As another year draws to a close, it’s a good time to look back on challenges we have faced, issues which will face us in the future and to celebrate the work and dedication of people who work or volunteer in Leeds to deliver better health and wellbeing for the city.
At the end of November our ‘State of the City’ gathering brought together over 150 city leaders, health and care specialists and, most importantly, service users who are experts by experience, to work through some of the big issues and challenges facing the city’s health and care system.
We know the UK health and care system remains the envy of many other nations. Lives are longer and better. Ill health and injury is treated in ever-improving and more innovative ways. Prevention is smarter and better planned. All of which means people are living better lives. And of course, healthcare is still delivered free when needed.
However, we can’t rest on our laurels. There are huge differences in the health and wellbeing of the richest and poorest in our city, as there are nationally. If you grow up in Adel you’ll be likely to have five years longer living healthily than the rest of the city, and almost 11 than the poorest wards in Leeds.
We also know more than one in five adults still smoke, killing 1,305 people every year; diagnosed dementia is up by a fifth; alcohol and obesity are causing disease and disability, and we have to look at the broader issues such as pollution and transport that play a significant role in the city’s health and wellbeing.
That is why we were determined to get as many decision makers, influencers and deliverers of health and care services together as was practical. We wanted to share information, highlight challenges and most importantly, look to improve what we do so the results are better for everyone.
Integration of services is at the forefront of much of the improvement that is happening and the opportunities for the future. Integrating policy beyond the NHS and Social Care Services can take us into territory that can deliver a healthier Leeds in the years and decades to come.
Listening to the voices of Leeds
At the full council meeting in November (video – see item at 4 mins 29 seconds on the timeline) we had a great discussion about the important role that health and wellbeing boards play in their community.
What came out strongly in the debate is the crucial importance of health and care services for Leeds, and the need to make sure we are matching their delivery to the needs of the population. As increasing responsibility for health and wellbeing is given to local authorities, it becomes more and more important to make sure the voices of those who use (or will use) services are heard, as well as the thoughts of health and care professionals. That will mean we can make decisions reflecting the experiences of those who use the services, rather than just imposing new ways of working and service provision from the top down.
Of course engaging and consulting isn’t new, and all involved in the Health and Wellbeing Board will continue to engage and consult in coming months and years. As difficult decisions and new opportunities come up, both the council and NHS organisations will ask for opinions and advice, helping inform policy making and service provision.
The more people who make their voices heard, the better informed we can be. It is up to us all to get involved and encourage others to get involved as well.
Our board meetings are open to everyone and if you want to contribute, comment or ask a question of the board, we welcome that. The next board meeting is 4th February 2015.
If you let us know well before the meeting that you want to ask about something, it will mean we can research the issue for you and be able to respond in more depth. Please contact firstname.lastname@example.org if you have a question.
In focus: Personalisation
As the Health and Wellbeing Board evolves and develops, we have been looking at changing how we do things so we are more effective. With lots of boards around the country still working out what works best for their local situation after their first year or so, we in Leeds aim to mix joining up chances to develop agreed and integrated policy and practice with chances to learn more about key areas.
November gave us a chance to look at what personalisation could mean in Leeds. As well as picking up details from professionals, we heard the stories of Lily Cheng, Lesley Sterling-Baxter – who spoke about her daughter Rebecca’s experience -and Rob Moriarty. Each has a range of experiences with health and care systems, as well as of personal budgets.
‘Personalisation’ encompasses a broad approach to care, with personal budgets forming a significant part. The national and local policy direction supports a radical increase in the design of personalised care and support. Personalisation potentially offers bespoke support to deliver the most effective help to those who need it.
Current progress on personalisation and personal health budgets
Personal budgets have been used in social care since 1997, so there are lots of opportunities for health to learn from social care and to integrate and coordinate how we deliver on these elements across our organisations.
Knowing service users are the best people to gain an understanding of what services are like to use, what is good and what can be improved, we asked Lily, Lesley and Rob to tell us about their experiences.
Lily Cheng is a personal budget user in adult social care. Following a motor accident she uses a wheelchair and as her speech is affected by her injuries, her communication is predominantly non-verbal.
Rob Moriarty is a 33 year old businessman and entrepreneur. A 1998 diving accident left Rob paralysed from the neck down and wheelchair-bound, completely dependent on 24 hour care. He recently started using a personal health budget and helps others by sharing his experience.
Lesley Sterling-Baxter’s daughter Rebecca has a genetic condition – Ehlers Danlos Syndrome (EDS) – which affects all of the connections in her body, making her extremely susceptible to dislocations, broken limbs and infection. Lesley gave up a job in commissioning to care for Rebecca and told us about the complexity of Rebecca’s condition and the ways she often needs complex medical intervention and care.
With a Joint Health and Wellbeing Strategy (pdf link) aim that ‘People are involved in decisions made about them’ and a priorities to ‘Ensure people have a voice and influence in decision making’ and ‘Increase the number of people that have more choice and control over their health and social care’, the contributions gave a real insight into the realities of everyday services. There are clearly opportunities for people on Personal Budgets to become ‘employers’ with Personal Assistants, to share experience and get advice on how best to manage being a Personal Budget holder.
Board members learnt how difficult management of personal budgets could be, particularly if you are already coping with illness and disability. The need for organisations to provide effective help and advice will be vital for if personal budgets are to succeed.
Healthy health checks
It was good news recently for Leeds as the Leeds Health Checks service was recognised last month for its success.
The Leeds team topped the ‘Best Impact for Patient experience’ category and were runners up in the best team category. The awards were open to individuals, teams and organisations involved in commissioning and delivering NHS Health Checks.
As a service linking health work across the city, they offer a great opportunity to make a long term impact on health, helping early prevention and intervention.
New services – new year
A variety of services have recently seen awards of new contracts, meaning that 2015 will see improvements in the way that sexual health services and drug and alcohol treatment services are delivered in Leeds.
Other services have also had new contracts and what is increasingly clear is that organisations are successfully linking together to come up with plans which can improve health and wellbeing in the city.
By making sure they have engaged with users and found out what works for them, not just the organisation, the opportunities for good outcomes are increased.
Congenital heart surgery consultation
Many of us in the city used the consultation opportunity to have our say about the future options for heart surgery, not just in Leeds but nationally.
We’re confident Leeds can meet the challenges in the future if resourced properly. We know we can’t be considered in isolation, and the better organisations can work together and support each other, the better chances of good outcomes.
We look forward to seeing what the results of the national consultation are and anticipate that we will need to continue to ensure Leeds is well represented in the future.
This year has seen a range of organisations work together to deliver advice and support as winter approaches. This covers a broad range of issues, from flu jabs and keeping warm, to gritting and school closures.
Homeless Accommodation Leeds Pathway (HALP), a new pathway to improve the healthcare provided to homeless people in Leeds was officially launched earlier this year. As the cold weather hits, this service links a wide range of city organisations offering some of the most vulnerable people in the city, invaluable support.
I’ll be providing more updates on what health and care services in Leeds are doing in the new year. In the mean time, best wishes for a happy Christmas and healthy New Year.
Cllr Lisa Mulherin