Our Healthier South East London Partnership Update - March 2020

Our updates provide an overview of the work of Our Healthier South East London (OHSEL), the integrated care system for south east London, over the last couple of months. They are designed for sharing with boards, governing bodies and other key partners and stakeholders.

Our response to NHS Long Term Plan
In January 2020, the OHSEL board meeting in public endorsed the integrated care system’s response to the NHS Long Term Plan. It was developed with input from all partners within the south east London system, including our workforce, patients and the public. The response sets out how we will deliver national and local priorities, in ways that complement the delivery of other operational and strategic plans that we have across and within south east London.

Work has already started on most of the priority areas and, we will continue to engage with our stakeholders as our plans develop. We will also evaluate and monitor the potential impacts of our plans, building on the draft equality impact assessment that we have undertaken on the overarching response.

The full response (including equality impact assessment) is available to read here.
ICS non-executive chair appointed
Richard Douglas CB has been appointed non-executive chair of the South East London Integrated Care System. This was part of a London-wide announcement of non-executive chairs for each of the capital’s five ICS/STPs.

During his working life, Richard held senior roles worked across both the Department of Health and NHS. Since his retirement he has been a non-executive director at NHS England/Improvement, he has worked in a number of senior executive roles and, in both phases of his career, he chaired executive committees and board committees to facilitate system coordination at a national level.

In his new role, Richard will oversee and ensure we enhance our partnerships, leading the way to better health, care and wellbeing for the people of south east London.

South East London CCG executive appointments
We will be moving to a single South East London CCG going live on 1 April 2020 (bringing together the 6 CCGs covering Bexley, Bromley, Greenwich, Lambeth, Southwark and Lewisham). As we reported in our last update Andrew Bland will be the Accountable Officer for the new CCG and Dr Jonty Heaversedge will be its chair. Several further appointments to the new executive team have now been confirmed:
• Bromley’s place-based director – Angela Bhan
• Greenwich’s place-based director – Neil Kennett-Brown
• Lambeth’s place-based director – Andrew Eyres (also Lambeth’s strategic director integrated health and care)
• Lewisham’s place-based director – Martin Wilkinson
• Chief Operating Officer – Christina Windle.
The recruitment process for place-based directors for Bexley and Southwark is still under way and further information will be shared as soon as it becomes available.

Update from programme groups
OHSEL supports south east London’s apprentices
Apprenticeships, open to anyone aged from 16 to 65, help train the NHS workforce to deliver better care and services for the benefit of patients. With more than 150 different apprenticeships in health and social care alone, ranging from GCSE-equivalent up to degree and masters’ levels, they are a great opportunity for existing staff, as well as attracting new talent from our local communities. Ultimately apprenticeships support workforce retention, as well as promoting diversity and inclusion.

Our Healthier South East London and the South West London Health and Care Partnership, with support from Health Education England, have been working together to promote and maximise the benefits of apprenticeships.

The aim is to help our key provider partners to meet the Government’s apprenticeship targets and use apprenticeship levy funds effectively, for the benefit of the current and future workforce. For example, the gifting or transfer option allows providers to transfer up to 25% of their levy fund to smaller, health and social care organisations – such as GP practices, local charities and other organisations in the local community.

In Bexley, for example, the Training Hub is leading the way on implementing apprenticeship training in local GP Practices and are set to have up to 40 apprentices in place during 2020, including new digital apprentices.

Evolve Education, a not-for-profit charitable organisation committed to enabling children in the local community to reach their full potential, has benefited from a levy transfer from Guy’s and St. Thomas’ NHS Foundation Trust to fund apprenticeship training for six new health mentors in Southwark schools.
Public Consultation on future apprenticeships funding bands
The Institute for Apprenticeships and Technical Education has just launched a consultation on its proposals to reform how apprenticeship funding levels are set.

They want feedback from everyone involved with apprenticeships. The consultation closes on Monday 6 April 2020 at midday. Full details can be found here.
National Apprenticeship Week February 2020
Many of our south east London providers took part in activities to promote apprenticeships. Guy’s and St Thomas’ and South London and Maudsley NHS foundation trusts ran many exciting events and competitions based on this year’s Look Beyond theme aiming to tackle outdated stereotypes around apprenticeships.

Sharon Kelly, Workforce Project Manager at Our Healthier South East London, says:

“Apprenticeships are an invaluable way to train the NHS workforce to deliver better care and services for the benefit of patients and are available to those from between 16 to 65 years old.
“There are over 150 different apprenticeships in health and social care alone, ranging from GCSE equivalent up to Degree and Masters’ levels. With over 20,000 apprentices in roles across the NHS, apprenticeships offer the opportunity to invest in and upskill our existing staff, as well as attracting new talent from our local communities; supporting retention and promoting diversity and inclusion.”
Community-based care
Urgent community response teams being rolled out-out by across south east London
From April 2020, expert urgent community response teams will begin to be rolled-out by the NHS in south east London to help support older people to stay in their own homes and avoid hospital admissions.

As part of a £14 million national NHS programme, south east London has been selected as one of seven areas – and the first in London – to deliver this new standard of care for elderly people across all six boroughs (Bexley, Bromley, Greenwich, Lambeth, Lewisham, Southwark).

The teams will give those who need it fast access to a range of qualified professionals who can address both their health and social care needs, including physiotherapy and occupational therapy, medication prescribing and reviews as well as help with staying well-fed and hydrated.

Expert teams will be on hand within two hours to help support older people to remain well at home and avoid hospital admissions.
Continuous improvement event for primary and community
The Health Innovation Network, Kings Health Partners and Our Healthier South East London came together in February to host an improvement event for primary and community care leaders across south east London. 
The event, aimed to build a growing awareness of the need to improve quality across health and care services, and brought primary care and community leaders together with national and regional improvement experts, to share learning. There were some inspiring presentations from local improvement projects in all six boroughs - including a nurse supporting frequent attenders in Emergency Departments in Bromley and the introduction of a team in Southwark and Lambeth for the early diagnosis of heart failure.

Roll-out of Health and Social Care Network on track
The Health and Social Care Network (HSCN), a national programme to help provider and primary care organisations get faster access and more robust service to the internet and clinical systems (via a cloud), has been progressing well in south east London. So far, 197 out of 273 GP practice (including branches) have transferred successfully and the majority are expected to do so by the end of April 2020.
Scanning medical records
This year, we successfully scanned around 250,000 paper patient records in 37 GP practices across the six south east London boroughs. The process takes old paper records and moves them online, so they are attached electronically to each person's care record; helping to complete patient information and freeing up space in GP practices for clinical use.
Having received some further funding for 2020/21, the service will be rolled-out to additional practices in south east London.

Digital First
Having just completed the first year of a five-year Digital First programme of work across primary care, which saw Lambeth CCG appointed as the Digital Accelerator Centre for south east London, Lambeth has now been tasked to look at new ideas and projects that will bring other GP practices in south east London in line with their standards.

This includes improvements to their telephone systems and the set-up of an e-hub pilot in one of their primary care networks (PCNs). The aim is to look at new ways of working that will reduce pressure on GPs through the effective use of technology, including remote consultations (that need to be in place by end of March 2020) and the NHS App.
Sharing care records and partnership working

Over the last 12 to 18 months, we have been working to improve the sharing of care records across GP practices, hospitals, mental health and community and social care services in London.
By working more closely together, we have been able to improve decision-making and quality of care. At the same time, this work has led to a reduction in duplication and professionals being able to plan services and care more proactively and effectively.
In addition, we have also started to work in partnership with wider health and care partners, hospitals, community teams and urgent care providers across London to make sure that patients get the best possible care and support, no matter where they go. For example, by understanding how health and data can be used to support positive changes.
For more information, visit the One London website. 

Better Births improve lives
The Continuity of Care Ambition is a national initiative that came out of the Better Births (2016) report. The aim is to make sure that every pregnant woman:
• is cared for by a small team of midwives (of no more than eight), with most care being provided by one or two midwives, and
• has met and been seen by the midwife that will look after them during her birth.
Research shows how with this kind of care, women are 19% less likely to lose their baby before 24 weeks, 15% less likely to have epidurals instead (to block pain) and 24% less likely to experience a premature birth.
All hospitals in south east London are working to increase the teams of midwives who care for women at all stages throughout their pregnancy, birth and postnatal period.
One patient’s story, in her own words, can be found below:
‘I am keen to share my experience as it has, quite honestly, been life-changing…
“...the most crucial aspect of this all has been the Clover Team and knowing that someone on the team would be there on the day. My community midwife had referred me for counselling for my first birth, and the therapy had been helping a lot, but I was still struggling. 
“As soon as I met my Clover Team midwife, I felt at ease and she has been a fantastic support throughout the whole experience. I also met the entire team at an event at the hospital, which helped me feel confident that someone would be aware of my circumstances if she wasn't available. This confidence really helped me feel that this time the process was proactive rather than reactive.
“When I had to go to the hospital at 36 weeks, as I thought labour was starting, my midwife came to my house and took me with her. I had to stay in that weekend, and the labour ward was packed, so it was a pretty stressful time, but everything else that had gone on up until that point, and the support from [clover team midwife], helped me to stay as calm as I could be.
“When I was back in hospital at 37 weeks to give birth [my midwife] was away, so I had another two midwives. They were both incredible, and their kindness, and professionalism during and after the labour helped me feel at ease. I had an extremely positive birth experience which I never thought would be possible. Since then, I have continued to receive support from the team, including checks [by midwives] who have made me feel confident and that my choices are important. I feel so lucky to have had such a fantastic start to life with two children!"
Rebecca, patient, Lewisham and Greenwich Hospital
Children and young people
Mental health in school trailblazers
Children and young people’s mental health and psychological wellbeing is one of the most challenging issues facing families, schools and wider society. In December 2017, the government introduced a new policy to create mental health support teams (MHSTs) to work with children and staff in education settings. The aim of these teams is to provide extra capacity to deliver evidence-based psychological interventions in schools and create better links with wider services.
In December 2018, Bromley was chosen successfully to be a trailblazer area and has now set up two wellbeing in schools teams covering primary and secondary schools. It is also trialing a four-week waiting time for access to specialist NHS children and young people’s mental health services.
Lewisham and Greenwich became trailblazer areas in December 2019 and are in the process of meeting with pilot schools to develop their service offer together.  Co-production with young people and partners has been key.
MHSTs are intended to provide early intervention on some mental health and emotional wellbeing issues, such as mild to moderate anxiety, as well as helping
staff within a school or college setting to provide a ‘whole school approach’ to mental health and wellbeing. 
Southwark, Lambeth and Bexley are planning for the development of MHSTs in their boroughs.
Urgent and emergency care
The ICS’ urgent and emergency care programme has just received funding (February 2020) from Health Education England to deliver a workforce development programme aimed at improving staff wellbeing, engagement and satisfaction.

This work builds upon a previous urgent and emergency care workforce project in which 14 members of nursing staff – ranging from heads of nursing to junior sisters – from across all five emergency departments took part in a programme to:

• build their own resilience
• be aware of their own personal impact
• support team-based working; and
• act as wellbeing champions within their organisations, starting a network of urgent and emergency care wellbeing champions across south east London.
The key findings from the first project showed that participants’ resilience and confidence in managing their own and others’ health and wellbeing had increased. Participants also reported changes to their practice following the programme, including practical changes such as running group sessions, skills development, and running team meetings or individual support sessions.

The new funding will be used to run a similar programme for a wider multidisciplinary cohort of staff that will include the training and support for a further 100 urgent and emergency care staff. This new programme of work, due to start this month (March 2020) will extend beyond emergency department settings to include, for example, urgent treatment centres and ambulances and will include other professionals such as doctors and therapists.