Reflections on 2016/17 from an Acute Care Collaboration Vanguard

With the two-year anniversary of the vanguard programme celebrated this week, we decided to take a look back over the past year of the Working Together Partnership Vanguard,  what we’ve achieved, what we’ve learnt and what comes next.

Acute Care Collaboration (ACC) vanguards were one of the later waves of vanguards and therefore haven’t all been on the scene for two years, however we were already operating as a partnership prior to becoming a vanguard so have a longer history than most of our ACC colleagues. What’s beneficial for us about our history, is that we have made it through that proportion of our earlier period which was spent constructing the building blocks for the partnership. It now feels like over the past year we’ve seen some real tangible examples of successful partnership initiatives taking shape, and we can feel confident in our projects, thanks to having taken the time to build strong foundations.

One of the corner-stones of the Working Together Partnership approach is using Managed Clinical Networks to engage staff and ensure partnership working is embedded in the Trusts. For each project we undertake we establish a Managed Clinical Network, supported by the Programme Management Office, but led and staffed by the Trusts themselves. Over the past year these networks have grown stronger, and have put forward their own real solutions to some of the resilience and sustainability issues that the Trusts in our patch face.

One example this year has included the Managed Clinical Network for Ear, Nose and Throat (ENT) services having established and implemented a shared out-of-hours ENT rota for the region and shared policies and protocols.

Another exciting example of work coming to fruition this year is the establishment of the Radiology Academy by the Radiology Managed Clinical Network. The Working Together developed and funded Academy is set to open its doors in September. The Academy will train radiographers to report as well as capture film, helping provide a sustainable workforce for the region.

We have seen more procurement developments this year building on previous early successes. This year we have taken on procurements for goods that are more complex than our earlier joint-procurements, for example we have procured surgical gloves; we have moved to a shared e-tendering platform and a shared workplan across the partner Trusts; we have also joined with other partners as and when it will benefit a procurement, with successful partnerships with the Shelford Group and Hull and East Yorkshire Hospital Trust.

Pushing the boundary with procurement has seen us awarded highly commended in the Yorkshire and Humber Academic Health Science Network Innovation, Improvement Impact Awards. It has also seen us recently shortlisted for the HSJ Value in Healthcare Improving Value through Innovative Financial Management and Procurement.

We have seen more informatics successes over the past year, including the successful pilot for an Inter-Trust Cancer Messaging system, which is designed to significantly speed up cancer referrals. The pilot is set to be rolled out across all the Trusts, and 19 tumour sites from April.

Working with the Commissioners Working Together team we have been involved in developing a case for change and business case for changing Children’s Surgery and Anaesthesia services across South Yorkshire and Bassetlaw, with the aim of creating a safer, stronger, and more equitable service. The Commissioners have led a 6 month public consultation on our proposals, and work to support our Trusts to deliver on a potentially changed service starts now, as the decision is set to be made at the end of June.

The past year has seen a significant focus on the roll we play around corporate services, following national announcements about exploring opportunities for shared services. Maintaining our strong engagement approach we have explored standardisation and streamlining approaches to various corporate services, with much work still progressing on this agenda. In the meantime savings we helped Trusts to secure by implementing best practice recommendations and systems for e-rostering and legal services won us our second HSJ Value in Healthcare Award shortlisting.

Another by no means small achievement this year has been winning over hearts and minds, which will very shortly allow us to progress to the next stage in our governance evolution. Our Trusts are in the final stages of agreeing a Committees in Common structure, which will allow Trust Chairs and Chief Executives to make shared decisions on matters that have been delegated to them by their Trust Boards. We are really pleased to be moving to this structure, and feel it is a clear demonstration by our partners of the value they see in working together.

The final reflection on 2016/17 is that it’s been an interesting year for us as the Sustainability and Transformation Plans (STPs) came into being. Because we are an ACC vanguard which works across a geographical footprint rather than a specialism, and our partnership encompasses all of the major acute trusts in the STP region, in some senses we are now emerging as a large cog in the STP engine room.

Whilst our existence has worked well for the STP because it’s meant that there are existing networks and structures that can be built upon, for the Working Together Vanguard it has led to some changes in our geography and the robustness of our partnership, with our partners in Mid Yorks and Chesterfield having to negotiate how they continue as our partners but also as members of a different STP footprint. It seems fitting that it’s on this note that we conclude our reflections, with much of the STP future still unknown.

In the meantime we continue to work hard to drive forward more successful collaborations in our region, and to show our colleagues across the country that in a period of necessary transformation and change we shouldn’t be overlooked – the Acute Care Collaborations have much learning to bring to the table. Perhaps it will be the very foundations and building blocks that the Working Together Partnership laid that will allow a strong, effective, high quality and sustainable health and care organisation for the future to rise to the challenge that we face?

Dr Des Breen, Medical Director and Janette Watkins, Programme Director for the Working Together Partnership Vanguard