Agenda and draft minutes

Health and Wellbeing Board - Wednesday, 20 September 2023 2.00 pm

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

Contact: Amelia Christopher 

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24/23

APOLOGIES FOR ABSENCE

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    To receive any apologies for absence and substitutions.

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    Minutes:

    Apologies were received from Jason Gaskell - Becky Whale substituted, Fiona Edwards - Tracey Faraday-Drake substituted, Tim De Meyer - Gemma Morris substituted, Joanna Killian - Michael Coughlin substituted, Carl Hall - Tracey Kadir substituted (remote), Lisa Townsend - Lisa Herrington substituted (remote), Karen Brimacombe, Rachael Wardell, Karen McDowell, Dr Pramit Patel, Jo Cogswell, Liz Williams, Rosemarie Pardington, Siobhan Kennedy, Sinead Mooney, Balwinder Kaur (remote), Graham Wareham (remote), Professor Helen Rostill (remote), Sue Murphy (remote).

     

25/23

MINUTES OF PREVIOUS MEETING: 21 JUNE 2023 pdf icon PDF 368 KB

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    To agree the minutes of the previous meeting.

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    Minutes:

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

     

26/23

DECLARATIONS OF INTEREST

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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

     

    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.

     

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    Minutes:

    There were none.

27/23

QUESTIONS AND PETITIONS

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    Additional documents:

27/23a

Members' Questions

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    The deadline for Member’s questions is 12pm four working days before the meeting (14 September 2023).

     

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    Minutes:

    None received.

     

27/23b

Public Questions

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    The deadline for public questions is seven days before the meeting (13 September 2023).

     

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    None received.

     

27/23c

Petitions

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

     

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    Minutes:

    There were none.

28/23

HEALTH AND WELLBEING STRATEGY HIGHLIGHT REPORT pdf icon PDF 263 KB

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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) as of 29 August 2023. The Highlight Report provides an overview of activity against Health and Wellbeing Strategy’s Summary Implementation Plan projects and programmes, describes what has been achieved against the outcomes, how collaborative working has aided this progress and identifies new data and insights that have been released in the previous quarter. It also has a section on communication activity associated with the HWB Strategy’s priority populations and priorities and a section on the progress of the review of the Joint Strategic Needs Assessment (JSNA) and a section on the implementation of the Health in All Policies (HiAP) implementation plan.

     

     

    Additional documents:

    Minutes:

    Witnesses:

     

    Poppy Middlemiss - Public Health Speciality Registrar, SCC

    Kate Barker - Joint Strategic Commissioning Convener, SCC and Surrey Heartlands ICS (Priority 2 Co-Sponsor)

    Jane Hunt - Mental Health Investment Fund Manager, SCC

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

    Dan Shurlock - Customer and Communities Strategic Lead, SCC

    Key points raised in the discussion:

     

    1.    The Chair noted that there were several initiatives which had been piloted, she asked the Board to familiarise itself with those and the evaluation their impact. For example, the Green Health and Wellbeing programme cost £225 per person compared to the average of £493 for Improving Access to Psychological Therapies and had a higher level of success for the targeted cohort. The Chair noted that when discussing initiatives to be funded for example by the Better Care Fund there needed to be a real understanding about initiatives’ impact.

     

    Becky Whale joined the meeting at 2.09 pm.

     

    Priority 1

     

    2.    The Public Health Speciality Registrar (SCC) outlined the spotlight item: ‘A Smokefree Surrey’ noting that:

    ·         The Surrey Tobacco Control Strategy was refreshed based on more recent data and changes in national and local policy and emerging themes such as vaping; it had been widely consulted on with partners since January.

    ·         An action plan had been developed to deliver the four priorities, to be delivered by the Surrey Tobacco and Alcohol Control Alliance.

    ·         The Strategy’s launch would coincide with the national campaign ‘Stoptober’.

    ·         The recent 2022 prevalence of smoking data showed that Surrey increased to 11.9% compared to 7.8% in 2021; this increase was being looked at with the Office for Health Improvement and Disparities (OHID) to check the data’s reliability.

    3.    A Board member noted that smoking prevalence is higher in routine and manual workers, those with a long-term mental health condition, and those that used drug and alcohol services. To meet the ambition of ‘no one left behind’, smoking remained a focus, via the four priorities of the Strategy and action plan, she thanked all the partners that contributed to the Strategy.

    4.    The Chair referred to the communications, resourcing and financing behind the Strategy asking whether those were sufficient to reach the target audience of smokers. The Public Health Speciality Registrar (SCC) noted that whilst the Strategy was high-level, the detail was included in the action plan, for example the recommissioning the local stop smoking service will ensure it reaches the target audiences.

    5.    The Vice-Chair was interested in the increase of smokers in 2022 as that was a significant jump for Surrey and was similar to the UK prevalence; she asked whether smoking included vaping. The Public Health Speciality Registrar (SCC) noted that the Strategy did not include vaping. She noted that the variables could have been wrong, it might be an artificial increase due to OHID’s change in methodology during the Covid-19 pandemic, it was an estimate and had a wide confidence interval; that was being investigated further.

     

    Tracey Faraday-Drake joined the meeting at 2.17  ...  view the full minutes text for item 28/23

29/23

FINDINGS OF THE HWB MEMBERS SURVEY AND A REVIEW OF THE HEALTH AND WELLBEING BOARD'S TERMS OF REFERENCE pdf icon PDF 303 KB

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    This paper shares the findings of the survey that eleven of the thirty-two Health and Wellbeing Board (HWB) members responded to earlier in the year. The Board is also required to review its terms of reference regularly, hence the need to update the Board’s Terms of Reference (ToR) given that its membership and purpose have changed since the last review, with the refresh of the HWB Strategy and the Health and Care Act 2022. 

     

    This paper proposes recommendations to further develop the activities and operations of the Board based on the current board arrangements, the feedback of the members of Board received and the updated legislation and guidance that relates to Health and Wellbeing Boards. 

     

    Additional documents:

    Minutes:

    Witnesses:

     

    Olusegun Awolaran - Policy and Programme Manager (P3) - Health and Wellbeing, SCC

     

    Key points raised in the discussion:

     

    1.    The Chair noted that it was disappointing that only eleven of the thirty-two Board members responded to the HWB Members Survey, however she had spoken to a few others who did not respond and it appeared that the eleven responses reflected the consensus. The Board’s Terms of Reference (ToR) had been updated, based partly on the feedback provided, she welcomed further feedback.

    2.    The Policy and Programme Manager (P3) – Health and Wellbeing (SCC) noted that:

    ·         The HWB Members Survey asked Board members about their views about the Board’s activities and progression of the Health and Wellbeing Strategy.

    ·         Positives: respondents were well-engaged with the clear vision and mission of the Board, with prevention at its core; and they recognised the work that had been done to track progress.

    ·         Opportunities: for more work to be done to integrate priorities and outcomes in each of the Board members’ organisations; and the need to move investment upstream into prevention.

    ·         The Board’s ToR was refreshed to align with changes in the Board’s membership and purpose, the refresh of the Health and Wellbeing Strategy and the formation of the Integrated Care Board (ICB) and Integrated Care Partnership (ICP) under the Health and Care Act 2022. Board member feedback included: more time for discussion and to focus on items about reducing health inequalities, to continue to support a focus on progress being made alongside issues and challenges through the lens of Priority Populations including Key Neighbourhoods, and to utilise informal engagement.

    3.    A Board member referred to Section 3.3.8 of the ToR ‘ensure a focus on prevention and the movement of funding upstream in the system to facilitate this’. She noted that the Board already had a focus on prevention, she asked for a measure to be added to that to strengthen and quantify it, ‘significant increase’ in the focus on prevention for example, as the Board was not elevating its prevention work as much as it should be. The Chair agreed, noting that proactivity was needed emphasising the action to be taken by the Board; she would review that. 

    4.    The Chair noted that an aim was to use the channels the Board had more for example through the informal sub-committees and possible working groups to undertake deep dives looking at granular information. She noted that whilst discussions may be happening elsewhere, the Board brought together many organisations in one place to have a collective discussion; some smaller players on the Board did not always feel that the Board was discussing things that impacted on them. She stressed the need for all Board members to have an equal voice in discussions and to feel as though they could contribute and raise issues, with support provided by other Board members to use their connections and power to have joined-up discussions to resolve issues. She would follow that up.

    5.    A Board member noted that from  ...  view the full minutes text for item 29/23

30/23

HEALTH AND WELL-BEING STRATEGY INDEX pdf icon PDF 429 KB

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    At the March Health and Wellbeing Board, a prototype of the Index was demonstrated outlining the Index and demonstrating the development of impact metrics that will enable an understanding of how effectively we are delivering the HWB Strategy across its Priority Populations and Outcomes to reduce health inequalities. An update of the progression of this work is presented, outlining further features and additional geographic levels. 

     

    Additional documents:

    Minutes:

    Witnesses:

     

    Ruth Hutchinson - Director of Public Health, SCC
    Uma Datta - Assistant Director, Data and Insights, Public Service Reform, SCC

    Richard Carpenter - Senior Analyst, Data and Insights, Public Service Reform, SCC

     

    Key points raised in the discussion:

     

    1.    The Chair noted that the Priority Two architecture was there, but partners needed to supply the information so it could be populated.

    2.    The Director of Public Health (SCC) noted that the Health and Well-being Strategy Index aimed to enable an understanding of the long-term collective progress against the Strategy’s mission about reducing health inequalities through the three Priorities. Each Priority had agreed outcomes and the Index being publicly available ensured transparency to residents in whether the outcomes were reached; pulling out the data for the Priority Populations was a challenge. The Index was high-level, it focused on the long-term impact indicators therefore it did not contain the short/medium term indicators of the forty-one programmes against the three Priorities; progress on programmes was included in the Highlight Reports.

    3.    The Assistant Director, Data and Insights, Public Service Reform (SCC) noted that since the prototype was presented to the Board in March, the Index had developed and had been further populated. The Index was currently a view of the indicators across the priorities for which there was robust data available. The Index was live and could be viewed at two levels of geography currently.

    4.    The Senior Analyst, Data and Insights, Public Service Reform (SCC) provided a demonstration of the Index noting that:

    ·         It would be published on Surrey-i, the Index opened onto a welcome page which outlined its purpose. The two levels of geography currently were District - demonstrated in March - and now Ward, each with their own tab. They were working on the Primary Care Network geographies and other health-based geographies to be online by the beginning of October.

    ·         Accessing the District tab provided a scorecard for the eleven boroughs and districts in Surrey via the map. The scorecard provided the overall performance and ranking one to eleven, the performance of the three Priorities, the outcomes under the Priorities and the indicators within the outcomes. Zero was the worst score and one hundred the best score - from red to green via quintiles. The titles of the outcomes had been shortened due to the limited space; to be updated. Hovering over the coloured circles provide more detail on each indicator such as historical data/trends.

    ·         Accessing the Ward tab provided a scorecard for the 187 wards via the map or drop-down menu. There were fewer indicators at Ward level currently as much of the data was not yet added ; that was a work in progress and support was needed in terms of adding more to the Index. The ranking was from one to 187. For example, Court ward (Epsom and Ewell) did well on Priority One, outcome two and a few of the outcomes under Priority Three.

    ·         The Priority Populations tab included four indicators that has not  ...  view the full minutes text for item 30/23

31/23

OUR SURREY STORY - A COUNTY WIDE BRAND pdf icon PDF 252 KB

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    The purpose of this paper is to make the Board aware of the opportunity Our Surrey Story presents to help achieve health and wellbeing objectives in the county, and identify where it could best support delivery of these.

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    Minutes:

    Witnesses:

     

    David Stedman - Senior Brand and Marketing Manager, Our Surrey Story, SCC

    Michael Coughlin - Executive Director – Partnerships, Prosperity and Growth, SCC

     

    Key points raised in the discussion:

     

    1.    The Senior Brand and Marketing Manager, Our Surrey Story (SCC) noted that Our Surrey Story (OSS) was a brand for the county with the broad aim of promoting a positive image of Surrey to benefit its economy, environment, community and health and wellbeing goals. The OSS Board had its first meeting last week; he sought the Board’s input as to how it could add value to those goals.

    2.    The Chair asked what the original aim was when the OSS Board was set up, and who officers would be reaching out to as partners and how would they get that engagement. It was unclear what the objectives were, who would benefit from the brand other than Surrey and how the Board’s involvement would further the cause of OSS. The Senior Brand and Marketing Manager, Our Surrey Story (SCC) noted that the direction was not yet set so the exact target audience was undefined. Potentially the focus could be on increasing the desirability of Surrey as a place for investment/relocation of businesses related to life sciences, and/or could focus on natural spaces and the positive contribution to physical and mental health. The broad audience was the residents, businesses and organisations of Surrey.

    3.    As a supplementary question the Chair asked whether the brand should also seek to attract audiences outside of Surrey. The Senior Brand and Marketing Manager, Our Surrey Story (SCC) noted that Surrey was behind other areas that had their own place brands which focused on the economy and/or culture and/or civic pride. He sought guidance from different sectors within Surrey about what they would identify as their priorities in terms of how a Surrey-wide brand could add value to their work.

    4.    As a supplementary question the Chair asked what the method was of attaining that information from the Board, for example would there be a questionnaire. The Senior Brand and Marketing Manager, Our Surrey Story (SCC) was reluctant to have something as formalistic. The Chair requested a methodology and a timeline for the Board to engage with the process.

    5.    The Executive Director – Partnerships, Prosperity and Growth (SCC) explained that OSS emerged from a discussion with Surrey’s businesses questioning what Surrey meant to people inside and outside Surrey. From research undertaken a few years ago, unlike other counties people did not conjure up a specific image of Surrey or if they did it was ‘gin and Jaguars’ or a wealthy and older population. Part of the OSS work built upon that research work with stakeholders who largely aligned on three things that more accurately described the county: Surrey was energetic and vibrant in terms of innovation and leading thinking, it had an amazing natural landscape which enabled a good quality of life, and it was well-connected internationally, with Parliament, London, and Gatwick and Heathrow Airports.  ...  view the full minutes text for item 31/23

32/23

INTEGRATED CARE SYSTEMS (ICS) UPDATE pdf icon PDF 352 KB

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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.

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    Minutes:

    Witnesses:

     

    Dr Charlotte Canniff - HWB Vice-Chair and Joint Chief Medical 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.    The Vice-Chair provided an apology noting that the written report at December’s Board would fulfil the reports request to align with the update to the Health and Wellbeing Strategy. She provided a verbal update on Surrey Heartlands ICS, its integration work was driven at local place level - the ICB had monthly place deep dives - and at the ICS system level working on larger priorities. Focus areas were: Financial efficiency requirements as demand was outstripping resources especially in mental health, current industrial action which impacted on recovery and waiting times, driving recovery in access especially for integrated urgent care, mental health and primary care, and winter planning. The ICS’s strategic priorities: Prevention, Integrated Care and Enablers via the Joint Forward Plan build directly on the Health and Wellbeing Strategy priorities:

    ·         Priority 1 - she and the Director of Public Health (SCC) attended the Delivery Oversight Group, where they provided an update on the ICS prevention strategy and aligning the governance and finance.

    ·         Priority 2 - there had been a change in executive leadership, the renewed focus was on operational provision and delivery. There had been a review of business-as-usual work and a new transformative programme called the Mind and Body programme focused on crisis interface, linking to the ‘Right Care, Right Person’ approach.

    ·         Priority 3 - ICB deep dives into its places around the priority populations including the Key Neighbourhoods.

    2.    The Chair noted a past agreed recommendation at the Adults and Health Select Committee regarding the patient journey and that a representative sample needed to be taken to understand how waiting lists were affecting people in terms of their mental and physical health outcomes; delays were exacerbated due to Covid-19 and industrial action. She requested that the data be provided. The Vice-Chair would liaise with the Committee Manager (SCC) to find out the recommendation’s responsible owner and what the results were.

    3.    A Board member noted that an update on ‘Waiting Well’ had previously been provided to the Board by Healthwatch Surrey, she noted patients’ disinclination to make a fuss despite deteriorating health and being unsure what to do. She noted that Healthwatch Surrey would be interested in undertaking a joint piece of work about whether patients were being sufficiently well informed through their journey.

    4.    A Board member noted that from a Surrey Heartlands ICS perspective they were reassured when the National Elective Care Recovery team raised the profile of health inequalities in elective care, for example a four year old had been on the waiting list for more than half their life. Each ICS had a Children and Young People’s Elective Recovery programme, peer ICB approaches in South East England were being used to understand where the widest health  ...  view the full minutes text for item 32/23

33/23

DATE OF THE NEXT MEETING

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    The next meeting of the Health and Wellbeing Board will be on 14 December 2023.

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    The date of the next public meeting was noted as 14 December 2023 (Thursday).