Hounslow HWB Members Supporting Statements for the Hounslow Joint Health and Wellbeing Strategy 2018-2022

Hounslow HWB Members Supporting Statements for the Hounslow Joint Health
and Wellbeing Strategy 2018-2022:

Hounslow Health and Wellbeing Board members were asked to prepare a short
statement on how their organization will support the implementation of the new
Hounslow Joint Health and Wellbeing Strategy 2018-2022. This was an agreed action
from the Health and Wellbeing Board ‘5 Year Review and Look Forward’ completed in
2018. The responses are compiled below:

How Hounslow Clinical Commissioning Group is supporting the new Joint
Health and Wellbeing (HWB) strategy: Our mission as a CCG is informed by our
strategic objectives. These goals are closely linked to the vision of the HWB strategy
and also to the JSNA priority areas that the HWB strategy is built around. We take a
life-course approach to the way that we commission services. This means that our
work aims to deliver improved health and wellbeing from the cradle to the grave,
enabling our community to start life well, live well and age well. Examples include our
work with the council to deliver children’s mental health services; preventative services
like cancer screening; and support services for dementia and long-term conditions.

Our commissioning is always informed by our drive to improve health outcomes and
reducing health inequalities. We work to ensure that the contracts we hold with local
providers deliver the best value for money and are structured to focus on outcomes
rather than processes. We aim to identify the most cost-effective medicines for health
professionals to prescribe, enabling the money released to be re-invested into new
services. We have a strong focus on improving the lives of people with mental health
issues and extending access to psychological therapies for common mental health
problems. We are also committed to expanding our social prescribing and digital
application offer to residents, enabling them to live happier and more connected lives.

Finally, we have a strong track record of patient engagement and we are strengthening
our partnership working with local NHS, council and voluntary sector colleagues. This
is part of an ambition to bring health and care closer together (integrating services) to
enable whole system partnership working that will improve the patient experience.
We also work closely with our partner organisations in the local Sustainability and
Transformation Partnership and as part of various North West London and pan-
London networks and transformation programmes.

LB Hounslow Adult Social Care: Hounslow Adult Social Care is committed to the
Joint Health and Wellbeing strategy. Central to the strategy is developing community
based approaches with our partners and local business helping those that are
vulnerable to access the support they need. Our work and our intentions are to keep
our residents independent, healthy and safe delaying their need for care and support.

We will do this by –
   Promoting engagement and providing easy access to health and wellbeing
      information so that people stay well and healthy for longer
   Reduce social isolation and increase preventative approaches for people with
      dementia to reduce the need on services
   Enable people living with learning disabilities to achieve their agreed outcomes

   Working with health to increase the Social Work support for people receiving
       treatment for mental health issues
      Ensuring safeguarding is central to the assessment and delivery of service
      Enabling residents to age in a place of their choice to minimise the use of
       residential care
      Develop and promote the use of more assistive based approaches such as ‘just
       checking’ telecare to reduce the cost of care packages enabling people to
       remain safe and independent for longer

LB Hounslow Public Health: LBH Public Health will give support to the
implementation of the Hounslow Joint Health and Wellbeing Strategy 2018-2022
through: supporting and making available data analysis to guide work and ensure
understanding of local needs (including through the updating of the JSNA and the
Memorandum of Understanding between LBH and the CCG), through focusing Public
Health services and support to support elements of the identified 12 priority areas,
giving strategic advice and input into cross borough work that may impact on health
and wellbeing and through facilitating one to two Health and Wellbeing Board
workshops each year on the Hounslow Joint Health and Wellbeing Strategy on agreed
topics. Public Health will support the four principles set out in the strategy throughout
the work of the team. Cross cutting work of the team will give support to reducing
health inequalities in the borough. Improving mental wellbeing will be an objective
throughout the various areas of Public Health services.

Hounslow and Richmond Community Healthcare NHS Trust: Hounslow and
Richmond Community Healthcare NHS Trust’s (HRCHs) vision is that people will live
healthier lives through high-quality, effective and coordinated care. This aligns
closely with the Hounslow Joint Health and Wellbeing Strategy and will support
delivery of the strategy and aligns with the four principles. To support the four
principles HRCH will:
     Work in much closer partnership with the whole resource available to us in the
       communities we serve; our staff, patients/clients and their families, other
       providers and commissioners of health and social care, the voluntary sector
       and local businesses; to achieve improved outcomes for our local communities.
       HRCH’s sustainability strategic objective aims to: create clinically
       sustainable/financially affordable systems solutions, use resources effectively
       to make the best use of tax payer's money and standardise and optimise, where
       possible, to reduce unwarranted variation
     Communicate clearly in an open and transparent manner ensuring that we
       clearly state what our service offer is so that patients and clinicians know how
       to access services, targeting services and messages where needed
     Ensure we shape care around the needs of patients, not around the needs of
       the services, providing care that is seamless and easy to navigate. For 2018/19
       we have embedded new way of working across care boundaries and this will
       continue over the following years
     Be a good partner through cooperating with other health and social care
       providers to shape the current and future care provision. We have committed
       to improving health outcomes through partnerships, co-designing services that
       meet the needs of our population in health and illness

Carers (Barbara Benedek): Over the 10 years that I cared for my husband who had
dementia, I have become a patient and carer advocate. I know that I represent the
Carers Partnership Board on the HWB, but I do feel a responsibility to speak on behalf
of patients as well.

I am on quite a number of health and social care committees and groups in Hounslow
and NWL – and that gives me the opportunity to have a reasonably good overview of
what is being done.

My interest is in the Age Well part of the strategy and I try, at every meeting I attend,
to encourage focus on the following 2 principles:

      Ensure clear and consistent communications
      Ensure services are well coordinated within and between partners

My experience is that clinicians and council staff often emphasise what they are
planning to do rather that what is on offer to patients and carers and how we can best
make use of those service.

If there are specific issues that the HWB wants raised at various meetings, I will do
what I can.

HealthWatch (Hounslow): HWH can support the strategy through assessing the
effectiveness and impact of it on the local community. This will fit in well with HWH
assessing the progress and success of HCCG’s integrated care pathway, including
urgent care, health deterioration, home visiting and frequent and complex. We can
support the strategy in measuring 2 of the defining principles – Ensure clear and
consistent communications and Ensure services are well coordinated within
and between partners through our Patient Experience Programme and involving the
public, patients, service users and carers in the development of the delivery plans and
in feeding back about their views and experiences of services. By supporting our HWB
partners through patient/service user/carer/public feedback mechanisms and
engagement we may be able to identify and influence positive and negative outcomes
and the impact on the wider community as well as supporting influence and community
investment.

The provider organisation for HWH (YVHSC) currently delivers the Hounslow Social
Prescribing service which can inform service efficacy, community resilience and report
back on locality specific concerns identifying potential gaps in provision.

WEST LONDON NHS TRUST: This document summarises how West London NHS
Trust’s operational plans and strategy contribute to the delivery of the vision and the
four principles set out in the Hounslow Joint Health and Wellbeing Strategy 2018-22.

As an established provider in Hounslow, West London NHS Trust is strongly placed
to work with Hounslow Borough Council, Hounslow CCG, provider partners and the
third sector to deliver our portfolio of comprehensive mental health services for local
residents, along with the integrated and preventative health and social care services
we provide in other parts of our organisation, in line with the vision and principles set

out in the Hounslow Joint Health and Wellbeing Strategy. The Trust is currently
developing and reviewing its Operating Plans for 19/20 as per the requirements of the
joint NHSE and NHSI planning guidance and the publication of the NHS Long Term
Plan and in doing so is already ensuring that the plans reflect the vision set out the
joint health and wellbeing strategy.

1. Deliver best value and outcomes
West London NHS Trust was inspected by the CQC in 2018 and rated “good” overall
for the services we provide. We have ongoing plans in place to continue to improve
the services we provide to ensure they deliver the best outcomes for local citizens
accessing our services.
Good financial management and strong governance provide the foundation for the
Trust’s delivery of high quality health services. Our ability to deliver value for money
and make efficiency savings over the past few years has enabled us to invest in our
services and has puts us in a strong position to continue improving the care we provide
into the future.
Since 2016/17 the Trust, working with Hounslow CCG, Ealing, and Hammersmith &
Fulham CCG has set up a mental health services transformation programme and team
to drive forward the necessary changes required to deliver value for money through
robust, coordinated, clinically appropriate, sustainable and responsive mental health
services that are as close to patients’ homes as possible. This programme of work
ensures that the Trust is able to share best practice and work together with our key
partners including Hounslow Council and Hounslow CCG to improve local health
services through co-production and engagement with people with lived experience of
mental illness, their loved ones, and wider communities in Hounslow.
We are working on a number of initiatives within our inpatient pathway continuous
improvement programme, focused on creating sufficient bed capacity within the acute
adults inpatient bed bases. This has meant that Hounslow residents have access to
mental health services including inpatient beds where appropriate reducing the need
to send patients to mental health units out of our area away from their communities
and their support network.

The Trust priorities for delivering the Joint Health and Wellbeing Strategy, value and
outcomes for patient and residents of Hounslow for the coming year include:

      Continuation of the work that we have already started in terms of improving our
       inpatient pathways and streamlining adult inpatient services that best meet the
       needs of Hounslow population and enhance patient experience.
      Embedding new standards that have been co-produced with service users,
       carers and staff, enhancing service user outcomes and experiences.
      Significantly improving our length of stay and bed occupancy rates, facilitating
       the management of patients with mental health conditions in the community
       where safe to do so.
      Implementing the recommendations from evaluation of Urgent Care Pathway
       and optimising access to urgent care through single point of access (SPA) and
       providing timely, 24/7 and responsive assessment and care to patients in
       mental health crisis.

   Increasing the number of patients who have timely discharge from acute (in-
       patient) care into community/ primary based care.
      Improving the interface between inpatient teams and Recovery teams -
       mechanisms include 7 Day standards work, interface meetings, DTOC action
       plans.
      Facilitating the transfer of care for patients with stable long term mental health
       needs into primary care when safe and appropriate to do so, in line with the
       locally agreed Shifting Settings of Care action plan.
      Undertake an active role in the redesign of the primary, secondary and social
       care pathways to improve productivity and efficiency
      Develop and embed care pathways in Hounslow; hence optimising recovery
       team caseloads and throughput as well as improving quality/ effectiveness of
       care
      Redesigning rehabilitation services with increasing focus on active
       rehabilitation and services delivered in community settings
      A dedicated children and young people’s transformation programme which will
       work on five priority areas: Improving Waiting times, Improving data quality for
       Community Eating Disorders service, Addressing needs of vulnerable groups,
       Redesigning the system and further improving Crisis Care for CYP.
      Collaboration with local stakeholders in understanding our role in whole system
       pathways and identifying opportunities for improvement for integrated service
       redesign.

The Trust is also in a unique position to work with Hounslow Council and Hounslow
CCG and other provider organisations and the 3rd sector to provide better value
through estates collaboration, taking into account the broad range of existing
healthcare premises, council premises, local schools and community facilities which
will open up further opportunities to improve care through integration and more closely
linked to local communities using a wider range of community assets, with the
potential of releasing financial efficiencies for reinvestment across the sector.

2. Ensure clear and consistent communications
As a trust West London recognises that nearly 50 per cent of residents in Hounslow
come from ethnic minorities, including a significant numbers of refugees and asylum
seekers. We will therefore build on the experience of our teams in communicating and
engaging with and producing information in a range of local languages and various
accessible formats, to communicate with local people including: Polish, Punjabi,
Somali, Arabic, Urdu, Tamil, Persian/Farsi and Gujarati, digital, easy read and braille.

Trust will also aim to deliver a significantly broader and more representative collection
of voices to influence decision-making and service development in Hounslow. To
achieve this we will work with and support our partners and local 3rd sector
organisations to utilise innovative and develop tools to create wider community
dialogue and engagement, using technology and apps to reach the hard to reach and
marginalised groups including people with mental health problems. Additionally, we
use social media and other digital platforms to encourage community networking, in
order to proactively build self-reliant and resilient and engaged communities in
Hounslow.

We will continue to proactively work in partnership with people who use our services,
the voluntary sector, GPs, HBC, partner organisations, our workforce, and HCCG to:

      Facilitate the development of patient support groups and peer networks that are
       self sustaining and utilise them as tools for 2 way communications between the
       trust, service users and residents.
      Build and promote community networks, because building capacity, skills and
       commitment within existing networks and stakeholders is vital for sustainability,
       including proactively recruiting, training and supervising local volunteers to
       work alongside our paid workforce in service delivery.

This will be achieved through:
    Extending membership of our monthly community forum, bringing together
       community and patient representatives with senior clinicians to design, evolve
       and transform our services, to users of the new services;
    Developing an online communications community forum, to reach people who
       do not have time to attend meetings in person, have confidence issues about
       expressing views in public or who are harder to reach;
    Extending links into the Black, Asian, Minority Ethnic and Refugee and
       LGBTQ+ communities.
    Extending our co-production training to staff working on the new services.
    Using tools to recruit local people to work on co-production, including deploying
       advisers speaking Polish, Arabic, Somali and other languages, road shows and
       social media.
    Extending the carers’ champions programme and carers’ awareness training to
       teams working on the new services;
    Ensure each of the new services undertakes self-assessments to verify that the
       voice of the carer is represented within service delivery, identify gaps and
       develop action plans to fill these.

3. Ensure that services are well coordinated within and between partners
We anticipate that by close working with other services in the borough, including the
local authority, primary care and the acute trust (Chelwest) and local community
physical health provider (HRCH) we will be able to support the delivery of the
Hounslow Joint Health and Wellbeing Strategy and ensure services are coordinated
between the partners. The Trust sees opportunities for aligning our services with
Hounslow GP Networks and council localities as a way of improving relationships and
integration with primary care and social care services. Similarly our understanding of
the financial challenges for the local health and social care, allows us to work
collaboratively with our Hounslow Borough council colleagues on shared challenges,
including focusing on prevention and preventative services.
The Trust is already working in a number of formal and informal partnerships to
integrate health services, and will be seeking to progress these in 19/20, working with
provider partners and commissioners (local and national /specialist) in Hounslow to
support delivery of partnership approaches outlined in the NHS Long Term Plan. The
Trust is actively involved in local developments and will be a signatory to the MOU
which is currently going through the governance process for approval before the start
of 19/20. The areas of focus include

Alliance Development
      Define the population and co-produce outcomes in each Priority Area
      Develop a service offer via joint working between commissioners and providers
      Joint development of the Full Business Case

The Trust were also successful in becoming one of the first wave National Trailblazer
sites for the new Mental Health Support Teams in schools, and two teams are now
being developed in Hounslow East and Hounslow West in 19/20.
4. Work in partnership across London
The Trust is committed to working collaboratively with commissioners and other local
providers to continue redesigning services and optimising efficiencies at regional level.
Our Operating Plan is aligned with the NWL Health and Care Partnership. Detailed
plans underpinning regional strategy are still in development and new interconnected
programme areas are being worked through to articulate the specific transformation
projects for the coming year and the Trust is playing a key role in this work. An example
of our key role being that the Trust’s Chief Executive Officer, Carolyn Regan, is the
Senior Responsible owner (SRO) for the NWL Mental Health & Wellbeing Programme.

The Trust, working across the NWL STP footprint, has collaborated to refresh joint
Children and Young People’s Mental Health and Wellbeing Transformation Plan. The
ambition of this plan which is in line with the Joint Hounslow Health and Wellbeing
Strategy is to promote emotional wellbeing and ensure that children, Young people
and their families, who experience mental health issues, have timely access to high
quality interventions and support in the appropriate settings.
The Trust has also actively adopted New Models of Care (NMoC), and currently leads
a consortium managing the CAMHS New Model of Care across North West London.
The CAMHS NMoC project commenced in 2017/18 with the support of NHS England,
and has to date successfully improved the coordination of care for local children and
young people requiring acute mental health admission, providing this care closer to
home, and releasing recurrent savings to facilitate investment into a new children and
young persons’ crisis pathway. This will mean that we can increase the capacity in our
local teams and provide crisis support for young people to prevent admissions and
continue to treat young people closer to home. For 2019/20 this will include (for young
people):

      Additional daytime assessment and support
      New intensive crisis community support capacity
      Step-down support from psychiatric hospital admissions

The Trust has also built a partnership with East London Foundation Trust and Barnet
Enfield & Haringey NHS Trust to form one of the largest New Models of Care with a
focus on reduction of out of area placements of North London patients.

West London NHS Trust’s corporate strategy explicitly references our organisational
ambitions to improve the quality of our existing services, and invest in estates and
workforce and deliver our transformation plans. We have committed to working with
stakeholders to coproduce care and to embed an ethos of continuous quality
improvement, education and research across our services. We have recently

refreshed our organisational identity to support recognition of the trust as a provider of
integrated physical and mental healthcare. Where appropriate we have taken a role
as lead provider, whilst in other areas nurturing partnerships with other providers and
commissioners to improve care. We have also stated publically our commitment to our
existing geographical focus on our work in North West London and Berkshire. Through
these commitments we believe we have a strong contribution to make to the delivery
of Hounslow’s vision: Our communities are healthy, happy, connected and enabled to
realise their full potential.

Department for Work and Pensions, Hounslow Jobcentre Plus: The Department
for Work & Pensions (DWP) will support the Hounslow Health & Wellbeing Strategy
2018-2022 by working with partners to deliver positive outcomes for our communities
by contributing to their health and wellbeing. DWP will support residents through
Universal Credit ensuring they are able to access training and employment
opportunities. We will engage with employers to offer Work Experience, Work Trials
and Work Placements to build peoples’ confidence and motivation. Further support
will be provided to improve mental health through the Work and Health programme
and we will continue to commission programmes which support health and wellbeing
e.g. the West London Alliance Mental Health Trailblazer delivered by Twinings. DWP
Disability Employment Advisers have already started to provide support to General
Practioners with FIT Notes and how we can support people with health problems to
look at employment options thorough training and up-skilling them with the work they
can do and enable them to realise their full potential. We will provide support through
volunteering opportunities and outdoor activities to promote better health. We will
continue to work with partners to support the Health & Wellbeing Strategy which will
result in healthier and happier lives and help to eradicate poverty.