Agenda and minutes
PDF 414 KBVenue: Woodhatch Place, 11 Cockshot Hill, Reigate, Surrey, RH2 8EF
Contact: Amelia Christopher
Media
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APOLOGIES FOR ABSENCE
To receive any apologies for absence and substitutions. Additional documents: Minutes: Apologies were received from Dr Charlotte Canniff, Gavin Stephens - Gemma Morris substituted, Professor Helen Rostill - Kate Barker substituted, Jason Gaskell, Fiona Edwards - Nicola Airey substituted, Liz Bruce, Siobhan Kennedy, Carl Hall - Cynthia Allen substituted, Sue Murphy.
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MINUTES OF PREVIOUS MEETING: 15 JUNE 2022
To agree the minutes of the previous meeting. Additional documents: Minutes: The minutes were agreed as a true record of the meeting.
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DECLARATIONS OF INTEREST
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
NOTES:
• 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.
Additional documents: Minutes: There were none.
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QUESTIONS AND PETITIONS
Additional documents: |
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Members' Questions
The deadline for Member’s questions is 12pm four working days before the meeting (22 September 2022).
Additional documents: Minutes:
None received.
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The deadline for public questions is seven days before the meeting (21 September 2022).
Additional documents: Minutes: One question was received from Rebecca Eddington. The question and response were published in the supplementary agenda.
A supplementary question was asked by Rebecca Eddington and the response can be found below.
Supplementary question asked by Rebecca Eddington:
The questioner asked if there was anyone specific that would lead the details for bridging into additional resources for mental health so that they could work together.
Response:
The Chairman noted that Liz Bruce, Joint Executive Director of Adult Social Care and Integrated Commissioning (SCC and Surrey Heartlands ICS) would be the best person to contact to follow up her question and her contact details would be put in the Microsoft Teams meeting chat.
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Petitions
The deadline for petitions was 14 days before the meeting. No petitions have been received.
Additional documents: Minutes: There were none.
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HEALTH AND WELLBEING STRATEGY HIGHLIGHT REPORT
This paper provides an overview of the progress of local shared projects and communications activity supporting delivery of the three Health and Wellbeing Strategy priorities as of 6 September 2022 with the priority population groups. The Highlight Report provides an overview of each Priority, describes what has been achieved in the previous period and how collaborative working has aided this progress.
The Young Carers Strategy is included for the Board’s endorsement. Additional documents: Minutes: Witnesses:
Karen Brimacombe - Chief Executive, Mole Valley District Council (Surrey Chief Executives’ Group) (Priority One Sponsor) Kate Barker - Joint Strategic Commissioning Convener - Children and Families, Surrey County Council and Surrey Heartlands ICS (Priority 2 Co-Sponsor) Mari Roberts-Wood - Managing Director (Head of Paid Service), Reigate and Banstead Borough Council (Priority 3 Sponsor)
Key points raised in the discussion:
Priority One
1. The Priority One Sponsor noted that: · Carers and young people are a priority population within the Health and Wellbeing Strategy (HWS) and the Board was being asked to endorse the Surrey Joint Strategy for Young Carers 2022 - 2024 (SJSYC). · Feedback from young carers during the consultation period on the SJSYC was that whilst they were proud to be a young carer it can have a negative impact on them, caring becomes normalised and therefore they do not seek support and teachers do not complete the young carers assessments as they are unsure when a young person is a carer. · The SJSYC would focus on ascertaining what the true figure of young carers across Surrey is, the scale of young carers was outlined in the report. · A rapid review would be undertaken to identify the challenges in ensuring an appropriate transfer of information from primary to secondary education. · A new information system would be developed to capture the numbers of and demographic profiles of Surrey’s carers. · If identified numbers grow, the services that are provided might also need to grow and the SJSYC commits to developing peer support networks. · The SJSYC sets out strategic priorities and a vision for Surrey of young carers feeling recognised, valued and supported, and being protected from providing inappropriate care; also ensuring that young carers achieve their full potential with access to the same opportunities as their peers. · The SJSYC would be developed into an all-age Carers Strategy to be live from the end of 2024. 2. A Board member welcomed the acknowledgement in the SJSYC of the importance of hearing young carers’ voices in every aspect of the work via the Young Carers Forum. For those young carers who do not wish to or were unable to engage with the Forum or did not self-identify as a carer, she asked how their voices would be captured. The identification of carers was vital so that support could be given, Healthwatch Surrey for example was finding that many adult carers did not self-identify as a carer. - In response, a Board member recognised the importance of finding other routes of engagement for hearing the voices of young people, who might not self-identify as a young carer. There were a range of different children's voice opportunities, for example the User Voice and Participation team engages with a wide range of children on a range of different issues. The SJSYC uses inquisitive language and it was important for staff working with children and young people to be curious about their lives, to ask the right questions in a gentle way and to explore their ... view the full minutes text for item 30/22 |
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HEALTH AND WELL-BEING STRATEGY METRICS: REVIEW AND REFRESH
Alongside the refresh of the Health and Wellbeing Strategy a revised set of metrics have been developed to better link with the updated priorities, outcomes and priority populations. The Health and Wellbeing Board is asked to agree the proposed set of metrics as a reflection of the greater focus in the Strategy on reducing health inequalities and wider determinants of health and Review and promote awareness of the metrics within their organisation to enable a common understanding and assessment of progress.
Additional documents: Minutes: Witnesses:
Ruth Hutchinson - Director of Public Health, Surrey County Council Phillip Austen-Reed - Principal Lead – Health and Wellbeing, Surrey County Council
Key points raised in the discussion:
1. The Director of Public Health (SCC) noted that as the HWS had evolved - as reported in quarterly updates - how that was measured also needed to evolve and the revised metrics and indicators reflected that. ‘Data, insights and evidence’ was a key system capability and the metrics formed a part of that, aligning with other key work within the Data Strategy as well as the Joint Strategic Needs Assessment (JSNA) and the Pharmaceutical Needs Assessment (PNA). 2. The Principal Lead – Health and Wellbeing (SCC) noted that: · The metrics had been outlined in terms of each of the Priority One - Three outcomes that are in the HWS, whilst there was not the same number of indicators per outcome as publicly available data was limited, the indicators did align to all of the outcomes including the new outcome under Priority Two and were to be measured over the long-term. · The importance of considering the indicators in terms of the priority populations was recognised and emphasised through the refreshed HWS. · A key benefit of the approach presented via the Surrey Index would be that the indicators can be understood at the wider Surrey level but also geographical levels below that such as district or borough, health: place or primary care network, or the Local Super Output Area (LSOA) level. · Having more granular data would be important in terms of understanding what the indicators mean in those key neighbourhoods in the HWS, however a limitation in measuring the outcomes was around what publicly available data was available on many of the priority populations and links were being made with various teams to help assist with filling in the gaps in information. · Screenshots of indicators around fuel poverty viewable at different geographical levels via the Surrey Index were shown down to ward level with the intention to go down to LSOA level where possible and that granularity was helpful in terms of benchmarking across Surrey and comparing each area over time. · Work would be undertaken collectively to ensure that the developing tools would interface where appropriate with products such as the JSNA. · Whilst the HWS indicators sit within a larger set of Indicators in the Surrey Index as well as Organisational Indicators, the proposal was that the Strategy indicators could be used as a collective reference point by organisations in Surrey; particularly as many of the indicators and outcomes can only be impacted on by collective action. · The request was for organisations when developing their own internal metrics to consider the links with and impact on the HWS indicators. · The intention would be to review the metrics and indicators on an annual basis so that where progress is or is not made could be measured over the long term, as a result it was hoped that the focus of the HWS and ... view the full minutes text for item 31/22 |
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UPDATE ON THE MENTAL HEALTH IMPROVEMENT PLAN
In recent months the MHIP, and mental health improvement and transformation work more broadly, has undergone a reset, in order to address some of the challenges which have been found to date, to align with wider system ambitions and to build on our successes. This paper provides an update on the changes that have been made, and next steps. It also asks the Health and Wellbeing Board to agree the Terms of Reference of the new Mental Health System Delivery Board.
Additional documents: Minutes: Witnesses:
Jonathan Perkins - Independent Chair, Surrey Mental Health System Delivery Board Kate Barker - Joint Strategic Commissioning Convener - Children and Families, Surrey County Council and Surrey Heartlands ICS (Priority 2 Co-Sponsor)
Key points raised in the discussion:
1. The Independent Chair (Surrey Mental Health System Delivery Board - MHSDB) noted that: · The Mental Health Improvement Plan is a piece of work that had been ongoing within Surrey for several years. · A peer report was produced in the early summer of 2021 which had multiple recommendations on the improvement of mental health, worked on by the Mental Health Partnership Board. · After a year a reset was needed to create more momentum to some of the recommendations from that peer report and from July that reset began and he was invited by the Board’s Chairman to chair the new Surrey MHSDB; in order to focus on those recommendations and review what was happening in the wider context in terms of mental health concerning: the development of the new ICS Strategy and inclusion of Surrey Heartlands ICS’s ‘Critical Five’, the implications of the Fuller Stocktake report and looking ahead to winter pressures as well as the cost of living crisis. · An update on that new governance in place, the summary of the new MHSDB and the draft Terms of Reference for the Board’s approval are included in Appendices 1 and 2. · Several senior people from across the system sat on the MHSDB to focus on how to deliver the improvements around mental health and emotional wellbeing in partnership. · The best of the previous governance arrangements formed the Co-production and Insight Group which had a broad membership from across the county who met together once a month; and the quality assurance of mental health was overseen by a new board. · There was a huge amount of work underway by the providers in the third sector and prioritisation was needed to concentrate resources. The MHSDB was undertaking a phasing exercise to look at what were the most important things that need to be achieved in the quickest time - Appendix 3. · The MHSDB was determined to move things forward as a partnership and unblock issues, making progress in the next few months. 2. The Chairman noted that there had been two Mental Health Summits where there had been good discussion but what was needed was frontline delivery and the MHSDB was doing that. 3. A Board member thanked the Independent Chair (Surrey MHSDB) for his leadership and time spent on revitalising the work, she also acknowledged the Joint Executive Director of Adult Social Care and Integrated Commissioning’s (SCC and Surrey Heartlands ICS) contribution to progressing delivery. 4. A Board member was grateful to the Independent Chair (Surrey MHSDB) for the invitation to join the MHSDB, she noted that the draft terms of reference were comprehensive and she supported the work underway. She asked the Independent Chair (Surrey MHSDB) how he envisages the MHSDB would measure the success of all the workstreams and priorities. ... view the full minutes text for item 32/22 |
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A COUNTY-WIDE STRATEGY FOR HOUSING, ACCOMMODATION AND HOMES: BASELINE ASSESSMENT
This report outlines the background to and drivers for the initiation of a county-wide housing, accommodation and homes strategy and sets out the initial findings of a baseline assessment exercise, upon which key priorities and action will be derived, through a partnership-based, collaborative deliberation programme.
Additional documents: Minutes: Witnesses:
Michael Coughlin - Executive Director - Partnerships, Prosperity and Growth, Surrey County Council Sarah Haywood - Partnership and Community Safety Lead, Office of the Police and Crime Commissioner for Surrey
Key points raised in the discussion:
1. The Executive Director - Partnerships, Prosperity and Growth (SCC) noted that: · The report was prompted by a number of drivers including economic and health, many would be aware about the links between health and housing, workforce was a key issue and many employers were impacted by the housing market on the ability to recruit and retain staff. · The link between housing and security and mental health is well made, there are a number of links between the work of the Board and the wider health market and housing in general. · The report sets out the role of housing in health as embodied in the Adult Social Care White Paper that every decision about someone's care should be a decision about their housing. As a result, SCC had commissioned this strategic piece of work. · ‘A County-wide Strategy for Housing, Accommodation and Homes’ is broad in scope and includes an ambitious range of issues to address, acknowledging that the housing market is dynamic and complex both in terms of the private sector and social housing and social housing rents. · The approach being taken is to look at the broader issues, to seek to undertake desktop research analysis and over thirty face-to-face interviews had taken place with representatives from all aspects of the housing market and housing provision to achieve a ‘Baseline Assessment’, a summary of the findings is attached at Annex 2 including the top strategic themes. · The focus is on county-wide strategic issues as opposed to local site specific or housing related policies or service issues at the local level and it does not take on matters that are the statutory responsibilities of others other than influencing and building the evidence work already undertaken. · The purpose of the ‘Baseline Assessment’ is to then test that approach to provide assurance that the key relevant issues within housing have been captured, it was being taken to several different audiences to test and quality assure it in greater detail - providing confidence for the next stage. · The next stage of the process would be to hold themed deliberative workshops - Annex 3 - out of that deliberative piece of work over the next couple of months, the intention would be to create a broad strategy which would contain proposals for lobbying which would assist in addressing the issues in Surrey or individual or collective action that could be taken. · As shown in the findings, partnership is a key part of the strategy and that is why an item has come to the Board and would go elsewhere to engage a broader group of partners, acting collectively where possible to achieve better outcomes. · The findings and the strategic priorities would be taken to a summit on 8 December 2022, through a proposed panel discussion including questions and ... view the full minutes text for item 33/22 |
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EVALUATION REPORT FROM THE COMMUNITY SAFETY ASSEMBLY
In March 2020, the then Community Safety Board merged with the Health and Wellbeing Board. The overriding aim of the merger was to create a whole systems approach and develop a sense of shared priorities through collaborative working. Following a detailed evaluation report and analysis of the feedback from the Community Safety Assembly, the Health and Wellbeing Board is being asked for agreement to explore some initial areas of focus.
Additional documents: Minutes: Witnesses:
Lisa Townsend - Surrey Police and Crime Commissioner Sarah Haywood - Partnership and Community Safety Lead, Office of the Police and Crime Commissioner for Surrey Rachel Crossley - Joint Executive Director - Public Service Reform, Surrey Heartlands ICS and Surrey County Council
Key points raised in the discussion:
1. The PCC noted that: · The Community Safety Assembly (CSA) had its first meeting in May and she thanked all those who attended, there was a provisional date in November for the next meeting. · The issues that had been discussed in earlier items touch on policing as often people and those in our most vulnerable categories come into contact with policing in a non-crime context; she was grateful for the work of the Board and interest in this area. · Following the first meeting of the CSA an Evaluation Report was produced - Annex 1 - which includes recognisable themes and the Board is asked to agree to explore some of the initial areas of focus in order to deliver change such as around information sharing, knowledge, collaboration, leadership/strategic prioritisation and unseen communities. · The CSA wished to continue to give updates to the Board on the thematic areas, particularly around domestic abuse, serious violence and fraud, in order to start to consider what actions could be taken to help the vulnerable. 2. The Partnership and Community Safety Lead (OPCC) noted that work was underway and links were being made and opportunities shared, she welcomed the collaboration with the Priority Three Sponsor and inclusion on the Prevention and Wider Determinants Board; noting a recent meeting on how to share information on the policing and community safety side with frontline professionals and what they are looking out for when they go into someone's home such as spotting the signs of exploitation and fraud. The next steps and recommendations were about working collaboratively to remove the blockages around the themes identified. 3. The Joint Executive Director - Public Service Reform (Surrey Heartlands ICS and SCC) linked in the information sharing theme with the Surrey-wide Data Strategy, the Chief Constable of Surrey Police chaired the steering group ensuring a broader view outside of health and social care. Whilst reports would continue to be brought to the Board, the steering group was having discussions about how to bring more partners in whilst being mindful about the ethical issues. 4. The Chairman noted the prominence of mental health concerning the Evaluation Report and that the Board would consider collectively how to drive forward community engagement via a future Board report on the Community Safety Agreement Implementation Plans.
RESOLVED:
Following a detailed evaluation report and analysis of the feedback from the Community Safety Assembly, the Health and Wellbeing Board provided agreement to explore some initial areas of focus:
· Explore the information sharing culture in Surrey and seek to promote a clear set of principles. · Develop the Healthy Surrey website further as a portal for professionals to access resources in supporting individuals and communities. · Increase the representation at the Health ... view the full minutes text for item 34/22 |
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SURREY PHARMACEUTICAL NEEDS ASSESSMENT (PNA) 2022
The purpose of this paper is to present key aspects of the Surrey PNA 2022, including its recommendations, to the Board for final approval and to seek agreement to its publication no later than 1 October 2022. Additional documents: Minutes: Witnesses:
Tom Bourne - Public Health Analyst Team Lead, Surrey County Council Ruth Hutchinson - Director of Public Health, Surrey County Council
Key points raised in the discussion:
1. The Public Health Analyst Team Lead (SCC) noted that: · Board members had sent through comments on the draft Pharmaceutical Needs Assessment (PNA) in advance following a four-week review period - which had been incorporated. · Every Health and Wellbeing Board nationally has a statutory responsibility to look at pharmaceutical need in their area and to publish and keep the PNA up to date. · The PNA is used for a range of legal and commissioning responsibilities and is updated every three years and there had been an extension to that three-year period because of the Covid-19 pandemic. · The national regulations set out the content and requirements of the PNA, the PNA was fully compliant with that and those regulations. · The Board delegated responsibility for the oversight and production of the PNA to the PNA Steering Group which had met regularly since last year. · Two positive aspects of the PNA drafting process in line with the process set out by the Department of Health and Social Care was that: the PNA Steering Group had gone beyond the minimum expectation of the regulations through carrying out extensive surveys with the public and providers, an extended version of the questionnaire was circulated to the targeted population groups and those in key neighbourhoods; there had also been a 60-day consultation with the public and the draft PNA had been circulated to the required organisations and it was shared additionally with the place-based leads and chief pharmacists, and was shared with neighbouring authorities. · Six quality concerns from members of the public outside the scope of the consultation had been received and were listed in the PNA and where possible those were sign-posted to a point of escalation. Those qualitative responses are aired at the Board meeting and are not verifiable. · The PNA Steering Group recognised that for some groups service provision is not equal across all populations, but in making a PNA conclusion reference must be made to the regulations which asks for specific statements and the need to look at the full body of evidence; the conclusions being that there are no gaps in necessary services, there was no consistent identification of additional pharmaceutical services and the locally commissioned services provided an improvement to provision. · The Board is asked to approve the final draft of the Surrey PNA and for it to be published on the Surrey-i website shortly, the PNA would last three years from 1 October 2022 to 30 September 2025. · The PNA Steering Group would revisit the PNA annually and would publish a supplementary statement taking into account new housing developments, increases in population and feedback from providers. 2. A Board member noted that it was a fantastic and comprehensive piece of work, she understood how it connected with her unlike the previous PNA and she wondered why the Board receives it for sign-off ... view the full minutes text for item 35/22 |
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BETTER CARE FUND PLAN 2022-2023: NARRATIVE AND FINANCIAL PLAN
This report is the Better Care Fund (BCF) Plan for 2022-2023. Guidance for the plan was published by NHSE in August 2022 and, following consultation with the Local Joint Commissioning Groups and data managers across Surrey, this plan has been developed and is for the Board’s approval. Additional documents: Minutes: Witnesses:
Jonathan Lillistone - Assistant Director - Commissioning, Surrey County Council
Key points raised in the discussion:
1. The Assistant Director - Commissioning (SCC) noted that: · The Board was asked to approve the Better Care Fund (BCF) Plan Narrative and Financial Plan 2022-23 and the report references the ongoing work underway around the review of the BCF and early update report which came to the June Board meeting. · The report sets out how the BCF is approached and managed in Surrey and with its partners, it sets out the priorities and several examples of how it is deployed and it draws linkages with wider pieces of work with health partners in terms of helping to deliver the Surrey Heartlands ICS’s ‘Critical Five’ and the findings of the Fuller Stocktake. · The report notes the importance of the district and borough councils as key delivery partners for many aspects of the BCF services. 2. The Chairman noted that the sign-off was a statutory responsibility of the Board and he noted that he had asked that in future that the Board does get an opportunity to look at the BCF Plan in more detail and at an earlier stage. He noted that as a result of the creation of the ICSs it was likely that there would be an expansion of the use of the BCF and also Section 75 agreements. 3. A Board member highlighted the increased scrutiny around the BCF given the tightening around the finances and the importance on the joint working in place over the next year, more time for scrutiny would be needed particularly as changes happen. 4. A substitute Board member noted that one of the things that was new for the BCF this year was an exploration around the demand and capacity concerning intermediate care services, whilst the inclusion of that area was not mandated for the submission she noted that it was a useful piece of work which should be undertaken across Surrey and she asked for that piece of work to be followed up and to note that it was being considered in the context of the BCF. - The Assistant Director - Commissioning (SCC) noted that he was happy to pick up that suggestion through the BCF review work and would liaise with the substitute Board member.
RESOLVED:
That the Health and Wellbeing Board approved the Better Care Fund (BCF) Plan for 2022-2023 (Annex 1 and 2).
Actions/further information to be provided:
1. The Assistant Director - Commissioning (SCC) will liaise with officers to ensure that the Chairman’s request to receive the BCF Plan in more detail and at an earlier stage is taken forward. 2. The Assistant Director - Commissioning (SCC) will follow up the suggestion made by the substitute Board member (Nicola Airey) around undertaking a piece of work across Surrey exploring the demand and capacity concerning intermediate care services, particularly in the context of the BCF.
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INTEGRATED CARE SYSTEMS (ICS) UPDATE
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.
Additional documents: Minutes: Witnesses:
Professor Claire Fuller - Chief Executive, Surrey Heartlands ICS Nicola Airey - Executive Place Managing Director, NHS Frimley, Surrey Heath Place
Key points raised in the discussion:
1. The Chief Executive (Surrey Heartlands ICS) noted that the Surrey Heartlands Integrated Care Partnership would be meeting for the third time as a statutory body after the Board meeting and would be discussing the production of the Integrated Care Strategy, building on the work started by the Board and linking to its priorities. 2. The Chairman noted that there was a piece of work underway at the national level around the interaction between the Health and Wellbeing Board and the ICS, as in some areas where there is a coterminous footprint it is often the same people making similar decisions. 3. The Executive Place Managing Director (NHS Frimley - Surrey Heath Place) noted that the Frimley Integrated Care Partnership would be meeting for the first time tomorrow. She noted that all the executives within the Integrated Care Board were now in place. She noted that some of the place-based roles were being changed around so she would gradually be moving from Surrey Heath into Bracknell, her incoming replacement has portfolio leads on children, young people and learning disabilities. She noted that this Board meeting might be her last so she noted her thanks to the Board.
RESOLVED:
That the Board noted the updates provided on the recent activity within the Surrey Heartlands and Frimley Integrated Care Systems (ICS) regarding the Integrated Care Partnerships and Integrated Care Boards.
Actions/further information to be provided:
None.
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DATE OF THE NEXT MEETING
The next meeting of the Health and Wellbeing Board will be on 21 December 2022. Additional documents: Minutes:
The date of the next public meeting was noted as 21 December 2022.
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