N H S Leeds C C G

A Message from Lord Pickles and Lord Blunkett, followed by N H S Leeds C C G's best practice article

The ability to listen and learn from one another has always been vital in parliament, in business and in most aspects of daily life. But at this particular moment in time, as national and global events continue to reiterate, it is uncommonly crucial that we forge new channels of communication and reinforce existing ones. The following article from N H S Leeds C C G is an attempt to do just that. We would welcome your thoughts on this or any other Parliamentary Review article.

Blunkett signature Rt Hon The Lord David Blunkett
Pickles signature Rt Hon The Lord Eric Pickles

www.leedsccg.nhs.uk

BEST PRACTICE REPRESENTATIVE 2019
THE PARLIAMENTARY REVIEW
Highlighting best practice
34 | ZINNIA CARE
they’re not working with an hour
or two’s notice, we need to cover
thatimmediately.
A service user can’t be told that
nobody’s coming to provide care
for them – that’s just unacceptable.
However, our staffing issues have
meant that office staff have often had
to leave to cover the call – managers,
co-ordinators and sometimes even
myself as director of the business.
We could opt to use agency staff –
and we have done in the past – but
that is an expensive road to go down.
Between council and agency fees the
cost is near-extortionate, and we as
the care provider have no choice but to
cover in any way we possibly can.
A key feature for any successful
homecare business is staff retention. In
our case, more than 50 per cent of our
staff have been with us for more than
three to five years. In this business,
we become part of our service users’
family. As our clients are vulnerable
adults who open up their homes
to us, staff consistency is of vital
importance and helps to build trust
and satisfaction.
Council contracts need to be
well thought-out
To help, we do need local and central
government alike to renew their focus
on a streamlined framework for adult
social care contracts. The release of
the long-awaited green paper would
certainly be helpful, but in lieu of that,
a short-term solution would be to
redefine how we win business.
One aspect that needs closer
examination is the distance that care
workers often have to cover. There’s
a lot of running around, and councils
just don’t care about that; they
don’t subsidise fuel costs or vehicle
purchases, which would help us to
deliver care more effectively.
The petrol cost alone of being a care
worker is not insignificant; some kind
of plan in place to help providers like
ourselves cope with the real demand
we face out there as the ageing
population continue to grow would be
most welcome.
Future legislation
Irrespective of the outcome of the adult
social care green paper, it is clear that
two things need to be brought to the
government’s attention: agency staffing
and mileage. Greater regulation and
more supportive frameworks in this
regard would be helpful n ot just for us,
but providers across the country.
In spite of these difficulties, however,
we at Zinnia Care continue to overcome
every obstacle and grow without
hesitation. In the future, I would like to
see us open further branches around
the country and become the homecare
provider of choice.
To do this, we will continue to operate
with our person-centred ethos in mind
and supply care which really makes
a difference to our service users and
their relatives.
We will
continue to
operate with
our person-
centred ethos
in mind and
supply care
which really
makes a
difference to
our service
users and their
relatives
“
“
Care staff can make a
difference in someone’s
life
35NHS LEEDS CLINICAL COMMISSIONING GROUP (CCG) |
HEALTHCARE & PHARMACEUTICAL
Chief Executive Tim Ryley
We aim to improve the health and
wellbeing of people of all ages
NHS Leeds CCG was formed through the merger of the
NHS North, NHS Leeds South and East and NHS Leeds
West CCGs. Covering a population of 870,000, and
encompassing 97 GP practices, its goal is to promote integrated
working across the city. Through the use of shared digital
records and the creation of local “hubs” in the community,
it aims to bring care into the localities. Chief Executive Tim
Ryley discusses the success of this integrated system and how
community involvement can help solve the challenges of large
urban areas.
Our ultimate shared aim, as outlined in our Leeds Health and Wellbeing Strategy
2016–21, is to make Leeds the best city in the UK for health and wellbeing, where
people who are the poorest improve their health the fastest. This is reflected in our
Leeds Health and Care Plan, which will improve health and wellbeing for all ages
and for all of Leeds. Our approach to integrated working means we can deliver
improved health and wellbeing, reduce health inequalities, ensure people have
better outcomes and have a more engaged community.
Leeds Care Record
Leeds is a hub for investment and innovation in health analytics. We are the first
major UK city where every GP can access an integrated electronic health and social
care patient record. We are a national and international centre of excellence for
children’s services, and we have ambitious plans for an innovation district, building
on our strong links with our world-class universities.
FACTS ABOUT
NHS LEEDS CCG
»Chief Executive: Tim Ryley
»Established in April 2018 with
the merger of NHS North, NHS
Leeds South and East and NHS
Leeds West CCGs
»Based in Leeds
»Services: Planning and funding
the delivery of NHS services in
Leeds
»No. of employees: Over 300
»NHS Leeds CCG is made up of
97 GP practices and covers a
population of around 870,000
people
»The CCG uses the clinical
expertise of locally based
doctors and nurses, supported
by experienced managers, to
commission healthcare services
»www.leedsccg.nhs.uk
NHS Leeds Clinical
Commissioning Group (CCG)
THE PARLIAMENTARY REVIEW
Highlighting best practice
THE PARLIAMENTARY REVIEW
Highlighting best practice
36 | NHS LEEDS CLINICAL COMMISSIONING GROUP (CCG)
Leeds Care Record is a joined-up
digital record which brings together
important information about patients,
enabling clinical and care staff to view
real-time health and care information
across care providers and between
different systems.
Our Adult Social Care dataset went live
in Leeds Care Record in 2016.Since
then, integrated care between the
council and Leeds Teaching Hospitals
NHS Trust has evolved at a fast
pace.The system helps practitioners to
obtain an up-to-date medical snapshot
and gain a holistic understanding of
the patient’s health journey. Areas
such as adding safeguarding flags and
more detailed information on care
plans have been identified for future
development.
Local care partnerships
The NHS in Leeds and Leeds City
Council are working towards
integrating systems and ways of
working to improve services for local
populations. Our work is built around
strong, well-established and locally
based “neighbourhood teams” that
combine community health and adult
social care services. These were integral
to our national NHS Pioneer status.
We have supported local care
partnerships by investing in a locality
leadership infrastructure from
general practice, and by supporting
the development of the Leeds
GPConfederation.
For example, our Child Family Hub
aims to improve access to specialist
children’s doctors. It has already
reduced the number of “unnecessary”
paediatric outpatient appointments
at hospitals. In a strategic approach,
it has brought together GP practices
in one part of Leeds to work with
staff from schools and the city’s NHS
trusts, creating a “hub”. A consultant
from Leeds Children’s Hospital
carries out clinics in the community,
meaning families don’t need to travel
unnecessarily to appointments and can
access them earlier. Previously, there
would have been an average 12-week
wait to see the paediatrician in hospital
following a referral: those patients can
now see the consultant within one
month – and GPs can get advice on
their case within two days.
Social prescribing
There are many factors which come
together to affect the health of
individuals and communities. Where we
live, our environment, genetics, income,
education level and relationships with
friends and family all have significant
effects on health and wellbeing.
Social prescribing is an intervention
to address unmet patient needs by
increasing knowledge about local
services and voluntary groups that
could provide appropriate support to
improve and encourage self-care and
facilitate health-creating communities.
Social prescribing puts patients in
contact with a link worker who could
help people access community-based
services that suit their needs much
better than a medical intervention.
Examples of this may include debt
advice or referrals to a Citizens
AdviceBureau.
Our Leeds Health and
Wellbeing Strategy
aims to improve the
health and wellbeing of
everyone
Our Child
Family Hub
aims to
improve access
to specialist
children’s
doctors and
has already
reduced the
number of
“unnecessary”
paediatric
appointments
at hospitals
“
“
37NHS LEEDS CLINICAL COMMISSIONING GROUP (CCG) |
HEALTHCARE & PHARMACEUTICAL
An example of this is Caring Hands.
Caring Hands is a collaborative project
between patients at a medical practice,
GPs and nurses, a social prescribing
scheme and third-sector organisations.
Caring Hands volunteers have
undergone training in befriending,
confidentiality and risk assessment.
They offer vulnerable, socially isolated
and anxious patients an additional
helping hand and listening ear when
geographical distances and increased
work pressures mean family members
are less able to be there.
Collaboration between different
organisations and volunteers can make
a real positive impact to patients’ lives
by tackling issues such as loneliness
and isolation. Services like these make
a huge difference to people’s health
and wellbeing.
Frequent attenders project
This group was set up in partnership
with Leeds Teaching Hospitals NHS
Trust, Leeds and York Partnership
NHS Foundation Trust and Barca, a
local community and voluntary sector
organisation. Their goal was to reduce
the number of attendances at A&E
by a specific cohort of people who
have been identified as being frequent
attenders and who would benefit from
mental health and psychosocial support.
Through joint working and
collaboration, the team have adopted a
consistent approach to understanding
and meeting the complex needs of
individuals who frequently use crisis,
emergency and urgent care services.
In their first year, the team achieved
a reduction of 31 per cent in
attendances for the selected group,
surpassing the 20 per cent target.
Following this success, the team have
selected a further cohort of frequent
attenders to work with, and have fully
integrated a case manager from Barca
into the team.
Leeds – continually innovating
All of this puts Leeds at the forefront
of health and care innovation
nationally. Our approach in Leeds is
built on firm foundations working
with all partners in a co-operative
way that also includes clinicians,
citizens and the third sector. Our
democratically elected members have
been central to this approach, working
closely with staff at all levels via our
Community Committees and in local
carepartnerships.
While we have achieved success,
challenges still remain. The key ones
are to tackle health inequalities and
unwanted variations in quality of
care. Beyond this, we must adapt
to an increasingly elderly population
with more long-term conditions,
for example diabetes, high blood
pressure and chronic obstructive
pulmonarydisease.
We are open and learn from each
other and our communities. Ultimately,
we believe in our people and we
believe that through working together,
co-producing solutions and shaping
opportunities, we will improve
outcomes for all ages and in all
communities despite the challenges we
face as a large urban area.
Collaboration
between
different
organisations
and volunteers
can make a real
positive impact
to patients’ lives
by tackling
issues such as
loneliness and
isolation
“
“
Ragbir Thethy,
consultant paediatrician
from Leeds Teaching
Hospitals NHS Trust at
the West Lodge Surgery
in Farsley
BEST PRACTICE REPRESENTATIVE 2019
THE PARLIAMENTARY REVIEW
Highlighting best practice
36 | NHS LEEDS CLINICAL COMMISSIONING GROUP (CCG)
Leeds Care Record is a joined-up
digital record which brings together
important information about patients,
enabling clinical and care staff to view
real-time health and care information
across care providers and between
different systems.
Our Adult Social Care dataset went live
in Leeds Care Record in 2016.Since
then, integrated care between the
council and Leeds Teaching Hospitals
NHS Trust has evolved at a fast
pace.The system helps practitioners to
obtain an up-to-date medical snapshot
and gain a holistic understanding of
the patient’s health journey. Areas
such as adding safeguarding flags and
more detailed information on care
plans have been identified for future
development.
Local care partnerships
The NHS in Leeds and Leeds City
Council are working towards
integrating systems and ways of
working to improve services for local
populations. Our work is built around
strong, well-established and locally
based “neighbourhood teams” that
combine community health and adult
social care services. These were integral
to our national NHS Pioneer status.
We have supported local care
partnerships by investing in a locality
leadership infrastructure from
general practice, and by supporting
the development of the Leeds
GPConfederation.
For example, our Child Family Hub
aims to improve access to specialist
children’s doctors. It has already
reduced the number of “unnecessary”
paediatric outpatient appointments
at hospitals. In a strategic approach,
it has brought together GP practices
in one part of Leeds to work with
staff from schools and the city’s NHS
trusts, creating a “hub”. A consultant
from Leeds Children’s Hospital
carries out clinics in the community,
meaning families don’t need to travel
unnecessarily to appointments and can
access them earlier. Previously, there
would have been an average 12-week
wait to see the paediatrician in hospital
following a referral: those patients can
now see the consultant within one
month – and GPs can get advice on
their case within two days.
Social prescribing
There are many factors which come
together to affect the health of
individuals and communities. Where we
live, our environment, genetics, income,
education level and relationships with
friends and family all have significant
effects on health and wellbeing.
Social prescribing is an intervention
to address unmet patient needs by
increasing knowledge about local
services and voluntary groups that
could provide appropriate support to
improve and encourage self-care and
facilitate health-creating communities.
Social prescribing puts patients in
contact with a link worker who could
help people access community-based
services that suit their needs much
better than a medical intervention.
Examples of this may include debt
advice or referrals to a Citizens
AdviceBureau.
Our Leeds Health and
Wellbeing Strategy
aims to improve the
health and wellbeing of
everyone
Our Child
Family Hub
aims to
improve access
to specialist
children’s
doctors and
has already
reduced the
number of
“unnecessary”
paediatric
appointments
at hospitals
“
“
37NHS LEEDS CLINICAL COMMISSIONING GROUP (CCG) |
HEALTHCARE & PHARMACEUTICAL
An example of this is Caring Hands.
Caring Hands is a collaborative project
between patients at a medical practice,
GPs and nurses, a social prescribing
scheme and third-sector organisations.
Caring Hands volunteers have
undergone training in befriending,
confidentiality and risk assessment.
They offer vulnerable, socially isolated
and anxious patients an additional
helping hand and listening ear when
geographical distances and increased
work pressures mean family members
are less able to be there.
Collaboration between different
organisations and volunteers can make
a real positive impact to patients’ lives
by tackling issues such as loneliness
and isolation. Services like these make
a huge difference to people’s health
and wellbeing.
Frequent attenders project
This group was set up in partnership
with Leeds Teaching Hospitals NHS
Trust, Leeds and York Partnership
NHS Foundation Trust and Barca, a
local community and voluntary sector
organisation. Their goal was to reduce
the number of attendances at A&E
by a specific cohort of people who
have been identified as being frequent
attenders and who would benefit from
mental health and psychosocial support.
Through joint working and
collaboration, the team have adopted a
consistent approach to understanding
and meeting the complex needs of
individuals who frequently use crisis,
emergency and urgent care services.
In their first year, the team achieved
a reduction of 31 per cent in
attendances for the selected group,
surpassing the 20 per cent target.
Following this success, the team have
selected a further cohort of frequent
attenders to work with, and have fully
integrated a case manager from Barca
into the team.
Leeds – continually innovating
All of this puts Leeds at the forefront
of health and care innovation
nationally. Our approach in Leeds is
built on firm foundations working
with all partners in a co-operative
way that also includes clinicians,
citizens and the third sector. Our
democratically elected members have
been central to this approach, working
closely with staff at all levels via our
Community Committees and in local
carepartnerships.
While we have achieved success,
challenges still remain. The key ones
are to tackle health inequalities and
unwanted variations in quality of
care. Beyond this, we must adapt
to an increasingly elderly population
with more long-term conditions,
for example diabetes, high blood
pressure and chronic obstructive
pulmonarydisease.
We are open and learn from each
other and our communities. Ultimately,
we believe in our people and we
believe that through working together,
co-producing solutions and shaping
opportunities, we will improve
outcomes for all ages and in all
communities despite the challenges we
face as a large urban area.
Collaboration
between
different
organisations
and volunteers
can make a real
positive impact
to patients’ lives
by tackling
issues such as
loneliness and
isolation
“
“
Ragbir Thethy,
consultant paediatrician
from Leeds Teaching
Hospitals NHS Trust at
the West Lodge Surgery
in Farsley

www.leedsccg.nhs.uk

This article was sponsored by N H S Leeds C C G. The Parliamentary Review is wholly funded by the representatives who write for it. The publication in which this article originally appeared contained the following foreword from Rt Hon Michael Gove.

Rt Hon Michael Gove's Foreword For The Parliamentary Review

By Rt Hon Michael Gove

This year's Parliamentary Review comes at a momentous time for parliament, as we collectively determine the destiny of the United Kingdom. 

On October 31, the UK will leave the European Union. The successful implementation of this process is this government's number-one priority.

Three years after a historic referendum vote, we will deliver on the decisive mandate from the British people. Trust in our democracy depends on it. Until that final hour, we will work determinedly and diligently to negotiate a deal, one that abolishes the backstop and upholds the warm and close relationship we share with our friends, allies and neighbours in the EU. But in the event that the EU refuses to meet us at the table, we must be prepared to leave without a deal.

As the Chancellor of the Duchy of Lancaster, it is my job to lead on this government's approach, should that scenario happen. Preparing for Brexit is my department's driving mission. But while I am leading this turbocharged effort, the whole of government is committed to this endeavour.

Ministers across Whitehall are working together to ensure that every possibility is considered, every plan is scrutinised and every provision is made. A daily drumbeat of meetings means that we are holding departments accountable, so that preparations are completed on time.

The chancellor has confirmed that all necessary funding will be made available. And we have mobilised thecivil service, assigning 15,000 of our most talented civil servants to manage our exit from the EU.

We will make sure that on November 1, there is as little disruption to national life as possible. Our trade relationships will continue to thrive, thanks to agreements with countries around the world worth £70 billion. Our country will remain secure, thanks to nearly 1,000 new officers posted at our borders. And the 3.2 million EU nationals now living and working among us can remain confident, with absolute certainty, of their right to remain in the UK.

Above all, our goal is to be transparent. Soon, we will launch a public information campaign so that citizens, communities and businesses are ready and reassured about what will happen in the event of “no deal”.

In my first few weeks in this role, I have travelled to ports and tarmacs, borders and bridges, all across the UK –from the seaside of Dover to the rolling green hills of County Armagh. I have heard from business owners and border officials, farmers and hauliers. They are ready to put an end to uncertainty. And they are ready to embrace the opportunities ahead.

Our departure from the EU will be a once in a lifetime chance to chart a new course for the United Kingdom. Preparing for that new course will be a herculean effort. But this country has made astounding efforts before. We can do it again.
Rt Hon Michael Gove
Chancellor of the Duchy of Lancaster