Agenda and minutes

Health and Wellbeing Board
Thursday, 5 December 2019 1.00 pm

Venue: Ashcombe Suite, County Hall, Penrhyn Road, Kingston upon Thames, KT1 2DN

Contact: Amelia Christopher  Email:

No. Item



    To receive any apologies for absence and substitutions.


    Apologies were received from Simon White, Steve Hook acted as substitute, Dr Andy Brooks and Ruth Colburn Jackson, Edmund Cartwright acted as substitute, Dr Elango Vijaykumar and Borough Councillor John Ward.






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


    (i)      Any disclosable pecuniary interests and / or

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




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

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

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



    There were none.




Members' Questions


Public Questions





    This paper summarises the development of the priority implementation plans for each of the three priorities for consideration collectively along with the revised metrics that area also proposed. The summary plans for each priority are intended to be an additional appendix to the published strategy. The implementation plans provide a current view on the activity that is planned within the system to positively impact upon the individual focus areas identified in the strategy and the associated outcomes.


    Additional documents:




    Rod Brown - Head of Housing and Community at Epsom and Ewell District Council

    Giles Mahoney - Director of Integrated Care Partnerships at Guildford and Waverley Clinical Commissioning Group (CCG)

    Rob Moran - Chief Executive of Elmbridge Borough Council

    Ruth Hutchinson - Interim Director of Public Health at Surrey County Council


    Key points raised in the discussion:


    1. The Head of Housing and Community at Epsom and Ewell District Council provided the Board with an overview of the Priority and raised additional points below:

    ·         Highlighted that it was important to tackle the Priority across all demographics rather than focusing solely on children.

    ·         Noted that a shared vision for those with ‘lived experiences’ was at the centre of the Priority.

    ·         That leadership from professionals in difficult areas was vital, such as the work by the Clinical Chair at North West Surrey CCG clarifying the milestones regarding dying a dignified death.

    1. The Director of Integrated Care Partnerships at Guildford and Waverley Clinical Commissioning Group (CCG) provided the Board with an overview of the Priority and raised additional points below:

    ·         He noted the need for a broader out of service delivery to avoid isolating the Priority, and having proactive alignment between the both Surrey Heartlands’ and Frimley’s 5 Year Strategies on the transformation of local health and care services.

    ·         Praised the work of the Dementia Clinical Lead at Surrey Heartlands Health and Care Partnership in addressing the low diagnosis rates in Surrey through the formation of a dementia strategy group.

    ·         Fundamental to the prevention of mental health issues in adults was to ensure good emotional wellbeing in young people which was central to the Healthy Schools programme.


    Dr Charlotte Canniff arrived at 1:14pm

    1. The Chief Executive of Elmbridge Borough Council provided the Board with an overview of the Priority and raised additional points below:

    ·         Noted the importance of supporting children and vulnerable adults to gain life skills through the use of mentoring with older more experienced people.

    ·         That apprenticeships were an underused tool and a levy transfer working group would be established to maximise their benefits.

    ·         Noted Havering’s effective Social Progress Index (SPI).


    Barbara Hertz and Hayley Connor arrived at 1:22pm

    ·         There needed to be greater clarity between partnerships and projects within the Priority such as the Employment and Skills Board, SPI working group and Children’s Programme Board - ‘Time for Kids’ had an obvious links.

    1. In the discussion on the three priorities, the Chairman noted that continual resourcing was essential and that a more streamlined approach with partners was effective - noting that there were 45 charities in Surrey to address homelessness.
    2. Members noted that it was important to have a clear understanding on who had responsibility over each of the three priorities and positively commented that it was good that children were more visible within the plans as ensuring the healthy lives of adults had a beneficial effect on children’s wellbeing.
    3. The Interim Director of Public Health provided an overview of the revised metrics and explained that further engagement work on  ...  view the full minutes text for item 50/19



    The Surrey Safeguarding Adults Board (SSAB) is a statutory Board with responsibilities

    set out in the Care Act 2014.


    The Board is chaired by an independent chair, Simon Turpitt. It is a statutory duty for all Safeguarding Adult Board’s to publish an annual report. To support the transparency of the work of the Board, the Annual Report is presented to the Health and Wellbeing Board.

    Additional documents:



    Simon Turpitt - Chair of Surrey Adults Safeguarding Board

    Key points raised in the discussion:

    1. The Chair of Surrey’s Adults Safeguarding Board (SSAB) summarised the report and noted positively that it provided stronger assurance, better and more in-depth data quality and a more robust committee structure.
    2. In addition to the report he noted:
      • That there was greater agency engagement through more training programmes.
      • To address the poor quality of enquiries through Section 42 of the Care Act 2014 in relation to safeguarding adults from abuse, Healthwatch Surrey were collating user experiences on the level of safeguarding, presented to the SSAB next week.
      • The accessibility of the website of the SSAB was improved through working collaboratively with the Children’s Board.
      • In collaboration with Adult Social Care (ASC), SSAB began to produce more regular and effective briefingdocuments especially for national Safeguarding Adult Reviews (SARs).

    3.    A Member praised the thorough report as it reinforced the responsibility required of all agencies to improve safeguarding work and noted the importance of hearing residents’ experiences.

    4.    There were concerns over the separation of the Children’s Partnership from the Multi Agency Safeguarding Hub (MASH) and the need to increase the Council’s engagement with private care homes engagement to ensure good safeguarding knowledge.

    1. Furthermore, a Member explained that the most numerous reports to MASH were from the police via concerned neighbours, the aim was to ensure the police were trained to address situations sensitively and meticulously. In response, the Chair of the SSAB mentioned the need for the police to have a standardised definition of vulnerability as many referrals in Surrey were not strictly related to safeguarding adults.
    2. A Member praised the report as it reflected upon real challenges and stated that more work need to be done on Section 42 to address individuals reluctant to information on safeguarding concerns.
    3. The Business Management Group was praised as it provided a mirror to the SSAB, by deciding upon issues that need to be escalated to the SSAB and having more regular talks with key statutory partners ensured greater strategic management.
    4. A Member stated that alignment as noted within the report’s second recommendation, was particularly salient following the Health and Wellbeing Board’s merger with the Community Safety Board.



    That the Health and Wellbeing Board:

    1. Considered and noted the Surrey Safeguarding Adults Board Annual Report.
    2. Agreed to ensure alignment of both Boards strategy so that there are more focussed work plans that build together and avoid overlap.


    Actions/further information to be provided:






    The Surrey Child and Adolescent Mental Health (CAMHS) Whole System Transformation Plan, updated October 2019, is presented for approval by the Surrey Health and Wellbeing Board.


    Additional documents:



    Sue Robertson - Associate Director of Strategic Commissioning, NHS Surrey CCGs

    Key points raised in the discussion:

    1. The Associate Director of Strategic Commissioning introduced the report, informing the Board that transformation work was led through engagement with Children and Young Person’s Havens, Hope House, Extended Hope, supporting children in crisis and eating disorder units for example and partnership work across agencies was crucial.
    2. A Member expressed that she could not approve the report as it did not address the 2014 and 2018 inadequate Ofsted ratings on Children’s Services in Surrey. In 2019, waiting lists increased enormously and this was not mentioned in this report, Members noted that the report needed to be more balanced and that problems needed to be acknowledged in order to move forward.
    3. A Member noted that Children’s Services was positively progressing and explained that Hope and extended Hope were the national leaders on CAMHS and the CAMHS contract would go out for procurement from April 2021.
    4. A Member stated that working in collaboration with many partners ensured that key areas of transformation were identified and noted that the regulator required the funding details of the 5 year forward strategy to be available publically online.
    5. In response, the Associate Director of Strategic Commissioning acknowledged the Board’s concerns over the incorrect balance of issues within the report and would amended parts of the report to reflect Member’s concerns prior to final publication.
    6. An attendee explained that she would like to see where the additional £4 million investment that the Chief Executive of the National Health Service planned to put into children’s services.
    7. A Member commented that she would like to see the ‘open letter to Children and Young People of Surrey’ on page 107 rewritten to reflect the future strategic spending of funding and to ensure economic commitment in future years on prevention.
    8. In response to a Member’s query on how CAMHS in Surrey compared to similar partners, a Member noted that it compared positively with other partners but explained that CAMHS addressed Surrey specific issues such as the issue of access and overwhelming public demand. An early intervention model was not in place which created a negative compound effect with mental health issues in children’s being more likely in adults.
    9. A Member noted that Adverse Childhood Experiences (ACEs) were being considered within Children’s Services in Surrey and the worry of labelling needed to be addressed.
    10. The Chairman in agreement with the Board agreed to defer the report to the additional public meeting of the Board on the 16December so it could be revised to incorporate Members’ concerns.



    The revisions to the report and its recommendations would be deferred to the additional public meeting of the Health and Wellbeing Board on the 16 December 2019.

    Actions/further information to be provided:


    The Health and Wellbeing Board to receive the revisions to the report at the Board’s additional public meeting on 16 December 2019.


TIME FOR KIDS pdf icon PDF 111 KB

    For the Health and Wellbeing Board to note the report. Time for Kids is a new perspective for all agencies working with children, young people and their families in Surrey.


    This paper sets out a new approach and perspective that will guide how all agencies work with kids in Surrey. The work was initiated by the voluntary sector in Surrey, via Surrey Youth Focus and has involved a ‘think tank’ approach that has included the police, National Health Service, Surrey County Council, Schools and children and young people. The Better Way Network, a national affiliation has brought an outside view to inform this Surrey based piece of work. The purpose of this item is to begin a programme of socialisation with all agencies about this new perspective and approach.





    Dave Hill - Executive Director for Children, Families and Learning (SCC)

    Key points raised in the discussion:

    1. The Executive Director for Children, Families and Learning introduced the report and thanked the Chief Executive Officer at Surrey Youth Focus for her input.
    2. Noted the positive example of Child Friendly Leeds - despite Leeds’ poor Ofsted rating five years ago, similarly to Surrey - which had a transformative impact on children’s services and hoped that Time for Kidsin Surrey would follow that successful initiative.
    3. The report echoed many of the Board’s fundamental principles, particularly early intervention and prevention to combat mental health crises, domestic abuse, and substance abuse - which accounted for 95% of referrals in young people.
    4. Highlighted the high amount of young people who did not have someone in their life they could depend upon and particularly in care the lack of a permanent social worker was detrimental. Good emotional wellbeing for children was bolstered by someone ‘crazy’ about them who they could trust.
    5. It was important the report was driven by the narrative provided by children with adverse experiences and he noted that children responded positively to the project.
    6. A Member commented that the project would not be compatible in certain areas, noting anti-social behaviour among young people in deprived areas.
    7. An attendee positively endorsed the project as it showed genuine attention and sensitivity to vulnerable children facing those difficult experiences.
    8. A Member explained that from a clinical perspective, the lack of attachment in children led to a high degree of accessing mental health services later in life so early intervention and prevention were vital.



    The Surrey Health and Wellbeing Board:

    1. Noted the important piece of work.
    2. Would promote and socialise Time for Kids in the agencies and Networks.
    3. Agreed to receive an update from time to time on progress.


    Actions/further information to be provided: