Integrated
Health and Care Strategy
Introduction and Context
1.
The
Humber and North Yorkshire Health and Care Partnership (formally
Humber, Coast and Vale) was established in 2016 as a collaboration
of 28 organisations from the NHS, local councils, other health, and
care providers including the voluntary and community sector.
The Partnership covers a geographical area of more than 1,500
square miles and serves a population of 1.7 million people, all
with different health and care needs. It includes the cities
of Hull and York and the large rural areas across East Yorkshire,
North Yorkshire, and Northern Lincolnshire.
2.
The
Health and Care Act 2022 that received Royal Assent on 28 April
2022 put Integrated Care Systems (ICSs) on a statutory footing,
empowering partners to work closer together to better join up
health and care services, improve population health, reduce health
inequalities, enhance productivity, and value for money, and help
support broader social and economic development. The Humber and
North Yorkshire Health and Care Partnership is one of 42 ICSs which
cover England.
3.
The
Health and Care Act sets out the four core elements of an ICS these
are Place, Provider/Sector Collaboratives, Integrated Care Board
(ICB) and an Integrated Care Partnership (ICP).
4.
The
ICP is a separate statutory committee, which brings together local
authorities and the NHS Integrated Care Board as partners to focus
more widely on health, public health, and social care. The
development of the Humber and North Yorkshire ICP over the spring
and summer of 2022 with membership being built from Place and with
Place leaders at the very heart. The Humber and North Yorkshire ICP
met for the first time in September 2022.
5.
One
of the key responsibilities of the ICP is to co-produce with
partners an Integrated Health and Care Strategy for Humber and
North Yorkshire and guidance was published by Department of Health
and Social Care on 29 July 2022 and is available online
here:
Guidance on the
preparation of integrated care strategies - GOV.UK
(www.gov.uk).
6.
The
expectation was that Integrated Health and Care Strategies must be
built bottom-up from local assessments of needs and assets
identified at place level, developed for the whole population using
best available evidence and data, covering health and care and
addressing the wider determinants of health and wellbeing. The
strategy should set out how the assessed needs of the population
can be met by upper tier Local Authorities, the ICB and partners
and over what timescale. The expectation was that the strategy
would be produced by December 2022.
7.
The
Health and Care Act 2022, also places a duty on the NHS Integrated
Care Board to have regard to Integrated Health and Care Strategy,
the Joint Strategic Needs Assessments (JSNAs), and Joint Local
Health and Wellbeing Strategies when exercising its functions and
developing its Joint Forward Plan and Operational Plans with NHS
Trusts and Foundation Trusts.
Process
architecture for developing our strategy
8.
Recognising the
requirement for a strategy to be developed, early in 2022 and to
support the ICP whilst it was developing a strategy design group
was established in early 2022 to provide a core function of
designing, co-ordinating, developing and overseeing the development
of the strategy based on an inclusive approach.
9.
The
strategy design group included broad representation from Local
Authorities, ICB and Place. It played a key role in analysing data
and intelligence and providing the information through which to
make sense of where we are and where we want to be.
10.
A
number of principles were agreed by the strategy design group which
underpinned its development. These were, that the strategy
would:
·
Be a living and breathing dynamic
approach
·
Be co-produced and created with the
system and its partners, including closely with local government
and based on lived experience of our
citizens/communities
·
Add value and not replicate what is
happening in Place
·
Enable other emerging strategies to
sense check against a set of ambitions and ensure there is a golden
thread
·
Make use of technology to support
the continuing development and engagement so that progress can be
seen, feedback given as emerging themes to develop.
11.
The
development process has been population health data and
intelligence driven, supported by strong clinical and care
professional leadership. The work has been a collective
responsibility to ensure that the strategy is co-owned, connected
to real work and is delivered by a living system which is empowered
to act.
12.
There
have been and continues to be the opportunity for all members of
the wider system to be involved through a networked approach to
engagement and open and transparent opportunities to be part of the
dialogue. It will be important to continue to provide the
opportunity for effective challenge and enable diversity of thought
and for the ICP to be prepared to listen to suggested change and
keep open minds to evolving the strategy even after
approval.
13.
In
tandem with this, engagement has taken place with a variety of
stakeholders and a number of open sessions have been held. A
desktop review of data, evidence and existing policies and
strategies and engagement with our communities has also been
undertaken. The reviews have considered existing strategies and
plans both within the architecture of our system, but also from
across our wider system and areas of work through which we come
together in partnership.
14.
In
addition, the ICP Committee heard the immediate feedback at their
meeting on the 26 October 2022 from the workshop that had taken
place on the same day, which had focussed on the vision of
‘start well, live well, age well and die well’ and the
following questions:
·
Where
are we now?
·
Where
do we want to get to?
·
How
will we get there?
·
How
will we know when we have got there?
There
have been numerous engagement sessions with Place with each Place
developing their strategy intent.
Where are we now
15.
The
information we have gathered from the engagement and document
reviews has now been taken to support the development of a strategy
document. As previously mentioned, we have set the aim to develop a
living and breathing strategy, not a weighty tome document to sit
on a shelf. Therefore, the document has been prepared with the view
of establishing a strategic intent that is clear and creates the
framework for the plans at Place.
16.
As
mentioned earlier the requirement of the strategy is that it is
developed based on the needs of our population and to do this, we
have taken the approach of ‘if Humber and North Yorkshire was
a community of 1,000 people’ what would it look like in terms
of its demographics, people’s economic, health and wellbeing
circumstances. We have also recognised that our communities
are also as unique as the people that live in them and provide us
with some of our greatest assets whilst acknowledging that they
also have very different experiences in their lives.
17.
The
ambition set out in the strategy builds on the one we have held for
many years as a Partnership which is for everyone in our population to live longer,
healthier lives. However, we have made it more specific with the
addition of by narrowing the gap in healthy life expectancy between
the highest and lowest levels in our communities by 2030
and
increasing healthy life expectancy by five years by
2035.
18.
To
reach this ambition our vision is through a life course approach to
ensure that all our people start well, live well, age well and
die well. And to deliver on both the ambition and vision our
intention is to
·
Create the conditions
for change, making it easier for our people, communities and
organisations to come up with the solutions they think will work
best in improving the lives of our people, their neighbours and
communities
·
Think person
by listening and paying attention to what they tell us matters most
to them which will enable us to remove barriers and give them
greater control over their own lives.
·
Think family
not in the traditional sense but by considering the different way
people consider a family, the people who are closest to them, who
can include relatives, friends or those who provide a temporary but
important relationship or network to support a person. By focusing
on supporting families, we want to create a safe and nurturing
environment that raise aspirations for all but particularly enable
every child to grow, learn and thrive.
·
Think community
by recognising the assets in our communities, harnessing the
strength and uniqueness, we will plan, design and implement health
and care services for people living across Humber and North
Yorkshire. We will focus on all our communities, however we will
place specific emphasis on working with those with the greatest
need, such as our coastal and rural communities
The strategy is for everyone to understand our ambition, vision and
intentions. To enable us to make this meaningful to a key
audience of the strategy our people and communities we have used
‘I’ and ‘we’ statements that will resonate
with them and have come from different engagement across our
system. We will use this as a mechanism for helping to
support the evaluation of the progress we are making.
Appendix A to this paper includes a copy of the final draft of the
strategy content which the ICP Committee considered and approved on
the 14th December 2022.
Alignment to the strategic vision for York Place
19.
The
ICP strategy has been produced with the intention of aligning and
enabling the strategic vision of each place area for the health of
their population and services in their locality. Within York, the
new 10 year Health and Wellbeing Strategy was produced in time to
be taken into account by the ICP, and shows good 'read-across'
between the documents, including the selection of the same overall
population health goal around inequalities in healthy life
expectancy. Many of the issues raised for local need in York,
including the 10 'goals' for population health improvement, find
reference and emphasis in the plans the CP are drawing
up.
20.
In
addition, the York Health and Care Partnership – the local
place board – produced in summer 2022 a 'York Health and Care
Prospectus' which is included as Appendix B to this paper. This
blueprint for a collaborative, high quality and health-generating
healthcare system in York lays the foundation for the ICS's work at
place in our locality, and deliberately reflects many of the themes
of the ICP strategy.
Next
Steps
21.
Whilst the
purpose of this strategy is to set the ambition and vision for our
people and communities with some description of our intentions of
how we will achieve this, it is only the framework from which other
specific strategies and plans will be developed and the allocation
of our collective resources will be informed.
22.
The
most important part of any strategy is turning it into action and
we have identified a number of next steps and these are as
follows:
·
The
final content version of the strategy is shared with each Health
and Wellbeing Board as the statutory committee for Local Government
and the Integrated Care Board for the NHS for approval.
·
The
strategy is used to prioritise our time, energy and resources
through:
o
Place
engaging with their communities, neighbourhoods and partners
building with communities to develop integrated delivery plans
– aligned also with local health and wellbeing
strategies. An initial plan on a page for each of our six
Places is set out in the appendices and these will be developed
further during the early part of 2023.
o
Providing the
guiding framework for the development of other specific strategies
and plans such as the 5-year Joint Forward Plan that the ICB with
Providers is required to produce.
23.
We
also want to understand the difference that is being made and
whether we need to adjust our ambition, vision and intentions by
keeping the strategy as a living and breathing document.
·
A
task and finish group has been established to develop the
population health outcome framework to provide the assurance and
evidence that we are making the difference we intended
·
Continued
engagement particularly with our communities as we develop and
implement the actions to deliver the strategy – Healthwatch
have kindly offered to support this as well as development of
communication messages.
24.
Finally, the
Communications Plan will be finalised and implemented. This
includes for example:
·
the
production of a professionally designed document,
·
the
development of an online space which will create the platform to
ensure we have a living and breathing strategy, will connect with
other strategies, and be a space where we share promising
practice
·
production of
case studies that demonstrate how the ambition, vision and
intentions are being delivered in practice with a focus on outcomes
and sharing learning.
·
A
full launch of the strategy will take place over the spring of
2023.
Recommendation
25.
The
Members of the Health and Wellbeing Board are asked to:
i.
Note
the update in the paper
ii.
Consider and
approve the final draft content of the Humber and North Yorkshire
Integrated Health and Care Strategy (appendix A)
iii.
Note
the next steps.
Reason: To keep
the Board updated on the Humber and North Yorkshire Integrated
Health and Care
Strategy.
Annexes:
Annex A: 202212
HNY Integrated Health and Care Strategy
Annex B:
York Health and Care Prospectus
