The Healthy Leeds Plan sets out the health and care contribution towards achieving this vision. The plan outlines our five year strategic vision and focuses on equitable access, excellent experience, and optimal outcomes for people living in Leeds, ensuring we get the best value from Leeds public money.
This appendix summarises the plan against the 31 national objectives for Leeds. It summarises current performance, anticipated performance by March 2024, the board overseeing the work and interventions that will be made over the next 12 months to support the system in meeting the target.
Urgent and emergency care
1. National Planning Objective
To improve A&E waiting times so that no less than 76% of patients are seen within four hours by March 2024 with further improvements in 2024 / 2025.
Baseline position: 76.5% April 2023
Anticipated position March 2024: 76%
Interventions to support achievement:
- Enhanced Community Response – deliver urgent community response services aiming to reduce disruption to people’s lives via alternatives to Emergency Departments (ED) attendance / admissions to hospital.
- Covid Urgent Eyecare Service (CUES).
- Social prescribing in A&E.
- PCAL+ – Creating a new single gateway that brings together the Primary Care Access Line (PCAL) and the Single Point Urgent Referral (SPUR) and Yorkshire Ambulance Service (YAS) push model.
- Enhanced Care at Home – Improving our urgent community offer to support people at home and reduce unplanned admissions.
- Active Recovery at Home – Increasing the number of people who can be supported at home following hospital discharge.
- Rehab and Recovery Beds – optimising and recommissioning intermediate care beds in Leed
- Transfers of Care – streamlining our transfers of care between acute and intermediate care services to reduce the non-value-added time
- Community Ambulatory Paediatric Service (CAPS).
Board overseeing progress: Same Day Response Board and System Flow Steering Group
2. National Planning Objective:
Improve category 2 ambulance response times to an average of 30 minutes across 2023 / 2024, with further improvements in 2024 / 2025.
Baseline position: 34 minutes, March 2023
Interventions to support achievement: Yorkshire Ambulance Service regional transformation work which includes expanding capacity, transforming services and improving efficiencies.
Board overseeing progress: Same Day Response Board
3. National Planning Objective:
Reduce adult general and acute bed occupancy to 92% or below.
Baseline position: 98.1% April 2023
Anticipated position March 2024: 98% (Occupancy of 92% not possible given level of demand, with any further reduction used to support elective recovery).
Interventions to support achievement:
- Out of Hospital Project for those with no fixed abode / multiple complex disadvantages.
- PCAL+ Creating a new single gateway that brings together PCAL and SPUR & Yorkshire Ambulance Service (YAS) push model.
- Community Ambulatory Paediatric Service (CAPS)
- Enhanced Community Response – deliver urgent community response services aiming to reduce disruption to people’s lives via alternatives to ED attendance/admissions to hospital.
- Active Recovery at Home – Increasing the number of people who are able to be supported at home following hospital discharge.
- Rehab and Recovery Beds – optimising and recommissioning intermediate care beds in Leeds.
- Transfers of Care – streamlining our transfers of care between acute and intermediate care services to reduce the non-value-added time.
Board overseeing progress: System flow steering group.
Community Health Services
4. National Planning Objective:
Consistently meet or exceed the 70% 2-hour turgent community response standard.
Baseline position: 56% March 2023
Anticipated position March 2024: 70%
Interventions to support achievement:
- Enhanced Community Response
- Enhanced Care at Home – improving our urgent community offer to support people at home and reduce unplanned admissions.
Board overseeing progress: Same day response board and Frailty Board
Primary Care
5. National Planning Objective:
Reduce unnecessary GP appointments and improve patient experience by streamlining direct access and setting up local pathways for direct referrals.
Interventions to support achievement:
- Children’s system flow.
- Digital remote monitoring for long term conditions and mental health
- Long COVID review and rehabilitation model development.
- Several respiratory initiatives including MART (maintenance and reliver therapies), expansion of pulmonary rehab, spirometry next step.
- COVID urgent eyecare services.
- Advice and guidance.
- Ophthalmology re-procurement.
- Social prescribing.
- Community digital health hubs.
- Integrated weight management.
- Multimorbidity – three or more long term conditions and mental health – delivery of Diabetes Steering Group work.
Board overseeing progress: Primary Care Board
6. National Planning Objective:
Make it easier for people to contact a GP practice, including by supporting general practice to ensure that everyone who needs an appointment with their GP practice gets one within two weeks and those who contact their practice urgently are assessed the same or next day according to clinical need.
Baseline position: 81.4%
Anticipated position March 2024: Anticipated target to be established.
Interventions to support achievement: Enhanced Access Service
Board overseeing progress: Primary Care Board
7. National Planning Objective:
Continue the trajectory to deliver 50 million more appointments in general practice by the end of March 2024.
Baseline position: 4,980K March 2023
Anticipated position March 2024: 5,019K
Interventions to support achievement:
- Implementation of the access recovery plan
- Delivery of the primary care workforce action plan
Board overseeing progress: primary care board.
8. National Planning Objective:
Continue to recruit 26,000 Additional Roles Reimbursement Scheme roles by the end March 2024.
Baseline position: 295 whole time equivalent April 2023.
Anticipated position March 2024: 515 whole time equivalent by December.
Interventions to support achievement: deliver of the primary care workforce action plan.
Board overseeing progress: Primary Care Board
9. National Planning Objective:
Recover dental activity, improving units of dental activity (UDAs) towards pre-pandemic levels
To be reported on at a West Yorkshire level.
Elective Care
10. National Planning Objective:
Eliminate waits of over 65 weeks for elective care by March 2024 (except where patients choose to wait longer or in specific specialties).
Baseline position: 715 March 2023
Anticipated position March 2024: 0
Interventions to support achievement:
- Opthalmology re-procurement
- ENT and Adult hearing Loss re-procurement
- Gastro re-procurement
- Reduction in outpatient follow up
- Advice and guidance
- Waiting well for planned care
Board overseeing progress: Planned Care Board
11. National Planning Objective:
Elective activity levels as a proportion of 2019 / 2020 activity reaching 108%.
Baseline position: N/A
Anticipated position March 2024: 106.5%
Interventions to support achievement:
- Patient Initiated follow up.
- ENT and adult hearing loss re-procurement.
- Reduction in outpatient follow up.
Board overseeing progress: Planned Care Board
Cancer
12. National Planning Objective:
Continue to reduce the number of patients waiting over 62 days.
Baseline position: 329, February 2023
Anticipated position March 2024: 288 people
Interventions to support achievement:
- Two weeks wait frailty assessment clinics
- Optimal pathways: head and neck, gynaecology, prostate, bladder, lung, skin, colorectal, Upper GI, pancreas.
- MDT streamlining
Board overseeing progress: Cancer Board
13. National Planning Objective:
Meet the cancer faster diagnosis standard by March 2024 so that 75% of patients who have been urgently referred by their GP for suspected cancer are diagnosed or have cancer ruled out within 28 days.
Baseline position: 75.5%
Anticipated position March 2024: 75%
Interventions to support achievement:
- Implement faecal immunochemical test.
- Two weeks wait frailty assessment clinics.
- Open access chest x-rays.
- Practice nurse training enable to request chest x-rays.
- Brain and central nervous pathway – developing a straight to test pathway.
- Optimal pathways: head and neck, gynae, prostrate, bladder, lung, skin, colorectal, Upper GI, pancreas.
Board overseeing progress: Cancer Board
14. National Planning Objective:
Increase the percentage of cancers diagnosed at stages 1 and 2 in line with the 75% early diagnosis ambition by 2028.
Interventions to support achievement:
- Pinpoint blood test.
- Implementation of breast pain clinic.
- Implement faecal immunochemical test.
- Open access chest x-rays.
- Practice nurse training.
- Brain and central nervous pathway developing a straight to test pathway, lung screening.
Board overseeing progress: Cancer Board
Diagnostics
15. National Planning Objective:
Increase the percentage of patients that receive a diagnostic test within six weeks in line with the March 2025 ambition of 95%.
Baseline position: 90.4%
Anticipated position March 2024: 95%
Interventions to support achievement:
- Community Diagnostic Centres in Seacroft Hospital, Armley and Beeston Medical centres.
- LTHT Transformation programme – Diagnostics.
- Gastro re-procurement.
Board overseeing progress: Planned Care Board
16. National Planning Objective:
Deliver diagnostic activity levels that support plans to address elective and cancer backlogs and the diagnostic waiting time ambition.
Baseline position: No specific target.
Anticipated position March 2024: No specific target.
Interventions to support achievement:
- Community diagnostic centres in Seacroft Hospital, Armley and Beeston Medical Centres.
- LTHT Transformation Program – Diagnostics
Board overseeing progress: Planned Care Board
Maternity
17. National Planning Objective:
Make progress towards the national safety ambition to reduce stillbirth, neonatal mortality, maternal mortality, and serious intrapartum brain injury.
Baseline position: still birth rate 3.9 per 1000 births February 2023
Anticipated position March 2024:
- still birth rate less than 3.5 per 1000 births
- neonatal mortality less than or equal to 3.55 per 1000 births
- maternal mortality 0
- serious intrapartum brain injury less than or equal to 10 per annum
Interventions to support achievement:
Single delivery plan includes:
- MNVP (Maternity and Neonatal Voices Partnership) Deep dive into engagement with service users to ensure care is accessible and close to home.
- Gestational Diabetes – targeted healthy eating and physical activity interventions.
- Maternity Mental Health.
Board overseeing progress: Maternity Board
18. National Planning Objective:
Increase fill rates against funded establishment for maternity staff.
Baseline position: quarter 3 2022 data:
- Midwifery workforce 342.21 whole time equivalent
- Obstetric workforce 87.82 whole time equivalent
- Neonatal nurses 128.32 whole time equivalent
- Neonatal consultants 11.5 whole time equivalents
- Aesthetic workforce 9 session per week
Anticipated position March 2024:
- Midwifery workforce 363.36 whole time equivalent
- Obstetric workforce 91.62 whole time equivalent
- Neonatal consultants 13 whole time equivalent
- Aesthetic workforce 12 sessions per week
Interventions to support achievement: As a system we are focussed on implementing the recommendations through the single delivery plan including the workforce element.
Board overseeing progress: Maternity Board
Use of resources
19. National planning objective:
Deliver a balanced net system financial position for 2023 / 2024.
Description of plan can be found in the main Healthy Leeds Plan (HLP).
Workforce
20. National planning objective:
Improve retention and staff attendance through a systematic focus on all elements of the NHS People Promise.
Description of plan can be found in the main HLP – coordinated by Strategic One Workforce Board.
Mental Health
21. National Planning Objective:
Improve access to mental health support for children and young people in line with the national ambition for 345,000 additional individuals aged 0-25 accessing NHS funded services (compared to 2019).
Baseline position: 8990 rolling 12 months
Anticipated position March 2024: 8800 rolling 12 months
Interventions to support achievement:
- Compassionate Leeds – identifies areas where our current systems are failing to provide the intervention and support that children and families need which align to the themes of improvement identified through the national Early Help Review.
- Prevention / timely access to services
Board overseeing progress: Children and Young Peoples Board
22. National Planning Objective:
Increase the number of adults and older adults accessing Improving Access to Psychological Therapies (IAPT) treatment.
Baseline position: 7212 quarter 4 2022/2023
Anticipated position March 2024: 7202
Interventions to support achievement: working to reduce waiting times to access NHS Talking Therapies
Board overseeing progress: Severe Mental Illness Board
23. National Planning Objective:
Achieve a 5% year on year increase in the number of adults and older adults supported by community mental health services.
Baseline position: 10,275 February 2023
Anticipated position March 2024: 11,693
Interventions to support achievement:
- Community Mental Health Transformation – Mobilisation of new integrated model of care for community mental health with Local Care Partnerships and PCNs.
- Community Mental Health Transformation – Developing and increasing capacity in psychological therapies for people with SMI and more complex needs.
- Community Mental Health Transformation – Developing and testing new workforce roles.
- Early intervention in psychosis pathway – Further develop EIP to incorporate identification and intervention for those with at-risk mental states.
Board overseeing progress: Severe Mental Illness Board
24. National Planning Objective:
Work towards eliminating inappropriate adult acute out of area placements.
Baseline position: 663 bed days quarter 2 2022 / 2023
Anticipated position March 2024: 450 bed days
Interventions to support achievement:
- Community Mental Health Transformation – Mobilisation of new integrated model of care for community mental health with Local Care Partnerships and PCNs.
- Community Mental Health Transformation – Developing and increasing capacity in psychological therapies for people with SMI and more complex needs.
- Community Mental Health Transformation – Developing and testing new workforce roles.
- Review and evaluation of MH crisis provision and models of crisis alternatives & crisis pathway redesign.
- Review and evaluation of mental health crisis provision and models of crisis alternatives and crisis pathway redesign
Board overseeing progress: Severe Mental Illness Board
25. National Planning Objective:
Recover the dementia diagnosis rate to 66.7%
Baseline position: 68.7% March 2023
Anticipated position March 2024: 68.5%
Interventions to support achievement:
- Practices to review their dementia prevalence rate and identify patients at clinical risk of dementia, offering assessment and referral.
Board overseeing progress: Severe Mental Illness Board and Frailty Board
26. National Planning Objective:
Improve access to perinatal mental health services.
Baseline position: 770 March 2023
Anticipated position March 2024: 863
Interventions to support achievement: Maternity Mental Health Service
Board overseeing progress: Maternity Board and Serious Mental Illness Board
People with a learning disability and autistic people
27. National Planning Objective:
Ensure 75% of people aged over 14 years on the GP learning disability registers receive an annual health check and health action plan by March 2024.
Baseline position: 83%, March 2023
Anticipated position March 2024: 75%
Interventions to support achievement: Annual health checks for people with learning disability. Focus on those patients who have not received an annual health check in previous 18 months.
Board overseeing progress: Primary Care Board
28. National Planning Objective:
Reduce reliance on inpatient care while improving the quality of inpatient care so that by March 2024 no more than 30 adults with a learning disability and / or who are autistic per million adults and no more than 12 -15 under 18s with a learning disability and / or who are autistic per million under 18s are cared for in an inpatient unit.
Baseline position: 31 across ICB and NHSE commissioned beds quarter 3 2022 / 2023.
Anticipated position March 2024: 26 (15 commissioned by the ICB and 11 NHSE / provider collaborative
Interventions to support achievement: No new initiatives planned for the next 12 months although an initiative focused on LD / autism step-up crisis alternative is in the process of being scoped.
Board overseeing progress: Learning Disability and Neurodiversity Population Board
Prevention and health inequalities
29. National Planning Objective:
Increase percentage of patients with hypertension treated to NICE guidance to 77% by March 2024
Baseline position: 65.9% quarter 4 2022 / 2023
Anticipated position March 2024: 77%
Interventions to support achievement: Multimorbidity three long-term conditions and a serious mental illness.
Board overseeing progress: Long-Term Conditions Board
30. National Planning Objective:
Increase the percentage of patients aged between 25 and 84 years with a cardiovascular disease risk score greater than 20 percent on lipid lowering therapies to 60%.
Baseline position: 63.9%, quarter 4 2022 / 2023
Anticipated position March 2024: 60%
Interventions to support achievement:
- InHIP project delivery – WY / AHSN funded Health Inequalities project.
- STF project Lipids – Project delivery on behalf of WY and Leeds.
Board overseeing progress: Long-Term Conditions Board
31. National Planning Objective:
Continue to address health inequalities and deliver on the Core20PLUS5 approach.
Baseline position: Current performance not available.
Anticipated position March 2024: No specific target yet.
Interventions to support achievement:
- Waiting well for planned care
- LCP community grants, social prescribing, Community of practice, digital health hubs
- Social prescribing in A&E, home plus, unplanned care for healthy adults
- Compassionate Leeds
- Prevention / timely access to services for children and young people
- Out of Hospital Project for those with no fixed abode
- Women’s health programme
Contents – Explore the Healthy Leeds Plan
- Introduction
- Our city and vision
- Our goals
- Population Health infrastructure
- Identifying our strategic initiatives
- Our plans
- Enablers
- Summary and next steps
- Appendix One: Leeds Operational Plan – Anticipated trajectories
- Appendix Two: Leeds Operational Plan Implementation