About Our Partnership
Hull University Teaching Hospitals NHS Trust (HUTH) and Northern Lincolnshire and Goole NHS Foundation Trust (NLAG) have high ambitions and are committed to delivering more together for the populations we serve.
For the last three years, our two trusts have been working together in the Humber Acute Services programme to review our services and to identify how we can better provide those services across our complex geography for the benefit of our patients. Our focus is on ensuring we improve clinical outcomes, reduce inequalities of access and address the workforce challenges that we face.
This work means each trust is putting the other as its most important clinical partner from now on. The only way we can improve our clinical services quickly is by HUTH and NLaG making the strongest possible commitment to each other. We have set up new arrangements at Board level to cement relationships and to speed up decision making. The reasons for making this commitment to each other and why each trust needs the other are as follows. For NLaG, working with HUTH stabilises a number of small specialties ensuring they can still be provided as locally as possible on the South Bank. Critically, it also provides greater service capacity and allows us greater critical mass in key services to create room for manoeuvre as NLaG tackles the issues it faces with having two relatively small acute hospitals.
For HUTH, the partnership means more shared expertise and a more resilient workforce, especially for services and specialties which struggle to recruit. Closer working will also support sustained service delivery and continuity of care, closer to home, for patients living in Northern Lincolnshire who currently access specialist services such as oncology and cardiology through HUTH. The partnership will also provide certainty for a number of other specialist services run by HUTH which are reliant on referrals from across the entire Humber region for their long-term sustainability.
Our two trusts are working towards one vision – a vision to provide the best possible care together across the whole of the Humber region. We expect some of our services, whether they are clinical or non-clinical, will experience changes as a result of this work. More and more of them will join up through joint senior appointments, joint capital bids and joint business cases. That’s what putting each other first will mean in practice.
This joint work does not mean the trusts are merging. Such a move would be a distraction for everyone at a time when we need to focus all our efforts on providing the best possible services across the Humber. Change may happen at some point, but what that looks like is not clear at the moment – the NHS nationally is seeing much change in structure through the emerging Integrated Care Systems and other organisational forms may be available to providers in a few years’ time. So we can’t, and won’t, predict what will happen in the longer term, but for the next three years, even as we growing more closely aligned clinically and organisationally, we will remain separate trusts.
Our commitment to each other can be evidenced through:
- Establishing a Joint Chair post in February 2020.
- Collaboration for the last three years on the Humber Acute Services (HAS) programme (including submission in September 2021 of a joint Expression of Interest applying for £720 million capital from DHSC’s Health Infrastructure Plan: Future New Hospitals).
- Creation of Committees in Common to oversee the plans for our joint clinical strategy, the HAS programme and the joint capital bid for £720 million.
- The HAS programme to the delivery of substantive clinical pathway changes in the areas of urgent and emergency care, maternity, paediatrics and neonatal and planned care.
- Delivering more joint services, with single clinical leads and single management structures in ten specialties including dermatology, haematology, cardiology and oncology.
- Developing programme of joint non-clinical appointments, including a joint Chief Financial Officer (CFO), and other support service collaborations.
Each Trust will, of course, still work separately where appropriate with other partners in areas like pathology and Women’s and Children’s services and, because the NHS is moving towards a more collaborative approach at Place (or Borough) level, we need to make sure we spend time developing relationships with our mental health and community partners as well as the emerging Primary Care Networks.
So alongside the HAS programme we are working with our partners in primary care, community care and local authorities to improve our pathways of care which our patients tell us are often fragmented, have high levels of duplication and, sometimes, poor communication between organisations. Only through collaboration will we deliver the services that we all believe our patients should receive. We need to focus on what we can deliver closer to or at home and what we need to centralise to make best use of scarce highly experienced and skilled clinical staff. As we do that we need to build on our communities and support the development of local workforce.
In addition, we will work closely with local government, further and higher education, the voluntary sector and the independent sector. This collaborative approach to all we do will ensure that we:
- deliver the highest quality and sustainable services to our patients;
- play our part in delivering locally the national NHS agenda around health inequalities, population health management and delivering care closer to home;
- play our part as “Anchor Institutions” within our localities maximising our role in delivering improved health and wellbeing, economic regeneration, local and regional innovation and increased levels of local employment;
- maximise the potential of partnerships for education, research and innovation;
- maximise the skills and strength of our workforce:
- Sharing resources
- Developing local where possible
- Improving training and development opportunities for all staff;
- implement integrated pathways of care across community and primary care reducing reliance on hospital services and providing services closer to or at home for our patients;
- reduce inequalities of provision and access across our local communities;
- make increased use of technology to support self help, prevention, early intervention, remote diagnosis and treatment where appropriate;
- ensure that our infrastructure maximises the use of technology in service delivery including use of robotics and Artificial Intelligence.
Humber Acute Services (HAS) programme
A significant element of our collaboration is through the delivery of the HAS Programme. The Programme is one of the largest change programmes nationally and is designing hospital services for the future across the Humber region in order to deliver better and more accessible health and care services for the population. The programme involves both NLaG and HUTH – and the four Humber Clinical Commissioning Groups (CCGs). The Programme has multiple dependencies including the development of integrated acute, primary and community care pathways, the implementation of community based diagnostics, significant capital investment to support new models of care and the development of the emerging ICS and ICPs.
The programme is actively designing solutions to support the implementation of new models of care and infrastructure across three distinct but inter-related programmes of work:
- Interim Clinical Plan (Programme One) – stabilising services within priority areas over the next couple of years to ensure they remain safe and effective, seeking to improve access and outcomes for patients.
- Core Hospital Services (Programme Two) – long-term strategy and design of future core hospital services, as part of broader plans to work more collaboratively with partners in primary, community and social care.
- Building Better Places (Programme Three) – working with a wide range of partners in support of a major capital investment bid to government to develop our hospital estate and deliver significant benefits to the local economy and population.
The work programmes are not standalone with significant interdependencies on:
- The implementation of new pathways of care across acute, primary and community services – “Left Shift” – delivering improved access and improved outcomes
- Strategic workforce planning at the levels of the ICS and at Place with a focus on building local skills, employability and sustainability
- Partnering with Local Authorities to ensure that our development plans maximise the benefit of investment in our local areas including “Town Centre” redevelopment and regeneration
- Delivering substantive improvements on economic and health inequalities of our local populations
- Gaining access to significant capital investment in our estate to allow us to implement our emerging pathways of care
Our infrastructure is failing and has high levels of backlog maintenance and risk of critical infrastructure failure in the coming years. As part of our collaboration we have developed a joint bid for £700m of capital funding through the New Hospitals Programme. If successful the funding would allow us to redevelop Scunthorpe General, invest in new facilities in Hull Royal and deliver improved elective and day case capacity in both Trusts.
This is an exciting time for both HUTH and NLaG. We have ambitious plans to work together to deliver outstanding care to the people we serve.