Agenda and minutes
PDF 437 KBVenue: Woodhatch Place, 11 Cockshot Hill, Reigate, Surrey, RH2 8EF
Contact: Amelia Christopher Email: amelia.christopher@surreycc.gov.uk
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APOLOGIES FOR ABSENCE
To receive any apologies for absence and substitutions. Additional documents: Minutes: Apologies were received from Rachael Wardell - Tina Benjamin substituted, Fiona Edwards - Tracey Faraday-Drake substituted, Tim De Meyer - Gemma Morris substituted, Kate Scribbins - Deborah Mechaneck substituted (remote), Professor Claire Fuller - Karen McDowell substituted, Jason Gaskell - Michelle Blunsom MBE substituted, Joanna Killian - Rachel Crossley substituted, Lisa Townsend - Alison Bolton substituted, Carl Hall, Jason Halliwell, Liz Bruce, Dr Pramit Patel, Jo Cogswell (remote), Liz Williams (remote), Kate Barker (remote), Siobhan Kennedy (remote).
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MINUTES OF PREVIOUS MEETING: 15 MARCH 2023
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: Regarding item 10, it was noted that the borough and district council representatives’ councils were beneficiaries of the Better Care Fund.
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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 (15 June 2023).
Additional documents: Minutes: None received.
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Public Questions
The deadline for public questions is seven days before the meeting (14 June 2023).
Additional documents: Minutes: None received.
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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 Health and Wellbeing Strategy (HWB Strategy) as of 30 May 2023. The Board is also asked to note the disbanding of the Surrey Local Outbreak Engagement Board.
Additional documents: Minutes: Witnesses:
Karen Brimacombe - Chief Executive, Mole Valley District Council (Priority 1 Sponsor) Adam Letts - Public Health Lead, SCC Kate Barker - Joint Strategic Commissioning Convener, SCC and Surrey Heartlands (Priority 2 Co-Sponsor) Phill Austen Reed - Principal Lead – Health and Wellbeing, SCC Mari Roberts-Wood - Managing
Director, Reigate and Banstead Borough Council (Priority 3
Sponsor)
Key points raised in the discussion:
Priority 1
1. The Priority 1 Sponsor chose to focus on the Surrey Breastfeeding Strategy 2023-2028 which was important in terms of supporting the Priority. 2. The Public Health Lead (SCC) provided an update on the refreshed Breastfeeding Strategy as outlined ‘In the Spotlight’ section which aimed to improve breastfeeding initiation and continuation rates, he added that the detail around changes implemented was included in the action plan; partnership work would be led by the Breastfeeding Strategic Group. It was recognised that not all parents want to or can breastfeed, acknowledging and respecting that was important. Partners were encouraged to champion breastfeeding as a public health priority.
Sue Murphy joined the meeting at 2.11 pm.
3. The Chair asked whether the Breastfeeding Strategy had a toolkit and communications package. The Public Health Lead (SCC) noted that such information was included within the action plan, which would be implemented gradually over five years; communications and engagement was a key theme. 4. A Board member noted that the benefits were outlined in relation to the infant and mother in terms of breast and ovarian cancer, and enhanced attachment. Noting that there remained social stigma around breastfeeding, she asked whether there could be more emphasis on the wide range of benefits to mother and child such as breastfeeding’s effect on countering post-natal depression and mental health; to increase that uptake in those lower socioeconomic groups. The Public Health Lead (SCC) welcomed that important point which had been considered at the Breastfeeding Strategic Group, linking closely with mental health specialists and was factored in as peer and general support using the trauma informed approach. 5. The Chair noted the important point made above around cultural attitudes to breastfeeding and asked whether discussions had taken place with cultural and minority groups, and whether they were involved in the action plan; she requested a copy of the action plan. The Public Health Lead (SCC) confirmed that those groups were being engaged with, the action plan had been widely distributed and partners included the Birth to Five Years Community Health Partnership and Maternity and Neonatal Voices Partnerships, and Surrey Minority Ethnic Forum. Other smaller projects were underway relating to certain population groups in Surrey focusing on the continuation rates. 6. The Chair referred to the ‘Challenges this quarter’ section and asked whether the two leads that left had been replaced and whether there was a risk to delivery. The Vice-Chair explained that the cardiovascular lead - two sessions a week - was replaced three weeks ago, the respiratory lead - one session ... view the full minutes text for item 14/23 |
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HEALTH AND WELLBEING STRATEGY SUMMARY IMPLEMENTATION PLAN JUNE 2023
This report provides the latest summary of the programmes engaged in implementing the Surrey Health and Wellbeing Strategy. Additional documents: Minutes: Witnesses:
Ruth Hutchinson - Director of Public Health, SCC Phill Austen Reed - Principal Lead – Health and Wellbeing, SCC
Key points raised in the discussion:
1. The Director of Public Health (SCC) noted that: - the update provided the high-level detail of the delivery of the programmes, working closely with the Senior Responsible Officers (SROs) to ensure alignment with the Priority Populations and Key Neighbourhoods; and ensuring impact on the ground to improve health inequalities. - attention was given to the programmes where there could be a collaborative focus and it was recognised that there were other programmes underway across the health and care systems which had an impact on the three Priorities. 2. The Principal Lead – Health and Wellbeing (SCC) noted that: - the Summary Implementation Plan set out the leads and partners engaged with on the 41 programmes so the risks could be identified and addressed; a logic model was used to understand the inputs and the outputs on the desired outcomes within the Strategy and resources targeted to maximise impact. - the impact indicators for the Priority Populations were being developed as part of the draft Health and Wellbeing Index and the next phase would go online in September; having stronger engagement with the SROs would be vital to understand whether the programmes were actively engaging with and targeting those Priority Populations and Key Neighbourhoods. - Priority 1: there were mechanisms to go back and ask further questions on the impact indicators and related programmes, to understand what impact was being had. Some of the indicators and related programmes in italics were earlier in their engagement and that had galvanised collective action such as the implementation of the End of Life Strategy. - Priority 2: there were connections and overlapping impacts between the programmes in terms of the outcomes such as isolation which was linked to the Green Health and Wellbeing programme and the Mental Health Investment Fund; it was expected that there would be more programmes supporting Voluntary, Community and Social Enterprise partners to help reduce isolation. - Priority 3: the big shift in the refreshed Strategy last year was the focus on the wider determinants and the Summary Implementation Plan represented a clearer picture of the touch points with the Growth Board and the Greener Futures Board, having joint conversations as well as drawing on the Community Safety Implementation Plans. - mobilising with partners in support of the programmes and formulating discussion points would be crucial to help overcome some of the challenges. - it was the first time that an outline could be included on the Health in All Policies (HiAP) approach, of which the related programmes cut across the three Priorities; to be reported back to the Board via the Highlight Reports. - engagement had been had with the sub-boards and the SROs, and the Board would receive an update every twelve to eighteen months on the progress. 3. A Board member noted that she could not see performance ... view the full minutes text for item 15/23 |
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COMMUNITY SAFETY ASSEMBLY AND IMPLEMENTATION PLANS
This short paper updates the Health and Wellbeing Board members on the developments under the Priority 3 outcome – ‘People are safe and feel safe’ - and in particular presents the Terms of Reference for the Community Safety Assembly and the proposed implementation plans. Additional documents: Minutes: Witnesses:
Sarah Haywood - Partnership and Community Safety Lead, Office of the Police and Crime Commissioner for Surrey
Key points raised in the discussion:
1. The Partnership and Community Safety Lead (OPCC) noted that: - she welcomed the Board’s comments on the Community Safety Assembly’s updated Terms of Reference, to be signed off by the Assembly in November. 2. The Chair noted that she alongside many Members and residents had a problem with understanding what counted as anti-social behaviour, having looked up the Anti-Social Behaviour Action Plan she did not sense its alignment with the report. She noted the need to understand how the Plan was integrated, noting that she needed to understand who was taking ownership or the responsibility over anti-social behaviour and to communicate that across the county. 3. Responding to the Chair, the Partnership and Community Safety Lead (OPCC) noted that: - the Implementation Plans sat under the Community Safety Agreement and then fed into the Strategy Implementation Plan, particularly Priority 3. - the four work programmes within the Implementation Plans were topical: serious violence, domestic abuse, violence against women and girls, and anti-social behaviour; there were lots of collaborative opportunities within those. - there were pieces of work underway nationally through pilot areas looking at the Government’s Anti-Social Behaviour Action Plan, local implementation would follow from the results of those pilots. - it was sometimes difficult for residents and communities to understand who to report anti-social behaviour complaints to, as in the absence of criminality it would not always be the police. She would liaise with the SRO to ensure that within the action plan there would be clarity on the correct responder. - a recent survey of victims’ and residents’ perception and feeling of what anti-social behaviour looked like in Surrey’s communities had been undertaken; the results of that needed to be triangulated against the data from practitioners and frontline officers; to target resources to the right areas. - updates would be provided to the Board on the four work programmes within the Implementation Plans, for example violence against women and girls was on the agenda for the July informal Board meeting. 4. A Board member noted that regarding the vision for anti-social behaviour in terms of the aim to continue to improve the understanding and response to incidents, it would be helpful to have a baseline of how effective the current response was. At a recent Thriving Communities Board in Stanwell the Police Community Support Officers present noted that they struggled to respond because they did not have the capacity. In terms of resourcing, she asked about how practical the Implementations Plans were on the ground noting that it would be important to have a holistic perspective, including for example preventative work in terms of community groups to occupy young people. 5. A Board member queried whether the Community Safety Assembly meeting twice a year would be sufficient to address issues and follow up actions promptly. He paraphrased from the report which noted ... view the full minutes text for item 16/23 |
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SURREY WIDE DATA STRATEGY - UPDATE
This paper aims to provide an update to the Board on the current progress and implementation for the Surrey Wide Data Strategy, as well as providing an insight into the challenges faced at this time.
Additional documents: Minutes: Witnesses:
David Howell - Joint Director for Strategic Insight and Analytics, Surrey Heartlands ICS Sarah Haywood - Partnership and Community Safety Lead, OPCC
Key points raised in the discussion:
1. The Joint Director for Strategic Insight and Analytics (Surrey Heartlands ICS) noted that: - the Surrey Wide Data Strategy sought to address the key challenges around data across the system, it was composed of four components: purpose, infrastructure, people, and opportunity; he would focus on the last three. - data and services were fragmented and needed to be integrated and joined up avoiding repetition and delays; there was a need to better understand the Priority Populations and health inequalities. - Infrastructure: a significant piece was underway to develop the Integrated Digital and Data Platform, which would deliver shared analytical capabilities for different use cases across the system: direct care, and secondary uses around performance assurance and wider analytical capabilities, Population Health Management, and research. Several business cases had been developed, providing more granularity and costings. - People: Surrey Office of Data Analytics (SODA) sought to solve key problems faced by the system, a use case for serious violence had been identified and towns development was ongoing. The focus was on prevention spend mapping and how that could be supported. - Opportunity: the Hewitt Review looked at how systems used data and work was underway to implement those recommendations and it provided the backing for funding around people and infrastructure, expanding capabilities. 2. The Partnership and Community Safety Lead (OPCC)thanked the report author for including serious violence within SODA’s work, which would result in a detailed needs assessment. 3.
The Chair noted that measuring, monitoring, and
reporting the impacts of projects, and data collection, use and
sharing, threaded through the upcoming agenda items as well as the
Joint Strategic
Needs Assessment (JSNA) and the Surrey Index. She queried
whether the architecture was robust and whether there was the
funding, capacity and staffing now to deliver all the strategies
and programmes throughout their duration. She asked whether the
organisations were able to provide the requested data. The Joint
Director for Strategic Insight and Analytics (Surrey Heartlands
ICS) explained that regarding the Infrastructure programme, the
work underway could be used to target the four use case areas,
investing and ensuring that they would be fit for purpose
system-wide. Regarding the Opportunity programme, the Full Business
Case would set out the funding required as a result of the
recommendations from the Hewitt Review. Regarding the People
programme, there were good skills across the system but there was a
shortfall in specific areas like data sciences. Sinead Mooney left the meeting at 3.31 pm.
RESOLVED:
1. Noted the progress that has been made to date across the system. 2. Ensured that the direction of travel and progress being made by the teams are in line with the views of the Health and Wellbeing Board membership. 3. Provided feedback and recommendations on the highlighted areas of challenge being faced at this time.
Actions/further information to ... view the full minutes text for item 17/23 |
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MENTAL HEALTH IMPROVEMENT PLAN - UPDATE
The Mental Health Improvement Plan (MHIP) is the Surrey system’s response to the 19 recommendations of the May 2021 report “Emotional wellbeing and mental health in Surrey: A review of outcomes, experiences and services”. The 19 recommendations describe how we can improve the services and support which we provide to our residents and promote their mental health and emotional wellbeing. The plan has been reset into four programmes the detail of which, with brief updates, is included in this report.
Additional documents: Minutes: Dr Charlotte Canniff and Rachel Crossley left the meeting at 3.33 pm.
Witnesses:
Liz Williams - Joint Strategic Commissioning Convener, SCC and Surrey Heartlands (Priority 2 Co-Sponsor)
Key points raised in the discussion:
1. The Joint Strategic Commissioning Convener (SCC and Surrey Heartlands) (Priority 2 Co-Sponsor) noted that: - the report outlined the progress of the four programmes and was a shortened version than that reported to the recent Adults and Health Select Committee. - Early Intervention and Prevention: that was well integrated into Priority 2 as covered in items 5 and 6. - Bounce and Access: she was a joint SRO and had worked closely with Unity Insights on the logic model and evaluation framework to be discussed and reviewed imminently, and with the Independent Mental Health Network run by the Surrey Coalition of Disabled People who co-designed the definition of Bounce using lived experience. In terms of monitoring and evaluating impacts, programmes were being mapped to highlight any gaps. - Crisis and Flow: since October 2022, led by colleagues in SABP, focusing on improving flow and discharge, and admission avoidance. - Enablers and Culture: as with SODA, there was a commitment to having the right data and analytics, the Surrey Hackathon Project had been convened. Transformation happening outside of the MHIP, such as the NHS Long term Plan and recovery work needed to be combined. - there were significant gaps in projects and programme resourcing around Bounce and Access, she was solely working on that and Unity Insights would finish their work in late June; the Joint Executive Director of Adult Social Care and Integrated Commissioning (SCC and Surrey Heartlands ICS) was working with system colleagues on the matter. 2. A Board member thanked the Priority 2 Co-Sponsor for all her hard work noting that in the absence of a mental health convener she was undertaking that role in addition to her current role. He noted that resourcing and funding was the biggest problem faced by the system and that needed to be addressed. 3. The Chair noted that mental health funding had been slashed, she had in her former role as Chair of the Adults and Health Select Committee asked for an impact assessment but had not received it. There were also impacts on the NHS in terms of physical ramifications of not handling mental health. She stressed the need to understand the impacts caused system-wide of funding cuts to mental health; with the judiciary, other organisations and the third sector having to face the consequences. She welcomed partners being able to supply that information to explain the full impact of not properly resourcing mental health. A Board member responded that in the health arena plans sent to NHSE were being finalised, any changes in programmes of work would go through equality impacts analysis, an aggregate form of that would be provided to the Board. 4. The Chair noted that in taking an amount of money from a cohort not being serviced for their mental health issues, ... view the full minutes text for item 18/23 |
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BETTER CARE FUND (BCF) PLAN 2023-25 AND BCF END OF YEAR REVIEW 2022/23
The Board is asked to approve the proposed Surrey 2023-25 Better Care Fund (BCF) Plan. The Adult Social Care Discharge Fund is incorporated into the BCF Plan for the first time this year. The BCF Plan has been developed in collaboration with partners across the system and represents the Surrey plan for resource allocation and outcome delivery.
Additional documents: Minutes: Witnesses:
Jonathan Lillistone - Assistant Director – Commissioning, SCC Karen McDowell - ICS Chief Operating Officer, Surrey Heartlands ICS
Key points raised in the discussion:
1. The Assistant Director – Commissioning (SCC) highlighted that: - the review of last year's Better Care Fund (BCF) set out the metrics and delivery and it had been submitted to NHS England (NHSE). - the current two-year BCF Plan was welcomed compared to previous one-year plans due to late national guidance. The report set out the systematic engagement with partners around developing the plan and priorities for 2023-2025, metrics and financial allocations; with more rigorous monitoring. NHSE feedback was included and changes were integrated around the use of additional discharge grant funding, as well as an additional narrative on the metrics and trajectory. - Annex 2: BCF Planning Template 2023-25 was the final and not a draft version, within that spreadsheet there was a technical error which NHSE was aware of regarding some of the tabs indicating red and incomplete.
Dr Russell Hills left the meeting at 3.54 pm.
2. The Chair asked how the BCF Plan would address the ‘wicked problems’ faced by the system as noted in item 11, as the BCF was spending the money on the initiatives. The Assistant Director – Commissioning (SCC) acknowledged the connection between the two, noting that the BCF linked closely with the Health and Wellbeing Priorities, particularly around prevention under Priority 2, discharge to assess and system transformation were linked. He noted that within the various schemes funded by the BCF, many were key contributors to delivering wider strategic priorities. The ICS Chief Operating Officer (Surrey Heartlands ICS) noted that there was alignment, it would be vital to ensure that the initiatives or schemes being invested in by the BCF would have an impact on the ‘wicked problems’ within the Joint Forward Plan.
Denise Turner-Stewart and Tina Benjamin left the meeting at 3.57 pm.
RESOLVED:
1. Approved the proposed 2023-25 BCF Plan (including Planning Narrative and Planning Template) 2. Noted: i. 2022/23 BCF Review which was submitted to NHSE on 23 May following delegated authority by HWB Board Chair. ii. Integrated Care Board (ICB) Additional Discharge Templates for Surrey Heartlands and Frimley Health and Care – both submitted to NHS England on 19 May 2023. iii. BCF Strategy Workshop next steps actions (from 3 March 2023) 3. Recommended that a Section 75 agreement* between Surrey County Council and Surrey Heartlands ICB should be developed, based on the BCF Plan, for approval by the Surrey-Wide Commissioning Committees in Common (CIC). 4. Recommended that a Section 75 agreement* between Surrey County Council and Frimley ICB should be developed, based on the BCF Plan, for approval by CIC.
*Section 75 agreements are made between local authorities and NHS bodies and can include arrangements for pooling resources and delegating certain NHS and local authority health-related functions to the other partner/s.
Actions/further information to be provided:
None.
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SYSTEM PLANNING: SURREY HEARTLANDS DRAFT JOINT FORWARD PLAN (JFP) 2023 - 2028
Surrey Heartlands Integrated Care System (ICS) Strategy, which draws on the Surrey Health and Wellbeing strategic priorities, was agreed by the Integrated Care Partnership in December 2022. The Joint Forward Plan is the five-year strategic delivery plan for the ambitions set out in the ICS strategy.
Additional documents: Minutes: Mari Roberts-Wood left the meeting at 3.59 pm.
Witnesses:
Karen McDowell - ICS Chief Operating Officer, Surrey Heartlands ICS
Key points raised in the discussion:
1. The ICS Chief Operating Officer (Surrey Heartlands ICS) noted that many Board members had been involved in the production of the draft five-year Joint Forward Plan (JFP), she highlighted that there had been multiple engagement sessions with partners and deep dives. She noted that the JFP was aligned to the Health and Wellbeing Strategy Priorities and the Integrated Care Strategy; and it would be published on the Surrey Heartlands website. She noted that the deadline date for submission was 30 June, it had been reviewed and approved by several boards including the Integrated Care Partnership (ICP).
RESOLVED:
1. Noted the near-final draft Joint Forward Plan and its alignment with Surrey’s Health and Wellbeing priorities and strategic approach. 2. Would provide an opinion of the plan. 3. Noted that the annual update of the plan would be provided in March 2024.
Actions/further information to be provided:
None.
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SYSTEM PLANNING: FRIMLEY DRAFT JOINT FORWARD PLAN (JFP) 2023 - 2028
The Frimley Integrated Care System (ICS) Strategy, which aligns with the Surrey Health and Wellbeing strategic priorities, was agreed by the Integrated Care Partnership in May 2023. The Joint Forward Plan is the five-year strategic delivery plan as agreed between the NHS organisations within the Frimley ICS geography.
Additional documents: Minutes: Witnesses:
Tracey Faraday-Drake - Director for Children and Young People and All Age Learning Disabilities and Autism / Place Convenor for Surrey Heath, NHS Frimley ICB
Key points raised in the discussion:
1. The Director for Children and Young People and All Age Learning Disabilities and Autism / Place Convenor for Surrey Heath (NHS Frimley ICB) noted that the draft Joint Forward Plan had been agreed at the Frimley ICB yesterday.
RESOLVED:
1. Noted the near-final summary presentation of the draft Joint Forward Plan and its alignment with Surrey’s Health and Wellbeing priorities and strategic approach, and would provide informal feedback. 2. Noted that the annual update of the plan would be provided in March 2024.
Actions/further information to be provided:
None.
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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:
Karen McDowell - ICS Chief Operating Officer, Surrey Heartlands ICS Tracey Faraday-Drake - Director for Children and Young People and All Age Learning Disabilities and Autism / Place Convenor for Surrey Heath, NHS Frimley ICB
Key points raised in the discussion:
1. No comments were made.
RESOLVED:
1. Noted 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.
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 20 September 2023. Additional documents: Minutes: The date of the next public meeting was noted as 20 September 2023. Prior to that there would be an informal Board meeting in July.
The Chair noted that public Board meetings would revert to two hours to enable more discussion on items.
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