Agenda and minutes

Health and Wellbeing Board - Wednesday, 21 December 2022 2.00 pm

Venue: Woodhatch Place, 11 Cockshot Hill, Reigate, Surrey, RH2 8EF

Contact: Amelia Christopher 


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    To receive any apologies for absence and substitutions.

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    Apologies were received from Fiona Edwards - Dr Priya Singh substituted, Jo Cogswell, Sinead Mooney, Siobhan Kennedy - Catherine Butler substituted, Karen Brimacombe, Professor Deborah Dunn-Walters, Jason Gaskell - Cate Newnes-Smith substituted, Professor Helen Rostill, Kate Barker, Liz Bruce - Rachel Crossley substituted.




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    To agree the minutes of the previous meeting.

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    The minutes were agreed as a true record of the meeting.




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    All Members present are required to declare, at this point in the meeting or as soon as possible thereafter


    (i)      Any disclosable pecuniary interests and / or

    (ii)      Other interests arising under the Code of Conduct in respect of any item(s) of business being considered at this meeting




            Members are reminded that they must not participate in any item where they have a disclosable pecuniary interest

            As well as an interest of the Member, this includes any interest, of which the Member is aware, that relates to the Member’s spouse or civil partner (or any person with whom the Member is living as a spouse or civil partner)

            Members with a significant personal interest may participate in the discussion and vote on that matter unless that interest could be reasonably regarded as prejudicial.


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    There were none.




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    Additional documents:


Members' Questions

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    The deadline for Member’s questions is 12pm four working days before the meeting (15 December 2022).


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    None received.



Public Questions

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    The deadline for public questions is seven days before the meeting (14 December 2022).


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    None received.




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    The deadline for petitions was 14 days before the meeting. No petitions have been received.


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    There were none.



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    This paper provides an overview of the progress of local shared projects and communications activity supporting delivery of the Health and Wellbeing Strategy (HWB Strategy) in the priority populations as of 29 November 2022. The Highlight Report provides an overview of each HWB Strategy Priority, describes what has been achieved in the previous period against outcomes and how collaborative working has aided this progress. It also has a section on key items (‘In the Spotlight’).

    The Highlight Report now includes a section on the progress of the review of the Joint Strategic Needs Assessment (JSNA) – chapters already published, chapters to be published by the end of the financial year and chapters that are in development.

    Additional documents:




    Mari Roberts-Wood - Managing Director, Reigate and Banstead Borough Council (Priority 3 Sponsor)

    Liz Williams - Joint Strategic Commissioning Convener, Learning Disability and Autism and all age Mental Health, Surrey County Council and Surrey Heartlands ICS (Priority 2 Co-Sponsor)


    Key points raised in the discussion:


    Priority One


    1.    The Priority Three Sponsor in lieu of the Priority One Sponsor noted that:

    ·         Progress had been made under the outcome: ‘the needs of those experiencing multiple disadvantage are met’, whereby the Changing Futures Lived Experience Group was meeting monthly and co-production work was being undertaken with those with lived experience.

    ·         In addition to the information within the ‘In the Spotlight - Uptake of Diabetes Prevention Programmes by Ethnically Diverse Communities’ section: there was a stark difference in the likelihood of developing type 2 diabetes between people from white backgrounds and those from ethnically diverse communities; 3.8% of people from white backgrounds live with type 2 diabetes compared to 5% of people from ethnically diverse communities. People from ethnically diverse communities might also develop diabetes at a younger age than their white counterparts. Culturally appropriate interventions and co-designing were vital.

    2.    The Vice-Chairman recognised that there had been a huge success with the three pilots - Epsom, Woking and Staines - and wondered whether there was funding or an appetite for Active Surrey to roll that out more widely to other areas with a high number of ethnic minorities, depending on the population health data. She noted that it would be helpful to see the data to assess whether the people participating in the prevention programme maintain their average blood glucose levels and do not develop diabetes.

    -       In response, the Priority Three Sponsor confirmed that the intention was for a wider roll out following the successes had, however funding was a challenge and discussions were underway. She would liaise with the contact at Active Surrey who might be able to provide the Board with an update on future plans for the particular programme. She agreed that tracking the outcomes were critical and she would look into the data.


    Priority Three


    3.    The Priority Three Sponsor noted that:

    ·         £20,000 in funding had been awarded from the Police and Crime Commissioner for Surrey to a charity called the Skill Mill as set out under the third outcome; the outcomes would be tracked and it was hoped that it would make a difference to some people's lives.

    ·         In addition to the information within the ‘In the Spotlight - Cost of Living’ section: the borough and district councils, and Surrey County Council had been busy with partners to provide advice on support with energy bills and other utilities, facilitating Warm Hubs across Surrey and signposting to grants and delivering communications through a Surrey-wide leaflet; working collaboratively with the Voluntary, Community and Faith Sector (VCFS) to provide targeted support through food banks and debt advice for example and gathering local intelligence on the most vulnerable.

    4.    A Board member highlighted the Canal Watch (Woking) which was  ...  view the full minutes text for item 43/22



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    The Health and Wellbeing Board Communications Group has developed the Health and Wellbeing Board Communications Plan which outlines joint priorities for communications activity in 2023. The plan builds on successful work from the previous year as well as making sure that the refreshed Health and Wellbeing (HWB) Strategy is reflected in the priorities within the Communications Plan.


    Additional documents:




    Giselle Rothwell - Director of Communications and Engagement, Surrey Heartlands ICS

    Sarah Archer - Communications Account Manager - Public Health, Surrey County Council


    Key points raised in the discussion:


    1.    The Director of Communications and Engagement (Surrey Heartlands ICS) noted that:

    ·         The Board’s Communications Group supported the Health and Wellbeing Strategy through a range of communications work, it was jointly chaired by her and the Strategic Director - Communications (SCC) and had a broad membership including representatives from the voluntary sector.

    ·         The Group had matured and evolved over the last couple of years, it was increasingly talking across Surrey with one voice across its partners; noting a joint campaign around mental health last year, the huge amount of work around Covid-19, and the current collaborative work on winter plans.

    ·         The Communications Plan 2023 had been refreshed to reflect the Board’s revised Health and Wellbeing Strategy.

    ·         Greater value could be added as a Group through focusing on larger campaigns during the year, resourcing them well to deliver greater impact; rather than doing lots of smaller campaigns. The Group was always looking for new ways of evaluating communications campaigns.

    2.    The Communications Account Manager - Public Health (SCC) noted:

    ·         That the Plan which had been Covid-19 focused over the last two years, had been tweaked and expanded to focus on the Health and Wellbeing Strategy’s priorities; whilst being flexible, reacting to health and wellbeing priorities as they change.

    ·         Areas of focus concerning Priority One included the: winter plan, children's immunisations including information on diphtheria and polio, promoting cancer screening and health checks, campaign around Stoptober, the Changing Futures Programme to reduce the stigma around people with multiple disadvantage; a new logo had been created.

    ·         Areas of focus concerning Priority Two included the: Face of Support campaign last year concerning early intervention, building resilience and connecting people in communities and working with the Community Champions to disseminate messages, using case studies to highlight lived experience and using mental health workers in a recent campaign.

    ·         Areas of focus concerning Priority Three included the: aforementioned Surrey-wide leaflet and there had been requests for that leaflet to go much wider, campaign about domestic abuse highlighting the coercive and controlling behaviours, work underway with other directorates around Active Travel which provided health benefits.

    ·         The Tactics and Channels, Opportunities and milestones, Key Audiences, and Success sections in Annex 1. 

    3.    A Board member noted that she fully endorsed the focus on a few campaigns a year and she encouraged the Group to look at the Food Strategy under development - under Priority One - which cut across a number of the key themes discussed such as the cost of living, sustainability and the health impact of diet; it would be useful to use those insights.

    -       In response, the Director of Communications and Engagement (Surrey Heartlands ICS) would take that suggestion to the Group’s next meeting.

    4.    A Board member asked whether there was sufficient linkage into the VCFS groups and priority populations and whether there was  ...  view the full minutes text for item 44/22



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    This report provides a summary overview of how this underpinning HWB Strategy, “system capability” for Empowered and Thriving Communities has been progressed to date. Positive examples are highlighted, particularly in some of the Key Neighbourhoods where there have been focused efforts to work more creatively and collaboratively alongside communities.


    Additional documents:




    Daniel Shurlock - Design Lead for Empowered and Thriving Communities, Surrey County Council

    Mari Roberts-Wood - Managing Director, Reigate and Banstead Borough Council (Priority 3 Sponsor)

    Dr Gillian Orrow, Co-Founder of Growing Health Together, Programme Director and Healthy Horley PCN Lead

    Dr Beccy Bowden - Chief Executive Officer, Community Foundation for Surrey


    Key points raised in the discussion:

    1.    The Design Lead for Empowered and Thriving Communities (SCC) noted that:

    ·         When the Health and Wellbeing Strategy was first refreshed with the goal to narrow health inequalities, there was a commitment to review how the system was working alongside communities and the identified Key Neighbourhoods were prioritised as they had the poorest health outcomes.

    ·         There were some fantastic examples across the system to be proud of in terms of building on learning and connecting more closely with communities; that work was being shared and done in a way that was understandable.

    ·         That engagement, listening and understanding of what was going on in Surrey’s communities, could be applied to other work and more needed to be done; looking at investment into community-led action for example, through various funds such as Your Fund Surrey and the MHIF.

    2.    The Priority Three Sponsor provided an example of the joint work in Merstham:

    ·         Merstham was the most deprived area in Surrey, looking at the 21 Key Neighbourhoods it had some of the most concentrated challenges. Reigate and Banstead Borough Council had been investing in community development work within Merstham for the past fifteen years. She encouraged Board members to visit the Merstham Community Hub - including a library and a community café - which was resultant from the engagement and co-design work with residents and it was supported by volunteers; it had played a key role during Covid-19.

    3.    The Co-Founder of Growing Health Together, Programme Director and Healthy Horley PCN Lead provided an example of Health Creation in East Surrey:

    ·   Health Creation had been game changing for East Surrey through Growing Health Together, which developed key working relationships with Surrey County Council and Reigate and Banstead Borough Council’s Community development team, building on the fantastic work that Reigate and Banstead Borough Council had been developing over the past fifteen years. Focused Health Creation work was undertaken in Nailsworth Crescent housing estate in Merstham, through engagement and listening the residents highlighted their priorities which included improving the quality of their housing, improving the social provision for young parents and their families, and improving the local environment in terms of green spaces and air quality. Through partnership work the various sectors worked alongside local people to affect the changes requested by the community, evidence from elsewhere in the country suggested that approach could catalyse significant and sustained reversal of even entrenched health inequalities.

    4.    The Chief Executive Officer (Community Foundation for Surrey) provided an example of future investment opportunities:

    ·         The Community Foundation for Surrey (CFS) was established in 2005 and its mission statement was to grow philanthropy to change the lives of local people for  ...  view the full minutes text for item 45/22



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    The Surrey Safeguarding Adults Board (SSAB) is a statutory multi-agency board with responsibilities set out in the Care Act 2014. The SSAB is chaired by an independent chair, Mr Simon Turpitt.


    There is a statutory duty for all Safeguarding Adult Boards to publish an annual report and disseminate to various parties, of which the Health and Wellbeing Board is one.


    Additional documents:




    Simon Turpitt - Independent Chair, Surrey Safeguarding Adults Board


    Key points raised in the discussion:


    1.    The Independent Chair (SSAB) noted that:

    ·         There had been an increase in concerns raised which had turned into an increase in Section 42s.

    ·         The upward trend had continued concerning Safeguarding Adults Reviews from six in the previous year, last year there were 14, and this year there were 26; that was comparatively high as throughout his time in Surrey there only used to be a few a year. Covid-19 and the resultant backlog was a partial explanation for the increase, there was a lot of pressure on people around mental health, as well as instances of alcohol and drug abuse.

    ·         Prevention was good however it was vital to understand the underlying causes, seeing those clearly was difficult by the time the cases reached the SSAB however there was better data and more information available. 

    ·         The world had moved on since the Annual Report was published, worries looking ahead were staffing: recruitment and retention, especially around the areas in the voluntary sector predominantly which were being put under enormous pressure, the financial environment, care homes and domiciliary care, capacity in social care and the NHS; and the rise of mental ill health particularly around those who had never presented before and in children, and an increase in needs related to autism.

    ·         It was vital that all understood what safeguarding means, how to manage issues and how to provide support, ensuring that vulnerable residents are looked after.

    ·         The support from all agencies had been immense and critical for the SSAB, he noted his thanks.

    2.    The Chairman noted that the report had been reviewed through other parts of the system and acknowledged the challenges ahead with the increased reviews.

    3.    The Chairman thanked the Independent Chair (SSAB) for all the work undertaken over the past year. He noted that it was likely to be Simon Turpitt’s final meeting as the Independent Chair (SSAB) with his successor to be in post early January and on behalf of the Board he thanked him for his hard work in chairing the SSAB over a significant number of years.




    1.    Considered and noted the Surrey Safeguarding Adults Board Annual Report 2021/22.

    2.    Considered the SSAB Annual Report in relation to the HWB strategic priorities to ensure collaborative working between the Boards.     


    Actions/further information to be provided:






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    The Annual Report of the Surrey Safeguarding Children Partnership (SSCP) is part of the safeguarding partners accountability to members of the full Partnership, the national Child Safeguarding Practice Review Panel, relevant agencies and, most importantly, Surrey’s children and families who are the principal beneficiaries of the activity of the Partnership.


    The Annual Report covering January 2021 - March 2022 has been approved by the Executive and the full Partnership and was published in December 2022 after being quality assured by Partners. This is in line with the usual publication timelines.



    Additional documents:




    Alison Cutler - Partnership Development Manager, Surrey Safeguarding Children Partnership

    Simon Hart - Independent Chair, Surrey Safeguarding Children Partnership 


    Key points raised in the discussion:


    1.    The Partnership Development Manager (SSCP) noted that:

    ·         In 2018 the Working Together guidance was published by the Government whereby the responsibility for safeguarding arrangements shifted primarily from the Safeguarding Children Board to the Safeguarding Children Partnership and more substantially, the responsibility shifted to three partners: health, police and the local authority.

    ·         As part of those new arrangements, the requirement was that those statutory partners produce an Annual Report outlining the activity and impact of the SSCP and that report is then scrutinised by the Independent Chair (SSCP).

    ·         Some of the activity from last year focused on learning and improvement, examples highlighted how the learning from reviews was used to move forward practice across the partnership; mental health was a focus area.

    ·         The SSCP undertook audits for partners to look at how they were managing safeguarding practices within their organisations and over the past year there had been some large improvements there.

    ·         The SSCP continued to focus on early help and thresholds, that was progressing well but was an area to be looked at in the coming year.

    ·         Adolescent resilience and support, including emotional health and wellbeing continued to be a focus and one of the highlights in the report was the formation of the Mental Health Alliance and the impact that had in providing better support to schools through their primary health workers.

    ·         Neglect remained a big issue and that came up in Serious Case Reviews and national child safeguarding practice reviews, the SSCP was continuing its work around Graded Care Profile roll out across Surrey.

    ·         Three of the challenges that the SSCP was looking at in the months ahead were: a greater consistency in the quality and effectiveness of multi-agency safeguarding practice and involvement in child protection processes, learning lessons from the reviews and identifying areas where it could improve, and the issues of recruitment and retention which were issues nationally but needed to be monitored in Surrey.

    2.    The Independent Chair (SSCP) noted that:

    ·         His role was to make an objective and independent comment on the Annual Report, which he strongly supported explaining that the governance arrangements that were in place had become well established.

    ·         The SSCP was well supported by the partners both from the point of view of maintaining the stability of the funding arrangements, but also the amount of time that agencies were committing to the SSCP.

    ·         The newly added section on the inspectorates’ findings was an additional strength.

    ·         The section dealing with recruitment and retention was highly appropriate and it would continue to be one of the major challenges to safeguarding in Surrey, as it was nationally.

    ·         Other challenges to safeguarding were: the growing gap between levels of need and capacity which was a significant potential risk, emotional wellbeing and mental health particularly concerning adolescents and the SSCP had undertaken important work in relation to adolescent suicide  ...  view the full minutes text for item 47/22



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    In the Autumn Statement, £500m was announced as an Adult Social Care discharge fund. The fund is distributed to areas via the ICB (60%) and Local Authorities (40%). The fund will be pooled into the Better Care Fund and agreed between the ICB and HWB on what it needs to be spent on.


    Additional documents:




    Lucy Clements - Health Integration Policy Lead, Surrey County Council and Surrey Heartlands ICS


    Key points raised in the discussion:


    1.    The Chairman noted that Surrey received £8.5 million through the Better Care Fund and it had to make a submission to the Government within the tight deadline of 16 December 2022, which it had done.  

    2.    The Health Integration Policy Lead (SCC and Surrey Heartlands ICS) noted that the report outlined the allocation coming to Surrey and what the proposals were for spending that money as a Surrey system, both Surrey Heartlands and Frimley ICSs.

    3.    A Board member thanked the team as the timescale for submission was very tight. She noted that it was a good joint piece of work and reiterated that it was important for the Board to have greater scrutiny over the Better Care Fund submission and to look at the governance around that, particularly as there was even more money coming in through the Better Care Fund.

    -       The Chairman agreed that it was a good collaborative piece of work, some of that information had been shared with Government ministers who were keen to see how the money could be used to free up beds. He agreed that the Board needed to have more involvement in the Better Care Fund process and how the money is spent before being asked to sign it off, sometimes retrospectively.




    1.    Approved that Discharge to Assess (D2A) would be the priority scheme funded from this grant c£6.5m.

    2.    Approved that any remaining monies once D2A has been funded, c£2m, would be spent on the priority cohorts of Mental Health, Self-Funders and P3 placements (outside of D2A), subject to a business case and agreement at ICS Execs.

    3.    Approved that if Surrey Heartlands or Frimley develop a funding gap on D2A as the year progresses, the use of this £2m would be reviewed and potentially re-prioritised.


    Actions/further information to be provided:


    1.    The Health Integration Policy Lead (SCC and Surrey Heartlands ICS) will follow up the Board member’s (Claire Fuller) and Chairman’s comments that the Board needed to have greater scrutiny over the Better Care Fund submission and involvement in the process going forward and to look at the governance around that such as how the money is spent before being asked to sign it off, sometimes retrospectively, particularly as there was even more money coming in through the Better Care Fund.





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    The Board is asked to note the update provided on the recent activity within the Surrey Heartlands and Frimley Integrated Care Systems (ICS) regarding the Integrated Care Partnerships and Integrated Care Boards.


    A verbal update will be provided on both the Surrey Heartlands ICS’ and the Frimley ICS’ implementation of the ‘Next steps for integrating primary care: Fuller stocktake report’.

    Additional documents:




    Dr Priya Singh - Chair, NHS Frimley Integrated Care Board

    Tom Lawlor - Director of Operations, Surrey Heath, Frimley ICS

    Professor Claire Fuller - Chief Executive Officer, Surrey Heartlands ICS


    Key points raised in the discussion:


    1.    The Chair (NHS Frimley ICB) noted that:

    ·         The Frimley ICS was in the process of re-examining and refining the Integrated Care Strategy, the work to align to that and to ensure delivery had been well supported across the system.

    ·         There was an understandable general anxiety in society and that fed into the way in which pressures were being felt across the public services, however reflecting on the work that had been done with the Integrated Care Partnership (ICP) and Integrated Care Board (ICB) the way in which the workforce was rising to the challenges regardless of the pressures was commendable, for example the preparation around winter planning.

    ·         There were additional pressures now of Strep A for example, however people across the system were working constructively together and she thanked the public service partners and the teams.

    ·         The work that the ICP had been doing was focused on creating key priorities, ensuring clarity and the alignment around that; an example of work underway included fuel poverty and being able to have actionable insight from that population health data.

    2.    The Director of Operations (Surrey Heath, Frimley ICS) noted that:

    ·         In terms of the implementation of the Fuller Stocktake report and the next steps for primary care, the recommendations were aligned with Frimley ICS’s goals and so had been built into the existing work within the system.

    ·         The Frimley ICS had adopted that population health management approach and used that to aid and improve access to services and to improve the appropriate continuity of care. There had been a focus on understanding the population and different cohorts and then providing the right pathways and care for those people.

    ·         Within its neighbourhoods there were existing integrated care teams and the Frimley ICS had used those to evolve and refine what it was doing based on the needs of a particular neighbourhood such as looking at care navigation, using the multi-disciplinary teams ensuring proactive and reactive care for people, providing same-day access and tailoring that provision, and using the insights and data throughout the connected care system to highlight opportunities and areas for improvement.

    ·         The Frimley ICS sought to work with its communities to make the changes needed and that had been one of the big differences and changes in terms of the method and how the system works with people.

    3.    The Chief Executive Officer (Surrey Heartlands ICS) noted that:

    ·         The Surrey Heartlands ICS had declared a system-wide critical incident yesterday, which reflected the high levels of system pressures and demands in part linked to the number of different infections circulating. 

    ·         It was important for the system to ensure that it continued to focus on transformation and making those longer-term changes, so that it does not simply remain reactive. 

    ·         The system took its Fuller  ...  view the full minutes text for item 49/22



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    The next meeting of the Health and Wellbeing Board will be on 15 March 2023.

    Additional documents:


    The date of the next public meeting was noted as 15 March 2023.