBBs) and Overview and Scrutiny Committee members have told us
As already described, our strategy and plans start from improving people’s health and wellbeing and having access to high quality joined up health and care services, wherever possible in the communities where people live, informed by the need described in local Joint Strategic Needs Assessments. Our Joint Forward Plan sets out what will be delivered in local places and what will be delivered across West Yorkshire. Each of the place plans are owned by the Place Committees of the ICB and respond to the national planning priorities, delegated functions from the ICB, the ten ambitions set out in our Integrated Care Strategy and priorities set out in the joint local health and wellbeing strategies. More information about how this works is on our website.
Our HWBBs have an important role to play in the delivery of our strategy We have worked closely with them to develop both the strategy and this plan. Starting discussions with the Boards in January 2023 and continuing through the development of the plan, their views on the plan can be described as:
Our local and West Yorkshire Overview and Scrutiny Committees are also key partners to support us in the development of this work and discussions have again been held over the development of this plan.