Decision details

·         The Health and Wellbeing Board met informally on 2 June 2021 and discussed the following items:

-       Health and Wellbeing Strategy Highlight Report

-       Review of the Final Draft of the Community Safety Agreement 2021-2025

-       Digital Workstreams for Restoration and Recovery Across the System and Digital Inclusion

-       A Renewed Vision for Data: Driving Insight-led decision making, Demand Management and Performance to Improve Outcomes

-       Surrey Mental Health Partnership Board: Review and Improvement Programme

-       Addressing Wider Determinants of Health Inequalities in Surrey: Poverty

-       Surrey Carers Strategy 2021-24

·         Following the meeting the Proper Officer took the decisions as listed below in consultation with the Chairman of the Health and Wellbeing Board using the Council approved delegation ‘to delegate all non-executive decisions (as far as the law allows) to the relevant proper officer in consultation with the relevant chairman or member nominated by the chairman’.

Decisions made:

HEALTH AND WELLBEING STRATEGY HIGHLIGHT REPORT

1. Noted progress reported against the three priorities.
2. Supported wider use of the new format for the Highlight Report.
3. Agreed the reframed Priorities, Outcomes, System Capabilities and Priority Populations (see appendix 2) to enable a refresh and alignment of the Strategy’s design principles and programmes.
4. Agreed to an informal Board meeting in July to discuss:

o The Strategy’s ongoing design principles

o Criteria for the inclusion of programmes within the Strategy and on Board agendas

o The Strategy’s programmes

o Links to the Empowering Communities roadmap

o Alignment as part of the broader Health Inequalities programmes.

5. Acknowledged that any future changes to the roles, responsibilities and governance of the Board will be aligned to the requirements of the Health and Social Care white paper 2021 which are still to be confirmed by HM Government.

Reasons for Decision:

That an overview of the progress of local shared projects supporting delivery of the three Health and Wellbeing Strategy priorities as of May 2021 be provided.

REVIEW OF THE FINAL DRAFT OF THE COMMUNITY SAFETY AGREEMENT 2021-2025

1. The Community Safety Agreement be approved.
2. Consideration of the Agreement be ensured and its focus areas fit into the Health and Wellbeing Strategy review and refresh.

Reasons for Decision:

This paper recommends a new Community Safety Agreement for 2021/22 for the following reasons:

·         It will ensure the Health and Wellbeing Board fulfils its statutory duties under Section 17 of the Crime and Disorder Act 1998;

·         It will offer opportunities to develop relationships between the Health and Social Care, Community Safety, and Criminal Justice partners by clearly setting out our ambition;

·         It will allow us to start to meet the aims of the merger;

o   Set out the shared priorities that bind the HWBB, PCC and the Community Safety Partnerships;

o   Ensure there is coordination at the strategic and local delivery level;

o   Formalise performance reporting structures so both successes and needs are captured and shared; and

o   Provide a governance framework and accountability for both Surrey residents and partners

DIGITAL WORKSTREAMS FOR RESTORATION AND RECOVERY ACROSS THE SYSTEM AND DIGITAL INCLUSION

1. The significant digital capabilities being delivered across the system as part of Restoration and Recovery and the need for partnership working be noted.
2. The need for more joined up communication of digital across partners and a greater focus on citizen engagement at every level be supported
3. The ongoing data analysis and insights regarding digital exclusion given its relationship to health inequalities be supported.
4. The development of a Digital Inclusion Strategy, as requested by the ICS System Board be supported.

Reasons for Decision:

There is a plethora of digital development work currently being planned and / or delivered across the system to drive Restoration and Recovery from the pandemic that partners will need to work on together.   This work requires engagement at every level to ensure practitioner buy in to new ways of working and a deep focus on the needs of people to ensure digital products work for the people we are codesigning them with.

Health inequalities have been exacerbated during the pandemic. Digital delivery of services has been a key strategy for outbreak control but has also resulted in some service users being unable to access services due to a lack of equipment, connectivity and/or skills. Further research needs to be undertaken to understand how some population groups are digitally excluded and a Digital Inclusion strategy developed.

ARENEWED VISION FOR DATA: DRIVING INSIGHT-LED DECISION MAKING, DEMAND MANAGEMENT AND PERFORMANCE TO IMPROVE OUTCOMES

In relation to the system capability:

1. Endorsed the need to renew the ambition around data and intelligence, recognising that we need to jointly design the data infrastructure and analytics capability to inform and monitor the ambitions of the refreshed Health and Wellbeing Strategy.
2. Confirmed support for the areas for collaboration and next steps (see sections 5, 7 and 9) and suggest any additional areas
3. Agreed that Chief Constable Gavin Stephens (Surrey Police), leads on behalf of the wider system, the development of a longer-term vision and roadmap to progress our shared intelligence ambitions and outcomes, and works with the Chair of the Surrey Office of Data Analytics (Michael Coughlin, Surrey County Council) and relevant data and intelligence leads in partner organisations, to deliver it.

In relation to the JSNA:

4. Agreed the renewed governance for the JSNA through an operational oversight group with representatives from the CIA Steering Group, to include Surrey County Council public health, adult and children’s services, the Insight & Analytics team, the CCGs, Community Teams, Healthwatch and Districts & Boroughs. Others may be co-opted as appropriate.
5.  Agreed that the new operational oversight group will oversee delivery of the JSNA.

In relation to the Alpha Version of the Surrey Index:

6. That the use of the Surrey Index to guide local level decision making and targeted interventions in local areas be supported.
7. Individual and collective leadership to ensure the Surrey Index is used to inform partnership and organisational strategies and decisions around future service delivery and resource allocation be provided.
8. That the Surrey Index in their respective organisations, other partnership forums, and with local communities and residents be championed.
9. Buy-in from partners, including District and Borough councils be built, so that more local level up to date data can be included in future iterations

Reasons for Decision:

The Health and Wellbeing Strategy includes a commitment to develop and embed system capability around intelligence to drive and guide decisions and activity to achieve greater efficiency and effectiveness. In the past year the Board has seen how important intelligence has been to support the county’s response and emerging recovery to the Covid-19 pandemic. We now have an opportunity to build on this and accelerate our ambitions - developing a common vision and joint ambition for data, insight and intelligence - alongside the refresh of our Health and Wellbeing Strategy. 

Reasons for the recommendations relating to the JSNA and Surrey Index are included in the appendices.

SURREY MENTAL HEALTH PARTNERSHIP BOARD: REVIEW AND IMPROVEMENT PROGRAMME

1. Accepted and endorsed the report, findings, and recommendations of the Mental Health Partnership Board the peer-led review.
2. Approved the proposed governance structure of the future MHPB and oversees progress.
3. Ratified and approved the Improvement Programme which has been devised to achieve a full redesign of the emotional wellbeing and mental health system model, aligned to national best practice with co-design by service and users at its centre.
4. Acknowledged the need for strategic programme support for the Improvement Programme, to ensure the alignment and implementation of system, organisation and tactical resources and services to drive forward and manage the implementation of the mental health service’s redesign.

Reasons for Decision:

The MHPB commissioned Peer-led review involved interviews with staff and senior leaders from all agencies, service users and carers, as well as engagement with businesses and residents who had no contact with mental health services. The review also considered the available data and outcomes, findings from previous Surrey surveys and reviews, a benchmarking exercise and a relational value audit.

The Peers found that there was consistent evidence across all service users, carers, system leaders, frontline professionals, audit results and the available data that Surrey’s mental health system is not effective in design, function or culture to facilitate the Health & Wellbeing Board’s priority of “Supporting the mental health and emotional wellbeing of people in Surrey”.

The recommendations are designed to ensure that there is a robust governance structure in place and influential leadership, management and oversight of the redesign of Surrey’s emotional wellbeing and mental health system. That an accessible model, biased towards prevention and early help, is designed in a timely and effective way to better meet the needs of Surrey residents.

The Health and Wellbeing Board are in a good place to ensure that the emotional wellbeing and mental health needs of Surrey’s residents are met from a wide continuum; ranging from supportive employers, educated and informed neighbours, friends and family all the way through to the availability of caring, accessible and supportive services for people with mental ill health and that this service model is driven by a sound evidence base, is co-produced by users and carers of services, has positive outcomes for all and is designed to respond and react to individual needs and the future, using technology and human relationships to drive forward the vision of a healthier and happier Surrey.

ADDRESSING WIDER DETERMINANTS OF HEALTH INEQUALITIES IN SURREY: POVERTY

1. Noted the significant demands, issues, and concerns raised about the changing nature of poverty through the pandemic and its impacts on people, and in particular health inequalities.
2. Endorsed the inclusion of action against poverty as a delivery programme within the refresh of the Health and Wellbeing Strategy.
3. Confirmed support for the ongoing examination of best practice across Surrey, and the country, with a view to highlighting key initiatives which could positively impact residents and communities experiencing poverty in Surrey.
4. Initiated a delivery programme to target reduction of poverty at system level, as part of the Health and Wellbeing Strategy refresh, drawing together a working group of key partners across Surrey to coordinate best practice initiatives and a jointly-owned action plan to address the causes and experience of poverty in Surrey.
5. Received a further report, through this working group, outlining different approaches in tackling poverty across other counties in the UK to elaborate on a potential future strategy for Surrey.

Reasons for Decision:

Priority 3 of the Surrey Health and Wellbeing Strategy is about supporting people in Surrey to fulfil their potential. Living in relative poverty has drastic impacts on physical health and emotional wellbeing, and therefore fundamentally undermines residents’ ability and position to achieve their full potential.

There is a clear opportunity in the refresh of the Health & Wellbeing Strategy to build in a new delivery programme to address socio-economic disadvantages - ‘reducing health inequalities so no-one is left behind’.  A collective effort across the system is needed to understand and counter both the causes and symptoms of relative poverty to ensure that sometimes-overlooked children, young people, families, older people, and carers can access the same life chances as their peers in Surrey. 

SURREY CARERS STRATEGY 2021-24

1. Approved the Surrey Carers Strategy 2021-24.
2. Supported and promoted the implementation of the Surrey Carers Strategy 2021- 24 as the Surrey-wide strategy to inform the ongoing development, delivery and improvement of services for carers in Surrey.
3. Adopted the values identified in the Surrey Carers Strategy 2021-24, which were developed in partnership with carers and partners across Surrey.
4. Agreed the strategic priorities 2021-24, which were developed based on what carers have said matters most and would make the biggest difference to them, and the specific commitments made in order to deliver against these priorities.
5. Supported the proposal for delivering the Surrey Carers Strategy 2021-24, which will see the development of a system-wide and local action plans, and the monitoring of the strategy through the Carers Strategic Partnership Board and the Joint Carers Strategic Commissioning Group.
6. Noted and agreed the proposal for the development of a Young Carers Strategy, which will dovetail with the Surrey Carers Strategy to create a truly all-ages approach.

Reasons for Decision:

The recommendations listed are critical in establishing a Surrey-wide approach to carers, and will enable achievement of the ambition that carers are seen as a priority and responsibility across Surrey – ‘carers are everybody’s business’. The Surrey Carers Strategy creates the necessary framework to inform delivery of key requirements, actions and improvements for carers, including those outlined in the Surrey Health and Wellbeing Strategy, at national level and, importantly, by carers themselves.

In order to ensure that we have high quality, consistent and accessible services and support available for Surrey’s unpaid carers, it is essential that we have a clear and cohesive vision, universal values, and priorities that put carers at the centre. The Surrey Carers Strategy 2021-24 draws together each of these key things, creating an approach – and set of commitments – that can be understood and owned by partners across the system.