Agenda item

Purpose of the item: To inform Select Committee on the delivery of the Surrey Heartlands Integrated Care Strategy and highlight main areas of co-ordination with Surrey County Council Priorities.

Witnesses:

Mark Nuti, Cabinet Member for Adults and Health

Rachel Crossley, Executive Director for Public Service Reform

Lucy Clemence, Health Integration Policy Lead

Liz Bruce, Joint Executive Director Adult Social Care and Integrated Commissioning

Key points raised in the discussion:

1.    A Member asked about areas of deprivation in Surrey and the prevalence of health issues therein and how this strategy will benefit residents. The Health Integration Policy Lead responded that the rationale for the strategy was to show what the Council and NHS were there to do for all residents and to bring together the new partnership and demonstrate how it will work together. Furthermore, the strategy was a guide for the Integrated Care Board to direct its resources.

2.    The Chair asked about the place-based approach, the connections between this strategy and the Surrey Health and Wellbeing Strategy and for witnesses to elaborate on how the strategy would contribute to the Council’s climate goals. The Executive Director stated that the places were based on the former Clinical Commissioning Group areas and hospital footprints that did not align with local government boundaries which presented some organisational challenges for example, how to delegate more decision making to a place what would governance look like. There was already place representation on the Health and Wellbeing Board. The Executive Director was the net zero lead for the NHS in Surrey and there were now green plans for each of the ICSs and hospital trusts with a 2050 target with a lot of work ongoing on but limited funding.

3.    A Member asked to what extent did the Fuller’s stocktake report shape this Strategy particularly around access to urgent care and the national need for more investment in primary care. The stocktake was reflected throughout, particularly in Ambition 2 around how the integrated neighbourhood teams would influence how person-centred care across health and social care was delivered to populations across Surrey Heartlands and support services like same day urgent care. A response to the Fuller Stocktake called One Service, One Plan had been submitted to NHS England. The Executive Director highlighted cloud telephony in primary care as an example of investment in that sector.

4.    A Member asked about rural deprivation and how NHS Surrey Heartlands would manage risk. The Executive Director talked about investment in data teams and access to more information at a lower level than before and how this would allow them to look at smaller populations and their needs. The Cabinet Member commented that the Neighbourhood Teams would support this as well integrating with the Council’s No One Left Behind priority.

5.    Regarding bed management the Joint Executive Director referenced the work that the Council had been doing with two hospitals. Surrey and Sussex Hospital (SaSH) and the Royal Surrey, that had lower performance on discharge to assess and could now evidence greater numbers of patients discharged in a more safe and timely way with a reduced period of stay.

6.    The Chair raised the demand for mental health provision and whether there be a system wide approach to this need. The Health Integration Policy Lead cited the Mental Health Investment Fund’s support for prevention programmes. There was also the Mental Health Improvement Plan across the system. The Lead acknowledged the workforce challenge in this area and in response to the Vice-Chair would go back to the team on the deadline date for bids for grants from the Fund.

7.    Witnesses were asked how the strategy would break from the past to empower minority ethnic communities. The Health Integration Lead stated that there was a focus on priority populations and key neighbourhoods which included BAME communities, and the ambition was that service development and delivery would be driven by local communities. The Vice-Chair followed up by asking how the strategy might help tackle taboos surrounded mental and sexual health in BAME populations.  The Executive Director cited the work of outreach teams in public health, inclusive materials, translatable webpages and gathering quarterly user data on uptake, and support in migrant hotels and work to reduce stigma. Surrey Minority Ethnic Forum (SMEF) had helped design wellbeing coordination service and awareness training.

8.    The Chair asked how Surrey Heartlands and the Council would measure the effectiveness of the strategy. The challenge was the breadth of ambition and the cross-cutting nature of the strategy as well as the long-term national funding to allow for future planning. Where metrics already exist for Ambition 1 they would be utilised. For Ambitions 2 & 3 these would be monitored the Integrated Care Partnership. The data would need to supplemented by resident voices but this was currently work in progress. 

9.    A Member asked how officers planned to recruit and retain enough staff to deliver on the ambitions of the strategy. The Health Integration Lead highlighted the United Surrey talent system-wide strategy and its innovative approaches such as the Health and Care Academy and connections to the Council’s skills plan.

RESOLVED:

The Select Committee recommends that Surrey Heartlands ICS:

1. Ensures adequate senior management training provision at every level of this strategy, including the promotion of effective management techniques amongst commissioners and providers.
2. Continues to align with the Integrated Care Strategy with the wider Health and Wellbeing Strategy for Surrey.
3. Embed work on reducing digital exclusion amongst residents within the strategy, and to increase support for those who lack digital access.
4. Expand the use of Provider Collaboratives, and to ensure that these collaboratives are effectively monitored.
5. Expand support for those with protected characteristics through helping to tackle reservations surrounding mental and sexual health.
6. Further integrate green prescribing as part of a holistic approach to health and wellbeing.