Walsall Together

What is Walsall Together?

Walsall Together is an ambitious and exciting programme to transform the health and social care you receive in Walsall. The programme brings together all the local NHS organisations; NHS Walsall Clinical Commissioning Group made up of GP practices across Walsall; Walsall Healthcare Trust: Dudley and Walsall Mental Health Partnership Trust and Walsall Council. As well as the voice of Walsall residents and key representatives from the voluntary sector.

Our joint vision is to address the changing needs of our population with integrated care solutions that maximise the potential of the individual person, the teams that support them and the wider health and care system.

Why do things need to change?

The challenges that exist nationally are no different in Walsall. As our population continues to grow and people are living longer – and often with long-term health conditions – the increasing demand being placed on our health and care services is not being matched by the available funding.

At the same time, health inequalities are widening, with certain groups of people more likely to develop certain diseases and more likely to die from them prematurely. We also know that gaps in quality exist, with some areas benefiting from better quality health services than others.

We know we need to look at new ways of thinking of doing things to make the difference that we have not been able to make to date.

Walsall Together Model

How will the new model work?

Walsall is part of a wider system of health and care – Black Country Sustainability and Transformation Plan which is a whole system partnership for CCGs across the Back country. This plan will set out how services across the region will work together over the next five years to improve our collective population’s health and wellbeing, to improve service quality and to deliver financial stability.

As part of this work a new Model of Integrated Health & Social Care has been developed and to tackle the challenges listed above, locally. It will build on some of the joint work that is already taking place, as well as improving outcomes and delivering a better experience for those that use services, in a more financially sustainable way. To achieve this we are focussed on the following four areas:

Resilient Communities – Early intervention and prevention to support people and communities to live independently and to have active, prosperous and healthy lives. For example a new a borough wide initiative between health, social care, the voluntary sector and community groups called ‘Making Connections Walsall’ is being developed by Walsall Council’s Public Health team to improve the health and wellbeing of residents by tackling loneliness.  It will commission and work with the voluntary sector to utilise social networks and community groups to improve the health and wellbeing of the community (targeted interventions to build social relationships amongst isolated groups).  The aim is to utilise existing expertise and knowledge in voluntary sector organisations by taking referrals from health and social care professionals.

General Practice and Integrated Health and Care Teams – Creating patient-centred care that is more co-ordinated across care settings and over time, particularly for patients with long-term chronic and medically complex conditions who may find it difficult to ‘navigate’ fragmented health care systems. For example people registered with GPs in Walsall  will be supported by a team that is made up of  GPs, community nursing, social care, mental health and the voluntary sector, providing accessible, high quality co-ordinated care in people’s homes and communities.

Walsall-wide specialist and services – Accessible, high quality care with local hospital teams working as part of a network of specialist care. Supporting people with health needs to prevent unnecessary hospital admission and receive care in the most appropriate setting. For example, a person who no longer needs to be in hospital but may need extra support to help them recover, will be able to access care at home which is appropriate to their needs. This could include physio, home-help, specialist services and equipment to enable them to live independently.

Single point of access – A single point of access for care coordination and navigation for all health, care and prevention services. To ensure rapid and timely access, effective co-ordination and improve efficiency for professionals and patients. For example this will avoid patients being signposted to and from one service to another service. Instead patients and professionals will have one point of access.