Agenda and draft minutes
PDF 299 KBVenue: Woodhatch Place, 11 Cockshot Hill, Reigate, Surrey, RH2 8EF
Contact: Toby Nash
Media
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Apologies for Absence
To receive any apologies for absence and substitutions. Additional documents: Minutes: Apologies were received from Sam Burrows – Nicola Airey, Director of Places and Communities (Frimley ICB), substituted; Terence Herbert; Julie Llewelyn – Neelam Devesher, Chair of the Community Foundation for Surrey, substituted; Tim De Meyer – Sarah Graeme, Assistant Chief Constable, Surrey Police; and Rachael Wardell OBE. |
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Minutes of Previous Meeting: 11 December 2024
To agree the minutes of the previous meeting. Additional documents: Minutes: The minutes were agreed as a true record. |
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Appointment of Co- Chair The Chair, in his capacity as Leader of the Council, informed the combined meeting that Cllr Mark Nuti was to be appointed Co-Chair of the combined Health and Wellbeing Board and Surrey Heartlands Integrated Care Partnership. Cllr Mark Nuti would assume Chair of the meeting when the Chair was otherwise unable to attend. Additional documents: |
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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 (13 March 2025). Additional documents: Minutes: There were none. |
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Public Questions
The deadline for public questions is seven days before the meeting (12 March 2025). Additional documents: Minutes: There were none. |
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Petitions
The deadline for petitions was 14 days before the meeting. 1 petition was received. Additional documents: Minutes: 1 petition had been received and was discussed at item 5.
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Petition: Pharmaceutical Needs for Thames Ditton
The petition received requests that Surrey County Council's Health & Wellbeing Board and the NHS recognise the need for a pharmacy in Thames Ditton village itself (which until early 2024 had had a pharmacy for as long as residents can recall) regardless of any conclusions to the contrary which may be indicated in the draft Pharmaceutical Needs Assessment (PNA) due for publication in April 2025. Agenda item for Health and Wellbeing Board. Additional documents: Minutes: Speakers: Karen Randolph, petitioner Sian Bates, petitioner Cllr Tim Oliver OBE, Leader of the Council and Chair of the HWB and SH ICP Dr Louis Hall, Public Health Consultant Key points raised during the discussion: 1. The petitioners emphasised local pharmacies’ role in providing accessible healthcare services and advice for minor ailments. 2. The combined electronic and paper petitions had 1200 signatures. 3. The petitioners requested the Pharmaceutical Needs Assessment (PNA) steering group reconsider its conclusion that there were no gaps in pharmaceutical services. 4. The Public Health Consultant noted the petition response. The response highlighted that applications to enter the pharmacy market must be submitted to the Pharmaceutical Services Regulation Committee of Surrey Heartlands Integrated Care Board (ICB). In receiving them, the Committee could consider applications where unforeseen benefits were identified even if not noted in the PNA. 5. Surrey Heartlands ICB had confirmed that no application had been received to open a pharmacy in Thames Ditton. 6. It was emphasised that the Health and Wellbeing Board did not decide pharmacy applications but was consulted for comment only when submitted. 7. The petitioners requested that the Health and Wellbeing Board acknowledge the petition’s statement of unmet need to be used to support any submitted pharmacy market application(s), which the Chair acknowledged. 8. The petitioners and Board discussed inviting and submitting applications to open pharmacies. The Public Health Consultant confirmed that applicants could gain support when putting forward an application. Resolved: That the petition was noted. Actions/further information to be provided: None. |
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Community Safety Partnership Update
An update from the Office of the Surrey Police and Crime Commissioner on the formation of the Community Safety Partnership. Agenda item for HWB. Additional documents: Minutes: Speakers: Sarah Haywood, Serious Violence Programme Lead (Office of the Police and Crime Commissioner (OPCC)) Key points raised during the discussion: 1. The Serious Violence Programme Lead (OPCC) updated the Board on the mobilisation of the Community Safety and Prevention Board (CSPB). 2. As reported in December, the CSPB would assume strategic oversight of Community Safety from the Health and Wellbeing Board. 3. A working group had considered the structure and membership which would be detailed in the Terms of Reference. 4. There was an ambition to streamline the governance structures related to community safety and unite strategic leaders under one Board. 5. Various operational Boards would come under the oversight of the CSPB. 6. Consultation had emphasised maintaining place-based work. 7. Focus would be on data and intelligence to inform strategic direction. 8. Opportunities were expected around co-commissioning and responding to Government initiatives. 9. Nine pieces of legislation had been identified by the Working Group as underpinning the CSPB’s work. 10. CSPB membership was generated from bodies identified by the legislation. Subject matter experts would be invited to meetings as appropriate. 11. A gap was identified for an Integrated Care Partnership representative, and one was requested to be put forward. 12. A member of the Board noted that although the CSPB name included community, the only partners identified were statutory services. Concern was raised that the public would want representatives on the CSPB. The Serious Violence Programme Lead agreed to relay to the working group. 13. The Serious Violence Programme Lead noted Surrey’s 11 place-based community safety partnerships (CSPs) contained community voices which were listened to and valued. However, concern was raised that this would filter community voices, and the strategic Board would lack lived experience. 14. The Chair noted that there was no formal feedback from the place-based CSPs to the (OPCC). 15. A Board member urged aligning the CSPB’s strategic objectives with those of the Children’s and Adult’s Safeguarding Boards. 16. The Vice-Chair (Health and Care) asked whether the new governance structure would identify unwarranted variation in delivery or outcomes at a local level. The Serious Violence Programme Lead noted a lack of strategic thinking on Community Safety which the CSPB would address through a data-based approach. 17. The Vice-Chair (Health and Care) encouraged adoption of language referencing towns and villages, priority populations, and key neighbourhoods to demonstrate a common, shared system, approach by partners. The Serious Violence Programme Lead noted this and would feed it back to the working group. 18. The Chair noted that local government reorganisation would likely lead to the OPCC being absorbed into the Strategic Mayoral Authority, cautioning that the structure would need to evolve with reorganisation. 19. A Board member stressed not losing focus on antisocial behaviour and community harm, which impacted perceived safety of the community. 20. The Board discussed including further lived experience, suggesting a model used in research to inform the CSPB. The Serious Violence Programme Lead assured the Board that victims and survivors were routinely included in ... view the full minutes text for item 6/25 |
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HWB Strategy (HWBS) Highlight Report Including HWBS Index Scorecard Update
This paper provides an overview of the progress in the delivery of the Health and Wellbeing Strategy (HWB Strategy) as of 24th February 2025. The Highlight Report is available in an accessible, web friendly format, and provides: · An overview of activity against HWB Strategy’s Summary Implementation Plan projects and programmes, describing what has been achieved with the Priority Populations and against the Priorities/Outcomes and some system capabilities. · Outlines examples of collaboration by partners. · Identifies examples of new data/insights and opportunities/challenges that have arisen, including via the HWBS Index. · The progress of the review of the Joint Strategic Needs Assessment (JSNA) chapters. · Communication activity associated with the HWB Strategy. Agenda Item for Health and Wellbeing Board and Surrey Heartlands ICP. Additional documents: Minutes: Speakers: Mari Roberts-Wood, Chief Executive Officer, Reigate & Banstead Borough Council, and Chair of the Prevention and Wider Determinants of Health Delivery Board (PWDHDB). Professor Helen Rostill, Co-Chair of the Mental Health Prevention Board Ruth Hutchinson, Director of Public Health (SCC) Key points raised during the discussion: Priority 1 Highlight 1. Making Every Contact Count (MECC) training packages were being delivered across the system on several topics and being applied by staff in their work. Opportunities 2. The Changing Futures programme, aimed at improving outcomes for those experiencing multiple disadvantage, had secured funding from Central Government, the National Lottery Community Fund, and the Household Support Fund. 3. The Accelerating Reform Fund, a specialist social prescribing pilot service for prison leavers, had been accepting referrals since January. It was a partnership between Surrey County Council, Guildford Probation Service, and the Kent, Surrey and Sussex Health and Justice Partnership Challenges 4. The illicit vape and tobacco market continued to grow. There was concern that Trading Standards lacked the capacity to enforce the impending ban on disposable vapes, exacerbated by funding for additional underage sales officers ending in March 2025. Priority 2 Highlight 5. There had been a focus on men’s mental health. 6. Mentell, supporting men’s mental health through awareness campaigns and online peer support, operated across surrey. 171 men were using the service, and 251 organisations were supporting awareness campaigns. 7. The Co-Chair of the Mental Health Prevention Board considered promoting such services pivotal in suicide prevention work. Opportunities 8. A celebration event for the mental health investment fund, which supported grassroots initiatives to improve mental health outcomes for local communities, was held in January. The fund was administered by Surrey Community Foundation which agreed to match the remainder of the fund. 9. The first grant of the jointly administered fund had been awarded to the Surrey Domestic Abuse Partnership, specifically East Surrey Domestic Abuse Services (ESDAS), to focus on suicide prevention in young people up to the age of 30, with funding spread over 5 years. 10. The next round of funding was available and focused on those up to the age of 30 experiencing multiple disadvantage. 11. The Co-Chair of the Mental Health Prevention Board highlighted a visit to Epsom and Ewell High School to review their support for mental health and wellbeing and efforts to change the culture and reduce stigma associated with mental health. Challenges 12. There had been a decline in the percentage of young people accessing NHS-funded mental health support. The Co-Chair of the Mental Health Prevention Board suggested that the lack of unified data, meant much activity wasn’t being recorded, such as the support being provided by Epsom and Ewell High School. It was hoped that data collection would improve in the coming year. 13. There were several funding challenges, particularly for initiatives funded non-recurrently. The First Steps phoneline was and real-time suicide surveillance programme were highlighted. Priority 3 Highlight 14. There had been 18 further signatories to the Good Company’s end poverty pledge since ... view the full minutes text for item 7/25 |
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Better Care Fund (BCF) Update
The Board are asked to note this progress update to the paper that was discussed at HWB in September 2024 regarding the Surrey 2023-25 Better Care Fund (BCF) Plan. The BCF Policy Framework sets out the Government’s priorities including improving discharge, reducing the pressure on urgent and emergency care and social care, supporting intermediate care, unpaid carers, and housing adaptations. A key aim of the BCF has always been to support the Local Authority to deliver its Care Act duties and to protect those components of Adult Social Care that support the national BCF priority areas. The BCF is also used to protect some health and voluntary sector services. The Adult Social Care Discharge Fund was incorporated into the BCF Plan for the first time in 2023/24. The BCF Plan covering 2023-25 is now coming to an end and planning has been released for 2025/26 by NHS England. The objectives of the 2025/26 BCF reflect the government’s commitment to reform via a shift from sickness to prevention and from hospital to home. This paper is written in the context of 2025/26 being a transition year as we await the new government’s 10-year NHS Plan in the summer, introduce new thematic leadership arrangements in SHICB and as Surrey County Council moves toward Local Government Reorganisation. We also anticipate further changes in BCF from 2026/27, accordingly we are committing senior officer resources to ensuring that we are in the strongest position possible for this year and as prepared as we can be in responding to future requirements when they become clear. This paper provides a general update to the Board, with the two key outcomes remaining the same: enabling people to stay well, safe, and independent at home for longer; and providing people with the right care, at the right place, at the right time. In recognising the complex environment of BCF there is a key alignment to our agreed Joint Transformation across Surrey. Key programs that will align to our national requirements in BCF include our single Surrey offer to Discharge to Assess and Support which focuses on maintaining independence and care in the right place and approach to support local residents. To create a key joint strategic plan for the BCF we are committed to review of all existing contractual arrangements, opportunities to transform and improve data compliance to evidence impact. Agenda item for HWB and Surrey Heartlands ICP. Additional documents: Minutes: Speakers: Jon Lillistone, Director for Integrated Commissioning (SCC) Jo Cogswell, Executive Director Strategy and Joint Transformation (Surrey Heartlands (SH) ICB) Key points raised during the discussion: 1. The Director of Integrated Commissioning summarised the work over the previous nine months to improve Better Care Fund (BCF) management. 2. As a result, performance of each service funded by the BCF, and how it contributed to the overall outcomes of the HWBS, was significantly better understood. 3. The 2025/26 BCF was covering a transitional year, with national conditions largely unchanged, ahead of an expected 10-year NHS plan. The plan was due for submission by 31 March. 4. Challenges existed around the discharge ready date metric, with efforts to ensure consistent reporting among System partners underway. 5. Discussions around differential funding between partners had taken place. 6. Regarding the proposed Better Care Fund steering Group, the Chair asked about membership. Proposed membership included: a. executive officers from Surrey Heartlands and Frimley ICBs b. one or two Local Joint Commissioning Group Chairs, and c. Surrey County Council representatives 7. The Executive Director Strategy and Joint Transformation (SHICB) noted the steering group would allow detailed discussion to maximise the budget. 8. The Executive Director Strategy and Joint Transformation (SHICB) emphasised the need to for appropriate commitments for 2025/26 and longer term. 9. A Board member asked how the voluntary sector could contribute, which had not yet been developed. 10. A Board member noted outstanding engagement with unpaid carer representatives, urging this be undertaken prior to approval. Resolved: The Health and Wellbeing Board and Surrey Heartlands Integrated Care Partnership: 1. Confirmed support to establish an HWB BCF Partnership Group that is a non-decision-making group where partners could come together and consider offer guidance on priorities, provide oversight of HWB system-wide performance and offer advice on HWB system-wide schemes of work. 2. Confirmed support to review the current investment and prioritisation approach across both health and care to ensure clear commissioning and contractual process, alignment to agreed investment priorities and development of opportunities that could ensure resolution to financial pressures. 3. Confirmed support for relevant HWB system officers to update local approaches and data collection to ensure that Surrey HWB can report to NHS England in relation to the new BCF National Planning Guidance. Actions/further information to be provided: The Director for Integrated Commissioning (SCC) to follow up on engagement with unpaid carers representative.
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Surrey Pharmaceutical Needs Assessment (PNA) 2025 - Draft Report
All Health and Wellbeing Boards have a statutory responsibility to publish and keep up to date a Pharmaceutical Needs Assessment (PNA). The PNA is updated every three years, with the last report being published in 2022. The development of the PNA in Surrey is delegated to the PNA Steering Group. The paper outlines the findings of the draft Surrey PNA 2025 and the recommendations which are being presented for sign off. Agenda item for HWB and Surrey Heartlands ICP. Additional documents: Minutes: Speakers: Dr Louis Hall, Public Health Consultant Linda Honey, Director of Pharmacy, NHS Surrey Heartlands Yinka Kuye, Community Pharmacy Clinical Lead, NHS Frimley Julia Powell, CEO, Community Pharmacy Surrey and Sussex (Local Pharmaceutical Committee) Key points raised during the discussion: 1. The Public Health Consultant noted that the Health and Wellbeing Board was required to sign off the Pharmaceutical Needs Assessment (PNA), which had been developed by the PNA steering group. 1. The PNA guided assessment of pharmaceutical market entries and to identify gaps in pharmaceutical need. 2. The PNA was informed by quantitative data, including socioeconomic and health, and qualitative data, from residents’ views. 3. The Public Health Consultant emphasised there had been flexible assessment across Surrey, rather than applying metrics uniformly. 4. Resident surveys showed little demand for out-of-hours access. 5. Data highlighted that greatest need matched key neighbourhoods identified in the Health and Wellbeing Strategy. Access to pharmacies was prioritised in those areas. 6. The Pharmaceutical Needs Assessment method developed would be used to ensure sufficient pharmacy provision over the 3 years of the PNA. 1. Although 98% of pharmacies had signed up to the Pharmacy First service, most were unable to deliver it due to public unawareness or seeking support elsewhere. 2. The CEO of Community Pharmacy Surrey and Sussex explained that pharmacies were funded from a fixed global NHS sum. Increasing the number of pharmacies would dilute funding and lead to closures. 3. The global sum allowed pharmacies to dispense prescriptions with margins made from buying medications at a lower rate than NHS reimbursement. The global sum had remained flat for 5 years. 4. Prescription charges were returned to the Government. 5. Pharmacy closures were more likely in deprived areas as those in wealthier areas could offer additional private services. NHS funding accounted for 95% to 99% of many pharmacies’ business. 6. A Board member noted the PNA remained high level and could not consider specific local needs like community cohesion. 7. Travel time was reviewed across Surrey to identify gaps, with walking distance an optional consideration in the national guidance. 8. The PNA flexibly considered access to car travel depending on urban or rural setting. The Vice-Chair (Health and Care) noted consideration for neighbourhoods less likely to have car travel access. 9. All areas had access to a pharmacy within 30 minutes’ walk, most were within 5 minutes’ drive. 10. The Steering Group had considered areas and populations with higher barriers to pharmacy access that were otherwise not identified by geography. These coincided with key neighbourhoods. 11. The Public Health Consultant considered that those experiencing higher barriers of access to pharmacies possibly also had similar difficulties accessing other services. Such consideration was beyond the remit of the PNA but relevant for the System to consider. 12. In response to a Board member’s question, the Public Health Consultant noted the 111 service could support urgent prescription needs. 13. It was noted that unpaid cares were significantly more likely to be in key neighbourhoods. Resolved: |
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Surrey Heartlands Joint Forward Plan 2025/26 - Limited Update
NHS England (NHSE) published their 25/26 national Priorities and Planning Guidance on 30 January 2025 - reported to the combined Health and Wellbeing Board and Integrated Care Partnership meeting at the seminar in February. In addition to the annual operating plans to be submitted to NHS England by 27 March 2025, NHSE asked systems to conduct a ‘limited refresh’ of their Joint Forward Plans by the end of March, pending a fuller review after the Government publishes its 10-year Health Plan later this year. Surrey Heartlands ICS has therefore updated the plan by means of a Preface to the current plan, aiming to publish this by 1 April 2025, in line with legislative requirements. The Joint Forward Plan (JFP) supports delivery of the ambitions set out in Surrey Heartlands Integrated Care Strategy. Surrey’s Health and Wellbeing Strategy drives Ambition 1 (Prevention). The plan also includes delivery milestones for Ambitions 2 (Delivering care differently) and 3 (What we need to deliver these ambitions). 2025 will be Year 3 of this five-year plan. The update (Preface) is presented for a formal opinion from the Health and Wellbeing Board at this meeting of the combined Health and Wellbeing Board/Integrated Care Partnership. The Board’s opinion will be published as part of the refresh. A more comprehensive refresh of the JFP will be undertaken during summer 2025, following publication of the 10-year health plan, the public sector spending review and any additional related guidance. Item for HWB and Surrey Heartlands ICP. Additional documents: Minutes: Speakers: Karen McDowell, CEO Surrey Heartlands ICB Key points raised during the discussion: 1. The Chief Executive Officer of Surrey Heartlands ICB noted that Surrey Heartlands ICB was required to submit plans to NHS England for finance, operational, and workforce by 27 March 2025 and include a limited Joint Forward Plan refresh. 2. A further review would be conducted in Summer 2025 once guidance on the 10-year NHS plan was available. 3. The Chair requested a paper outlining the ICB’s understanding of the post-announcement NHS landscape and delivery of the 10-year plan. Resolved: 1. The Health and Wellbeing Board and Surrey Heartlands Integrated Care Partnershipreviewed the proposed Preface to be added to the existing Joint Forward Plan in March 2025, with the expectation that a further, more substantial update would be developed during the summer and shared with the Health and Wellbeing Board/Integrated Care Partnership. 2. The Board was asked to provide a formal opinion for inclusion with the Preface, in the limited update to Surrey Heartlands Joint Forward Plan. Actions/further information to be provided: A paper outlining the ICB’s understanding of the post-announcement NHS landscape and delivery of the 10-year plan to be presented to a future meeting. Opinion to be drafted and agreed with the Chair. |
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Integrated Care Board Update: Surrey Heartlands ICB and Frimley Health and Care ICB
To note the update provided on the recent activity by the Surrey Heartlands Integrated Care Board (ICB), and Frimley ICB against the Health and Wellbeing Strategy. Item for HWB and Surrey Heartlands ICP. Additional documents: Minutes: Speakers: Karen McDowell, CEO Surrey Heartlands ICB Nicola Airey, Director of Places and Communities (Frimley ICB) Key points raised during the discussion: 1. The Chief Executive Officer of Surrey Heartlands ICB and Director of Places and Communities of Frimley ICB summarised that the updates covered statutory duties, workstreams and interaction with ICS Strategy, and values and behaviours of the ICBs. Resolved: 1. The Health and Wellbeing Board and Surrey Heartlands Integrated Care Partnership: 2. Noted the update provided on the recent activity by the Surrey Heartlands Integrated Care Board (ICB), and Frimley ICB against the Health and Wellbeing Strategy. Actions/further information to be provided: None. |
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In recognition of the rapidly evolving nature of Local Government Reorganisation and devolution in Surrey. An update on the current position will be presented to the Combined meeting of the Health and Wellbeing Board and Surrey Heartlands Integrated Care Partnership. Item for HWB and Surrey Heartlands ICP. Additional documents: Minutes: Speakers: Cllr Tim Oliver OBE, Leader of Surrey County Council and Chair of the HWB and SH ICP Key points raised during the discussion: 1. The Chair summarised the current position of Local Government Reorganisation, noting an interim business case deadline to Central Government by 21 March 2025, and a final submission by 9 May. 2. The papers outlined two unitarisation proposals: combining and splitting Surrey County Council and the 11 Districts and Borough Councils into two or three authorities. There would also be a Mayoral Authority in both proposals. Central Government would decide the model. 3. The Chair noted the County Council preferred a two-unitary model due to lower disaggregation costs. 4. Certain services would move to the Mayoral Authority from the 12 local authorities. 5. The fate of local authority debt, approximately £5.5bil in total, was unknown. 6. The Chair emphasised the importance of carrying forward the community, town, village, and neighbourhood-centred approach developed by the Health and Wellbeing Board and Integrated Care Partnership into future structures. 7. The Chair highlighted the opportunity for all public services to coalesce around reformed, collaborative working. 8. The Vice-Chair (VCSE) stressed the importance of considering culture and a focus interconnectedness in the new NHS and local government structures as well as other public services. The Chair concurred that system reorganisation was necessary, not just local government. Resolved: The Health and Wellbeing Board and Surrey Heartlands Integrated Care Partnership: 1. Noted the Council Report (Annex 1) and Cabinet Report (Annex 2) that went to SCC Cabinet and Council for discussion and agreement on 18 March 2025, ahead of the March 21 deadline to submit the interim plan to Government. Noted Part A of the interim plan for LGR in Surrey (Annex 3) which was the collective position of all councils in Surrey. 2. Noted Surrey County Council’s Part B of the interim plan for LGR in Surrey (4) which would be submitted on behalf of Surrey County Council on 21 March 2025. 3. Noted the D&B authored Part B of the interim plan for LGR in Surrey (Annex 5) which would be submitted on behalf of some of the D&B councils in Surrey on 21 March 2025. 4. Noted the partner engagement that had taken place in the lead up to the submission of the interim plan for LGR in Surrey. 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 18 June 2025. Additional documents: Minutes: The Board noted that the next formal meeting would be held on 18 June 2025.
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