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12 July 2024

This week’s leadership message comes from Dr Mark Wright, Chair of the Yorkshire & Humber Kidney Network and a kidney consultant, and Dr Sunil Daga, Consultant Nephrologist and West Yorkshire’s kidney health lead.

We also have a blog from Adam Smith, Project Manager for Health Innovation Yorkshire & Humber, supporting our acute trusts to adopt clinically proven and cost-saving medical technologies under NHS England’s MedTech Funding Mandate.

We’ve been talking about kidney health in these blogs over the last few months. Last week NHS West Yorkshire Integrated Care Board (ICB) hosted a 'Renal Priority Pathway' meeting with the Yorkshire & Humber Kidney Network. It was a great opportunity to bring together commissioners from the ICB and NHSE, people who live with kidney disease and people who provide kidney services in primary and community care and hospitals in our area.

We heard about the national spotlight that is currently shining on kidney services. The NHS has said that a period of transformation will be needed to help them deliver what the population needs now and in the years ahead. It is widely predicted that chronic kidney disease (CKD) will become more common in the future. Currently, about four percent of us have lost enough kidney function for it to have an effect on our bodies. These effects are important because they increase our chances of heart attack, stroke and other disabling problems.

We heard about the work that is going on with some GP teams to help people get the best treatment for their kidney disease. We now have one West Yorkshire Guideline for the Management of CKD to help clinical decision making and support right care, at the right time by the right professional. The 'Minuteful Kidney' project sends home testing kits to eligible people so that they can find out whether they have protein in their urine. If they do, it can be a sign of CKD. The sooner this is picked up and treated, the less trouble it can cause. Around 1000 people have received the kits now. Of those that have completed them, a quarter were abnormal and 4% very abnormal. If one of these kits drops through your letterbox, please follow the instructions and do the test. It could have a huge impact on your health in the future.

We also heard about what happens when people have sudden and unexpected problems with their kidneys. This is known as acute kidney injury (AKI). We heard about the impact this has on our hospitals as well as the people that experience it. There is variation in the way this is handled across West Yorkshire. Preventing AKI and treating it better could help ease the pressure on frontline and critical care services.

We went on to discuss what happens when people lose their kidney function completely. Sometimes people choose to have dialysis or a kidney transplant when this happens. The number of people wanting dialysis has increased rapidly in the last couple of years. The dialysis services have had to adapt at speed. We heard that new dialysis facilities will be needed very soon to cope with the increasing demand. There’s more to do in terms of promoting kidney donation and transplantation as this would reduce the demand for and on dialysis services.

It was great to hear the real-life experiences of people with kidney disease. It very much helped us to understand what it feels like to have kidney failure and the impact it has on quality of life, including the restrictions necessary to stay as healthy as possible. It highlighted for all in attendance, how important it is to keep everyone’s kidneys as healthy as we can.

Read more about Rehana Kosar’s story and how it has empowered her to become a champion in her Muslim faith community to address the myths about kidney transplantation and become an advocate.

It was really good to see so many key people in the room together. The commissioning of dialysis services is likely to change next year. We expect that it will transfer from NHSE to our ICB. This creates a great opportunity to look at the whole kidney pathway in our area and work out how we can transform support for people with kidney disease in West Yorkshire. If you would like to be more involved, please contact: wyicb-wak.ltcpc.wy@nhs.net

Thank you for reading,
Mark and Sunil

The MedTech Funding Mandate (MTFM) is an NHS Long-Term Plan commitment to introduce selected NICE-approved cost-saving devices, diagnostics and digital products to NHS patients quickly and inclusively. The policy supports technologies that are effective, improve patient outcomes, generate cost-savings and are affordable to the NHS. It mandates NHS commissioners and providers to agree local funding arrangements through their existing allocations.

The policy seeks to ensure equity in healthcare provision, reducing the likelihood that where patients live will affect the quality of care they receive. We have an opportunity to encourage ICBs to address health inequalities by improving patient equality of access to proven innovations, regardless of geography, ensuring everyone receives the highest standard of care.

While these technologies bring clinical effectiveness and cost-savings, they also provide opportunities for integrated care systems to address some of the significant pressures faced by the NHS, such as reducing hospital waiting times and minimising patients’ length of stay. Using new and innovative methods can improve healthcare efficiency by reducing the demand for costly theatre time and transitioning some surgical procedures to outpatient clinics, while still enhancing patient care quality.

In my role, I am always looking at ways to facilitate the uptake of innovation, such as helping to explore and overcome funding challenges and conducting detailed modelling of expected benefits and cost savings. However, I wanted to share some insight into what I feel is most important to delivering success: building strong relationships with our partners to position ourselves as trusted partners.

The MTFM guidance helpfully identifies the roles and responsibilities of those needed to support adoption of innovation successfully. These include innovators, NHS supply chain, ICBs, NHS providers, and the health innovation networks; however within these groups there are a myriad of teams and individuals who are crucial in achieving successful innovation uptake and doing this at pace.

I invest a lot of my time trying to influence and engage a wide range of stakeholders, meeting new people to continually grow my stakeholder network to enable change. Understanding what is important to these individuals and groups is vital for generating interest, engagement and enthusiasm to drive service transformation.

Before joining Health Innovation Yorkshire & Humber, I worked as a civil servant for 15 years. I had various roles which were originally operational, then later in learning and development, risk and audit before moving into project management. Reflecting on past experiences in these roles has heightened my awareness of how change is perceived, particularly by those who feel it’s being ‘done to them’. Whether it’s a training delegate unsure why they’ve been told to attend a course they don’t feel they need, or a team that becomes anxious once I’m introduced as an auditor, it’s crucial to ensure there is a clear understanding of the need for the change and the benefits of the intervention.

This is constantly on my mind when engaging our varied, busy stakeholders, especially when generating interest in these technologies. Training requirements are often a top concern for clinical teams, as they need to understand the impact on their time when learning something new. Commissioners and finance managers, understandably, focus on return on investment and ultimately, the bottom-line cost. For patients, I’m always reminded to never assume what might be the best for them without asking them first! I make it a key priority to ensure patients and carers are listened to and consulted with in the development and implementation of any innovation or new activity. Their involvement and experience of what works well and what could be improved, plays an incredibly important role.

My background in a public sector organisation, where we all followed the same set of standards and guidelines, gave me a unique perspective on how the MTFM policy could be delivered. The auditor in me asked questions around standards and compliance with national policy, and who in our trusts may have an interest in this and share related objectives. This led me to collaborations with regional Getting it Right First Time (GIRFT) leads, particularly in urology, who I’ve supported to help develop Urology Area Networks where adoption of MTFM surgical treatment for enlarged prostates can contribute to wider improvements. Creating links with clinical effectiveness teams and, unsurprisingly, internal audit teams has also allowed me access to the National Quality Improvement (inc. Clinical Audit) Network (NQICAN), where I have raised awareness of how to introduce some improvements to the delivery of urology services through innovation, and delivered a series of workshops for their members.

Building relationships takes time and investment; however it’s something that continues to reap rewards, enabling us to implement change swiftly and effectively, address issues and resolve these quickly and discover exciting new opportunities by working together for the benefits of our communities.   

Thank you for reading. You can find out more about my role and how I can support you to implement the MTFM technologies by contacting me at Adam.Smith@yhahsn.com.  You can also read our recently published Health Innovation Yorkshire & Humber’s 2023-24 Impact Report. The report showcases the programmes of work we have been delivering over the last year, including MTFM, with our partners and stakeholders across healthcare, industry and academia to improve the health and prosperity of our region.

Thanks for reading and have a good weekend,
Adam

In a message to the new government, Matthew Taylor, Chief Executive of the NHS Confederation, urges them to address key issues, such as the ongoing pay disputes, GP contract changes, and funding shortfalls, emphasising that there is an opportunity to transform the NHS as we know it, breaking the cycle of short-termism and stabilising the system with long-term improvements.

Photo credit: Andrew Hendry photography

Dr Sara Munro, the Leeds and York Partnership NHS Foundation Trust Chief Executive, has been named 9th top chief executive in the NHS by the Health Service Journal. Sara has led the Leeds and York Partnership NHS Foundation Trust since 2016. She has worked extensively in mental health, with a background as a mental health nurse and clinical work in inpatient mental health settings. Sara is passionate about the needs of service users, carers, local communities, and staff and about ensuring their voices are heard in the decisions made about services. 

Read more on the Leeds and York Partnership NHS Foundation Trust website.

The 2024 spring COVID-19 vaccination campaign ended on 30 June. 161,020 people in West Yorkshire have been vaccinated since the 10 week campaign started which included all older adult residents in care homes. Communications have been wider than in previous spring campaigns and spanned radio, social media, email and translated materials.

The autumn COVID-19 campaign will be delivered alongside a flu campaign and both are expected to start in early October.

Recruitment for the February 2025 cohort of NHS Global Fellowships is now open. Applicants must complete this application form and send a CV to england.global.fellowships@nhs.net. Shortlisted candidates will be invited to a virtual 35-minute interview between Monday 9 September and Friday 13 September.

Please ensure you have read the Frequently Asked Questions before applying. Closing date is 9am, Monday 19 August 2024.

There will be two Fellowship recruitment events, where information on the fellowships will be provided, along with an opportunity to ask questions. If you have any additional questions, please email england.global.fellowships@nhs.net.

Birth trauma awareness week runs from 15 to 21 July.  This is an annual event to raise awareness of birth-related trauma. As West Yorkshire’s new maternal mental health service – Paths –  recently launched, Dr Estelle Verdi, Principal Counselling Psychologist and Service Lead, talks about the launch of the new service in this special blog.

Paths is now open to birth trauma referrals from professionals only.

For more information, please email wycommsand.engagement@nhs.net or visit wypartnership.co.uk.

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