Background

The Clinical Strategy for Norfolk and Waveney is based on the experiences, hopes and ideas of the patients who use the NHS, the staff that work in it, and the communities that it serves.

It was developed with a wide range of patients, citizens, clinical and care professionals and supported by HealthWatch Norfolk, to signal what our population and our staff told us we want the NHS in Norfolk and Waveney to focus on over the next five years.

It was published in July 2022 after extensive engagement and the six statements below describe what our plan will try to achieve.

In Norfolk and Waveney My NHS will:

• See me as a whole person,
• Be one high quality, resilient service,
• Reduce long waiting times,
• Act early to improve health,
• Be reliable, and
• Tackle health inequalities.

We have simplified our plans for Year Two, keeping the six statements about what ‘My NHS will do’, but each of these has a specific focus. Under each focus area we have a series of actions. Together, these make up 19 new actions for this year, as well as 22 actions relating to these statements which are already included in our Joint Forward Plan (JFP).

We published an update on the first year of the strategy available here.

We report on progress against this strategy every 3 months through the ICB Performance and Commissioning Committee, and we publish an update on progress using a ‘You said, We did’ format every six months on our website. The previous update for Year One is available here.

Update on Year Two progress so far

So far in Year Two, we have achieved 7 of the 19 new actions with plans underway to deliver on the rest by March 2025.

Progress against the 22 actions which are also included in our Joint Forward Plan is recorded separately here.

Examples of Year Two completed actions so far:

1). See me as a whole person: Focus on people with Mental Health Needs

You said: We should focus on mental health just as much as physical health needs.

We did: We have commissioned a personality disorder (EUPD) pathway to improve support for people living with a personality disorder. This also aims to reduce the number of people needing to attend emergency departments and community mental health teams for support with their personality disorder.

Further information on mental health services and this pathway can be found here.

2). Be one high quality resilient service: Focus on primary care including dentistry, plus clinical care for Children and young people

You said: We want to be able to get through to GPs easily. There also needs to be more dentists available in Norfolk and Waveney.

We did: We have agreed an Access Improvement plan across all 20 primary care network areas of our system. All practices now have cloud-based telephony in place, or a confirmed plan to have this in place. The telephony service will make it easier for people to get through to their practices, and it includes a call back facility, so you don’t have to wait for the surgery to answer your call if there’s a big queue. 

In October 2023 we commissioned a new urgent dental treatment service to help people in pain access urgent dental care, even if they weren’t previously registered with a dentist.

Further information on our dental services can be found here.

3). Reducing long waiting times: Focus on elective care including cancer care, and care closer to home

You said: It is important that patients who are on a waiting list are actively cared for.

We did: We have opened two new operating theatres specifically for children at the Norfolk And Norwich University Hospital (NNUH) with building work underway for new orthopaedic operating theatres to help reduce our waiting lists for people who need operations. We are also building new community diagnostic centres to speed up how quickly people can get the scans or other tests they need.

Further information on waiting well can be found here.

Information on waiting times for procedures can be found here.

4). Act early to improve health: Focus on Population Health Management (PHM), prevention and care for older people

You said: We should focus on reducing health inequalities across Norfolk and Waveney.

We did: We have developed a strategy for our PHM work and have published our Health Inequalities Strategic Framework for action, working closely with Public Health colleagues in Norfolk and Suffolk County Councils.

We are focusing on reducing smoking in pregnancy to improve the health of the baby, as well as supporting the whole family to stop smoking which will improve their future health outcomes. All three maternity units at the acute hospitals now have smoking cessation leads, all maternity staff are receiving specific training, and a tobacco dependency treatment service is in place. 

Additionally, an Ageing Well programme has been established with specific workstreams focussing on prevention and supporting older people to live independently for as long as possible. The work also aims to improve care in care homes, improve support for people affected by dementia and get better recognition of frailty across our hospitals. A framework has also been developed to help local areas and providers identify where they need to do more to support people to live well in later life.

You can read the PHM strategy on our website by clicking this link.  

Take a look at our Ageing Well strategic framework here.

5). Be reliable: Focus on Emergency Care

You said: You want quicker response times to 999 calls, patients to be seen at the most appropriate places of care, and bed blocking to reduce so more people can be cared for if needed in secondary care.

We did: We have introduced an urgent care coordination hub so that when a person calls for an ambulance, but they don’t have a true health emergency, their case is reviewed by staff in teams within the ambulance service, primary care, mental health and community providers. This will help identify people can help keep at home if appropriate by sending a therapist out to them for example, or by admitting them to a ‘virtual ward’ where they can receive hospital level care at home preventing unnecessary admissions.   

We have dramatically reduced the delays in emergency ambulances, and we have expanded our virtual wards to the equivalent of 203 extra (virtual) beds where people receive hospital level care, but in their own homes.    

Further information on how to access urgent care please click here.

6). Tackle Health Inequalities

You said: Improve the uptake of health screening and vaccinations. Reduce the gaps in healthy life expectancy between different groups of our population.

We did: We have defined our ‘Plus’ groups – specific communities across Norfolk and Waveney who we know to have worse health outcomes.

We continue to work with trusted communicators in those communities to improve peoples’ access to health and care.

Our winter vaccination programme was the most successful in the East of England, protecting more people than ever from becoming seriously unwell with diseases common in the winter months such as flu and COVID.

You can read more about our work to address health inequalities by clicking this link.  

More details of the specific actions for each of the six statements are explained below:

Many of these are long term ambitions and have a long programme of work needed, but where this year’s specific action has been undertaken, we have marked it as complete, even though we know we need to keep working on it. The work for all other actions is ongoing.

Next Steps

We will continue to report progress against these actions internally every 3 months and publish updates like this one every 6 months.

We may add new actions during 2024/25 as we close these ones, but we aim to retain these six areas of focus against each of the six ambition statements from here on, as they align well with our wider objectives and our 5-year Joint Forward Plan.