Ha Happy ppy He Healthy althy at at Ho Home me Skills for Care Integration Event 23 rd May 2019 James Drury v1 1
Hello James.drury2@bradford.gov.uk 07970 479491 @jddrury Happy py Healthy althy & a & at Home ome 2
A sense of place Happy py Healthy althy & a & at Home ome 3
A proud history Happy py Healthy althy at Home ome 4
Looking to the future Modern, connected and outward facing with a proud history and heritage – significant untapped potential • Entrepreneurial culture : Young, creative clusters • Advanced manufacturing and Digital innovation : 25,000 manufacturing jobs; 4,000 digital. • Pioneering traditions in industry and science, politics and social reform. Leading edge technology University; Born in Bradford – delivering global benefits; DHEZ • World famous literary, arts and cultural offer: Memorable landscapes, countryside and heritage buildings; Curry Capital; first UNESCO City of Film • 1,500 community groups; 100,000 active citizens- ordinary people doing extraordinary things Happy py Healthy althy at Home ome 5
Our Economy • A £10bn economy : Ninth largest in Britain with circa18,000 businesses • Productive : Bradford’s productivity per worker is the highest in the Northern Powerhouse at £49,900, but average wages are low; £476 compared to £550 • Challenged by skill base : 14% working age residents have no qualifications compared to 8.3% across England. 42% working age people qualified to level 3 compared to 57% nationally • Employment rate : 67% compared to 74% nationally. We are working to get 20,000 more people into work to reach the national average. BME women make up 75% of our employment gap. • Job density is low : 690 jobs per 1,000 working age people, compared to 840 nationally • Economic Strategy : raise GVA by 4bn, get 20,000 more people into work, and get 48,000 more people with NVQ level 3 skills (to match UK average against all measures) Happy py Healthy althy at Home ome 6
Economic impact of Health and Care • 60,000 informal carers: saves state expenditure but also limits output of carers and impacts on their wellbeing • Significant economic contribution : Social care sector contributed £390m to the £10bn Bradford economy in 2016/17. This represents growth of 13% since 2011. Health and Care combined = £1bn GVA p.a. • Provides work for many : 13,600 jobs in social care sector. Health and Care combined = over 27,000 jobs, and growing. • Low Pay : Care workers paid at / close to minimum wage – contributing to high turnover (30%), and high vacancy rates (9%). • Recruitment and retention : local NHS trusts turnover rates between 13.5% and 15.5%. In social care turnover rates between 21% and 30% • https://www.skillsforcare.org.uk/NMDS-SC-intelligence/Workforce- intelligence/publications/Local-authority-area-summary-reports.aspx Happy py Healthy althy at Home ome 7
Our People • Young : 29% population aged 19 or younger (21.6% in Craven) www.bbc.co.uk/wearebradford • Diverse : Ethnic minorities make up 36% of the population in Bradford. In Craven 27% aged 65+ compared to 14.6% in Bradford • Entrepreneurial : 32,500 people self employed, and the number of businesses has increased by 20% over the last three years – faster rate of growth than the UK. Named by Barclays as best place for business start ups • Challenging future demography : By 2030 33% growth in over 65s but 3.4% growth in the working age population. • Health inequalities : 45% of people in Bradford live in areas of high deprivation Happy py Healthy althy at Home ome 8 (England average 20%).
Our Health • Child health: In Year 6, 38.6% children are overweight, but this ranges from 17.3% to 43%. • Adult health: Smoking prevalence has improved - now 18.9%, but England average is 14.9%. Physical activity rates are also improving. • Health inequalities: Life expectancy is improving – but there is a gap between the best and worst off - 7.4 years for men and 6.8 years for women. • Healthy life expectancy : people are spending more years living with poor health – 22.6 years for women, and 17.3 years for men Happy py Healthy althy at Home ome 9
Vision Our Vision People will be happier, healthier and have access to high quality care that is clinically, operationally and financially stable. People will take action, and be supported to stay healthy, well and independent through their whole life and will be supported by their families and communities through prevention and early intervention with a greater focus on healthy lifestyle choices and self-care. When people need access to care and support it will be available to them through a proactive and joined up health, social care and wellbeing service designed around their needs and as close to where they live as possible. Happ ppy Healthy althy at at Home
Focus on the wider determinants • Most of what helps us to have good health and wellbeing lies outside the healthcare system • Healthcare = 15% • Health behaviour patterns 40% • Social circumstances and environmental exposure 45% • Mc Ginnis et al the case for more active policy attention to health promotion Happy py Healthy althy at Home ome 11
Machine or Ecosystem
Heroic Leadership versus…. the Wicked Problem
Systems Leadership requires Listening • Questioning • Perspectives • Openness • Improvement orientation •
Our approach to partnership • Organic approach - relationships before structures • Strong history of commitment to working for the place and the people who live here • A broad and holistic view – aim for our partnerships to include a wide range of voices • 13 community partnerships – people & workers together – integration and collaboration in action – teams know each other and work with people as partners • Supported by health and care partnerships – senior leaders of local organisations sharing responsibility for delivery. • Underpinned by Strategic Partnering Agreement – collective decision making. Happy py Healthy althy at Home ome 15
Values and Behaviours Happy py Healthy althy at Home ome 16
Our Health and Care Plan • Happy Healthy at Home : Our mission ‘lived’ by the whole system – Based on achievement of the Triple Aim • Community Partnerships : Integrated workforce. Joined up community and clinical leadership. ‘enabling’ not ‘doing to’. Strengths based • Collaborative decision making : Through two Health and Care Partnership Boards, and ICB where we need one ‘whole system’ view. • Enabling networks : collective change supported by enabling networks combining all relevant resources across organisational boundaries. Airedale, Wharfedale & Bradford Health and Care Partnership Craven Health and Care Partnership North Locality Central Locality South Locality AWC Locality Wharfeda Airedale Craven CP S10 CP S7 CP N1 CP C4 CP C5 CP C6 CP S8 CP N2 CP N3 CP S9 le 17
Our Health and Care Workforce • 100,000 citizens active in community organisations • 592,000 Population • Care workers = over 1/3 of total workforce Informal • 60,000 carers • Nursing, midwifery and health visiting = next biggest Health and • 27,000 group 16% care workers • 68% community roles. 32% work in acute care. • Workforce demographics – significant proportion over 55 in both health and care sectors – knowledge and experience is critical • The needs of informal carers are critical – The Work Foundation report ‘Who Cares? 2018’ Happy py Healthy althy at Home ome 18
Workforce strategy - local Happy py Healthy althy at Home ome 19
Growing our Own Now and next Achievements to date • Health & Care Industrial Centre of • Health & Care ICE: Grow from 8 to 13 schools – doubling no. participants Excellence: work with 11-18 year olds to build understanding of health • Summer School: University hosted and care careers, work experience/ partnership with ICE 50 young people shadowing, inspirational speakers, two week immersive experience. First pathways one Summer 2019 • Skills House : bespoke job • Skills House : Community Engagement readiness support for job seekers Workers to develop relationships and liaison with care homes between target communities and the • Ambassadors : recruited 71 sector volunteers from health and care • Ambassadors : Grow to 80 sector – visit schools, engage ambassadors covering 75% schools young people. Share their stories. • Apprenticeship enrichment • Home Care : contracted on locality programme: integrated system focus basis to link staff into Community Happy py Healthy althy at Home ome 20 Partnerships
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