Foreword from Cathy Elliott, Chair of the West Yorkshire Integrated Care Board and Rob Webster, Chief Executive of the West Yorkshire Integrated Care Board
NHS West Yorkshire Integrated Care Board (NHS WY ICB) has developed its second edition of this Joint Forward Plan (JFP) with its partners to help deliver the West Yorkshire Integrated Care Strategy. The JFP sets out how we will meet our population’s health needs and how the partnership intend to arrange and/or provide NHS services to meet the physical and mental health needs of our population.
Our JFP and our Strategy are important documents that serve each other to support the work we do in our local places (Bradford District and Craven, Calderdale, Kirklees, Leeds and Wakefield District) with care providers. Both are worthy of focus and attention. We will be held to account for delivery and progress for the people and communities living across West Yorkshire.
We believe that “people own what they help create”. The development of our strategy and plan in West Yorkshire has been a collaborative effort involving colleagues from all sectors including voluntary, community and social enterprise (VCSE) organisations. We have also engaged with Healthwatch, considered local involvement activities, gathered insights from public meetings held by local Health and Wellbeing Boards, West Yorkshire Joint Health Overview and Scrutiny Committee, the NHS West Yorkshire Integrated Care Board (ICB), and the West Yorkshire Health and Care Partnership Board, and importantly people and communities. You can see examples in our annual involvement and consultation report.
Reports from Healthwatch and the Joint Forward Plan public consultation have emphasised the significance of ensuring access to care, including general practitioners (GPs) and NHS dentists, whilst also addressing health inequalities, improving coordination of care, enhancing workforce recruitment, and focusing on fundamental aspects of healthcare delivery.
We are committed to delivering better health outcomes and delivering joined up services, with faster access to care, closer to where they live, for people living in West Yorkshire, both in the short and long term. These priorities remain at the forefront of our efforts as we work towards achieving our ambitions for West Yorkshire health and care services and importantly staff, people, and communities.
The recent change in Government brings us the opportunity to reflect and refocus our work. The three areas of focus under the new Government have been set out as; moving care out of hospital into primary and community care; better utilisation of technology and data; and boosting prevention – maximising the opportunity of local partnership working to support people to stay well, reduce health inequalities and help people stay in work.
These priorities have always been part of our vision for the people of West Yorkshire and are woven through out Integrated Care Strategy and this JFP. We believe that the national prioritisation of this work is a positive step, which will support the delivery of this JFP.
We have already made much progress in this work, particularly in 2023/24. Across West Yorkshire (WY) we undertook 17.1 million GP appointments, with an increase of 6% since last year. With 494 (96%) of pharmacies signed up to the pharmacy first programme we are providing a comprehensive approach to delivering primary care in the right place at the right time. We also improved access for children to dentistry services in the last 12 months, increasing uptake by 9.9% on the previous year.
The number of people waiting more than 62 days between referral and starting cancer treatment in WY has decreased down to 476, which is lower than the national target and represents the joint lowest proportion across the country. We are also delighted to see the impact of our work on mental health is making significant changes WY is one of only five ICBs nationally achieving at least three of the six core long term plan targets relating to mental health.
At the end of March 2023, the ICB allocated £1 million to the VCSE sector, and a further £1.8 million to our Hospices (also part of the VCSE) recognising the immediate challenges faced in terms of sector sustainability.
We have continued through 2023/24 to embrace technology to deliver care, monitoring, and treatment in patients' homes, ensuring accessibility and inclusivity. Including through the introduction of remote monitoring technology in our virtual wards. In addition, 87% of our GP practices have enabled the NHS App to allow people to see their medical records, order repeat prescriptions and manage routine appointments.
We are particularly proud that along with our partners, we became the first partnership of sanctuary in the country for going above and beyond to welcome people seeking sanctuary into West Yorkshire.
We know that there is still work to do however and we have as a system identified seven priority transformation areas of work to undertake over the coming year. These include: mental health, with a focus on the utilisation of assessment and treatment units; the development of Integrated Neighbourhood Teams; outpatient transformation, including ophthalmology and ear nose and throat; and targeted secondary prevention.
Since the publication of our first Joint Forward Plan in 2023, we have continued to adapt to the changing context we find ourselves in. Our Board Assurance Framework and Risk Register captures the risks associated with this changing context. We have been facing the challenges of living with the widening health inequalities, the cost-of-living crisis, growth in demand on community health services, the effects of climate change and financial challenges across all sectors. We continue to work together to tackle these, and you can see examples in our collective response to the pressures on our children and young people services and the budget challenges. Industrial action continues to disrupt care for people and over the last year this has been an ongoing challenge in looking after the health and wellbeing of those waiting for care and our workforce. We are also alert to the risk of future pandemics and their potential impact on health and healthcare services.
Over the last year we have worked with our ICB colleagues to design and implement a new operating model for the Integrated Care Board, responding to the reductions of 30% in the running cost allowance for the ICB so we are ready for implementation on the 1st April 2024.
In addition, the transfer of functions from NHS England to the ICB, for example the commissioning of NHS dental services, and the merger of NHS England with NHS Digital and Health Education England has had an impact on our staff and the people we work with. We also continue to work towards the future transfer from NHS England of those services which are more specialised in nature, for example renal dialysis, specialist vascular services and complex spinal surgery services.
The last year has seen some of the most challenging times our local authorities have experienced. Increased need for many services such as children’s services, adult social care, homelessness and other housing services, alongside challenging financial settlements from Government, has brought significant pressures to council budgets and has led to difficult choices. We are working closely together in that decision making to ensure we can minimise the impact on the people of West Yorkshire and support our local government colleagues.
We know that in West Yorkshire we have increasing need in children’s services such as complex care, Special Educational Needs and Disabilities (SEND) and children and young people’s mental health. Alongside the challenges of the local authorities’ financial settlement, we are concerned about the future of delivery of these services and particularly the impact on our children and young people. We think that immediate action is crucial to secure a fulfilling future for every child in West Yorkshire and have agreed a system response to influence national thinking.
We also know that this has equally been one of the most challenging winters for mental health services and we are working as a system to learn and plan for next winter – keeping in view the financial constraints they face.
Whilst challenges are significant, we continue to believe that working together at all levels is the most effective approach to take if we are to deliver on these plans for people in uncertain times. Our Partnership's history demonstrates the benefits of collaboration.
Our Joint Forward Plan for 2024 showcases our continued commitment to improving health and care services for staff and everyone we serve. Significant risks remain and we will continue to work incredibly hard to ensure that we focus on implementation and delivery.
Thank you to everyone involved in the development of our refreshed plan – for your hard work and commitment. We look forward to hearing about the positive difference both plans make at all levels of our West Yorkshire Health and Care Partnership.