Staff Roadshow Join our Journey Welcome Welcome to

Staff Roadshow: Join our Journey

Welcome • Welcome to the first of the Walsall Together roadshows • The aim of the roadshows is to: • • give an overview of Walsall Together highlight some of the integration work that has been done share our plans for the future and what this might mean for you opportunity to ask questions • Roadshow etiquette • Introductions Walsall Together | Collaborating for happier communities 2

Walsall Together - Collaborating for happier communities • Established in 2019 • Partnership of health, social, housing, voluntary and community sector organisations • Working together to: • Promote equality and reduce inequalities by focusing on the wider determinants health • Provide high quality and accessible care for all who need it • Improve the health and wellbeing outcomes for the population of Walsall • Develop a skilled, motivated, and happy workforce • Make the best use of partnership resources Walsall Together | Collaborating for happier communities • Housing (whg) • Voluntary, community and social enterprises (including One Walsall) • Healthwatch Walsall • Primary Care Networks (General Practice) • Walsall Healthcare NHS Trust • Walsall Council (Public Health, Adult Social Care and Children’s Services) • Black Country Healthcare NHS Foundation Trust (Dudley and Walsall Mental Health Partnership NHS Trust) • Walsall Clinical Commissioning Group 3

A population health approach An approach aimed at improving the health of an entire population. It is about improving the physical and mental health outcomes and wellbeing of people within and across a defined local, regional or national population, while reducing health inequalities. It includes action to reduce the occurrence of ill health, action to deliver appropriate health and care services and action on the wider determinants of health. It requires working with communities and partner agencies. (The King's Fund, 2018) Walsall Together | Collaborating for happier communities 4

Sam Story • Play Sam’s Story • https: //youtu. be/3 Fd-S 66 Nqio Walsall Together | Collaborating for happier communities 5

Why we work together • Partnership working is something we have been doing for many years across Walsall • All working towards same the outcomes – better health and well-being for the people of Walsall • All face the same challenges as populations and demand on services grow and resources are limited • Joining up and integrating care and support allows us to share knowledge, skills and resources • Enables us to deliver the care and support that matters most to the individual • Wider action on prevention will help people stay healthy and reduce the demand on the health and care services Walsall Together | Collaborating for happier communities 6

Integrating care to reduce health inequalities • NHS founded to provide access to healthcare but healthcare is not the only thing that affects a persons health • The wider determinants of heath such as where we are born, grow up, live, work and age, as well as the decisions we make for ourselves and our families, collectively have a bigger impact on our health than healthcare alone • Lower life expectancy is caused by risks outside of an individuals control including: poverty, low educational attainment, unemployment, poor housing, discrimination, low social status, living in a high crime neighbourhood, poor access to services Dahlgren and Whitehead model of the main determinants of health Walsall Together | Collaborating for happier communities 7

Integrating care to reduce health inequalities • Reducing health inequalities means giving everyone the same opportunities to lead a healthy life, no matter where they live or who they are Walsall is one of the 20% most deprived districts in England In Walsall men die on average 10. 4 years earlier and women 8. 8 years earlier than the national average Walsall Together | Collaborating for happier communities Males living in Blakenall will die on average aged 74. 5 years compared to males in Streetly who will die on average aged 82. 9 years 34% of people living in disadvantaged communities are managing a long term illness or disability 8

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What this means for the people of Walsall • Local people, patients and communities at the centre of service planning and decision making • Better access to advice, education and support to help people manage their own health and well-being needs and prevent ill health • More joined up care and support for physical, mental and social care needs with health and social care, housing, voluntary and community sectors working closely together • More specialist community services providing care and support at home or as close to home as possible that is usually provided in hospital • All health and well-being care and support services accessible through care navigation, via phone, online, app or face to face • People will have more choice and control over the way their care is planned and delivered based on what matters most to them Walsall Together | Collaborating for happier communities 10

Integration in action Multi-Disciplinary working which allows expertise and skills of different professionals to assess, plan and manage care jointly Weekly MDT meetings to support people with one or more health or social care needs Shared Care Records Implemented Bedside Mobility Assessment Tool (BMAT) within the hospital Integration and colocation of teams in including adult community nursing, adult social care, mental health, social prescribing and specialist nursing Recruitment of social link workers within Primary Care and Locality Teams and whg Extended mental health support services via phone and online session for those struggling with lockdown Walsall Together | Collaborating for happier communities Family Safeguarding Model across Walsall – a whole family approach which makes it easy for parents and children to access all the support they need from within one MDT team, to help them deal with the complex issues of domestic abuse, mental health and drug/alcohol abuse that harm their lives and those Saddlers Vaccination of Centre their children 11

Integration in action Care Navigation Centre takes direct referrals from GPs and West Midlands Ambulance Service who have identified someone who is well enough to remain at home, but requires some additional support Integrated Assessment Hub - staffed by MDT’s providing an alternative to A&E for patients who arrive but can be cared for within the community. The inclusion of social care makes it one of the first fully integrated assessment hubs in the country Rapid Response Team set up to respond within 2 hours to urgent care needs within the community – reducing hospital admissions Saddlers Vaccination Centre – capacity to vaccination 5, 000 a day if required Recruitment of multiple key worker job opportunities available in the Housekeeping Department at the Manor Hospital. Empowers residents with low aspirations to develop their confidence, skills and maximise their chances of success when applying for jobs. Volunteer recruitment to support isolated or shielded with shopping and medication delivery, to those helping local families; supporting many local groups and charities, such as food banks and over the phone befriending services as well as on vaccination sites Walsall Together | Collaborating for happier communities 12

Continuing our journey • Huge amount of hard work has already been done building relationships, trust and confidence across the partnership • Next step to enable us to deliver fully integrated services that meet the needs of our entire population • Move to a whole population budget approach with one host provider (Walsall Healthcare NHS Trust) receiving an annual budget based on population size from Walsall Clinical Commissioning group • Based on outcomes rather than activity as it is now which will mean more of a focus on prevention rather that treatment Instead of measuring how many hip replacements we do we look at the hip health of the population and how we can improve that Walsall Together | Collaborating for happier communities Instead of looking at how many people we can put on a acute respiratory pathway we look at how we put interventional respiratory care in so we reduce the prescribed medication for respiratory conditions Instead of looking at ‘frequent flyers’ to GPs we look at how we can refer people into support from local charities and community groups that can better meet their need through for example social prescribing 13

Continuing our journey • WHT overall responsibility for integrating and co-ordinating care and support and improving population outcomes • Sub-contract local providers where appropriate to deliver integrated services • NHS partners and the Local Authority relationship is managed through a Section 75 Agreement – this allows us to legally pool budgets and resources and use them more effectively where they are most needed to meet the needs of our population • GPs will continue to deliver primary medical services under existing contracts (GMS / PMS / APMS) but will sign up to a GP Integration Agreement which sets out how GP practices and the partnership will work more closely together with the necessary commitment for the integrated care model to succeed Walsall Together | Collaborating for happier communities 14

We’ve already integrated… • Community Nursing 400 Nurses • Intermediate Care • Therapies • Adult Social Care 350 adults social workers 200 Therapists • Health Visiting • School Nurses • Maternity 100 additional roles Walsall Together | Collaborating for happier communities 200 School Nursing and Health Visiting 15

Soon we will be integrating… • Walsall Healthcare Trust’s Older peoples mental health (not Black Country Healthcare OPMH) • Primary Mental Health • Improving Access to Psychological Therapies (IAPT) • Frail Elderly Service • Outpatients/Diagnostics • Urgent Treatment Centre As we develop we will continue to identify other services for integration Walsall Together | Collaborating for happier communities 16

What does integration mean for me? • Contractually staff will see no change as a result of the partnership being formalised • You will still be employed by the organisation you work and your terms and conditions will not change • We will simply be looking at ways we can work more effectively and efficiently together to deliver more joined up services, improve quality and use resources in the best possible way • These are some examples of the ways that teams might see changes to the way they work: • The bringing together of health and social care teams • Joining up management structures • Sharing building space • Identifying where we can streamline pathways making them more beneficial to both staff and patients Walsall Together | Collaborating for happier communities 17

Looking ahead • Development and implementation of a People Strategy for Walsall that covers workforce challenges, health inequalities and integration across the partnership • Integration with Primary Care Networks (PCNs) including expansion of First Contact Practitioners and agreement on the approach to recruitment of the additional roles outlined in the PCN contract • Delivery of digital programmes including the Integrated Shared Care Record and Electronic Palliative Care Coordination System (EPa. CCS) and deployment of the Population Health module • Implementation of a partnership approach to population health management and reducing health inequalities • Integration of children’s including but not limited to Family Safeguarding and Maternity • Integration of Primary Mental Health and services Improving Access to Psychological Therapies (IAPT) Walsall Together | Collaborating for happier communities 18

Looking ahead • Investment from Walsall Healthcare earlier this year will enable the development of specialist Multi Disciplinary Teams to further support Locality Teams and long-term condition management in areas such as respiratory and cardiology • Further developments of integrated admissions avoidance services including Intermediate Care Service, Integrated Assessment Hub and Rapid Response • Further integration of Housing across the programme to address the wider determinants of health within Resilient Communities, integrated social prescribing model and integrated response to homelessness • Outpatients – a full, clinically-led programme of redesign will look at achieving an ideal balance between virtual and face to face contacts as we move into COVID recovery, and then shift to defining a future model of provision with a focus on improving population outcomes and reducing health inequalities • Continued implementation of the End of Life strategy Walsall Together | Collaborating for happier communities 19

Questions Walsall Together | Collaborating for happier communities 20