Agenda and draft minutes
PDF 238 KBVenue: Woodhatch Place, 11 Cockshot Hill, Reigate, Surrey, RH2 8EF
Contact: Amelia Christopher
Media
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APOLOGIES FOR ABSENCE
To receive any apologies for absence and substitutions. Additional documents: Minutes: Apologies were received from Fiona Edwards - Nicola Airey substituted, Dr Sue Tresman - Kim Jacobs substituted, Professor Helen Rostill - Kate Barker present as P2 Co-Sponsor, Tim De Meyer - Tamara Cooper substituted, Lisa Townsend - Lauren McAlister substituted (remote), Karen Brimacombe (remote), Sue Murphy (remote), Steve Flanagan (remote), Rachael Wardell, Liz Williams, Kevin Deanus, Jo Cogswell, Michael Coughlin, Sinead Mooney, Clare Curran, Carl Hall, Borough Councillor Ann-Marie Barker.
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MINUTES OF PREVIOUS MEETING: 20 MARCH 2024
To agree the minutes of the previous meeting. Additional documents: Minutes: The minutes were agreed as a true record of the meeting. |
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DECLARATIONS OF INTEREST
All Members present are required to declare, at this point in the meeting or as soon as possible thereafter
(i) Any disclosable pecuniary interests and / or (ii) Other interests arising under the Code of Conduct in respect of any item(s) of business being considered at this meeting
NOTES:
• Members are reminded that they must not participate in any item where they have a disclosable pecuniary interest • As well as an interest of the Member, this includes any interest, of which the Member is aware, that relates to the Member’s spouse or civil partner (or any person with whom the Member is living as a spouse or civil partner) • Members with a significant personal interest may participate in the discussion and vote on that matter unless that interest could be reasonably regarded as prejudicial.
Additional documents: Minutes: There were none. |
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QUESTIONS AND PETITIONS
Additional documents: |
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Members' Questions
The deadline for Member’s questions is 12pm four working days before the meeting (13 June 2024).
Additional documents: Minutes: None received.
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Public Questions
The deadline for public questions is seven days before the meeting (12 June 2024).
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 WELL-BEING STRATEGY HIGHLIGHT REPORT
This paper provides an overview of the progress in the delivery of the Health and Wellbeing Strategy (HWB Strategy) as of 28 May 2024. Additional documents: Minutes: Witnesses:
Karen Brimacombe, Chief Executive, Mole Valley District Council (Surrey Chief Executives’ Group) (Priority 1 Sponsor) Emma Jones, Public Health Lead, SCC Kate Barker, Joint Strategic Commissioning Convener (Priority 2 Co-Sponsor) Jack Smith, Prevention and Communities Manager, SCC Mari Roberts-Wood, Managing Director, Reigate and Banstead Borough Council (Priority 3 Sponsor) Julia Groom, Public Health Consultant, SCC
Key points raised in the discussion:
Priority 1
1. The Priority 1 Sponsor noted that findings from the work on encouraging young people to maintain a healthy weight revealed a gap in support for children aged between 5 and 17 years old and Active Surrey was awarded a contract for Be Your Best to deliver a programme of work to that cohort. Two outreach workers from the Surrey Bridge the Gap programme spoke to representatives from various government departments to promote how Surrey was delivering cost effective system outcomes. Changing Futures alongside the Alliance for Better Care presented their work at a national conference and received an award for supporting individuals with lived experience to get back into meaningful employment. Several agencies were working in partnership with community and faith organisations in Key Neighbourhoods to address the lower levels of referrals and uptake of NHS health checks. A Macmillan researcher had started work on cancer inequalities. There was training to raise awareness around hoarding and there was a SharePoint site for professionals to seek information. Training was being developed around preventing falls. A new Carers Partnership Group was operational and three quarters of its membership are non-paid carers. 2. The Public Health Lead (SCC) detailed the spotlight item: Surrey Tobacco Control: · smoking continued to be the significant contributor to health inequalities and cost Surrey £950 million per year. Under 12% of the population smoke and the highest prevalence is in routine and manual workers, people in treatment for substance misuse, Gypsy, Roma, Traveller Communities and those who face homelessness. · the Surrey Tobacco Control Strategy was launched in October 2023 and that same month the Government announced its plans to create a smokefree generation through the Tobacco and Vapes Bill. Whilst not enacted before the General Election, using the additional grant allocation of £1.1 million for the next five years work was underway in Surrey to support an additional 15,000 smokers to set a quit date. A partnership action plan was in place. · the evidence showed that only 6% of smokers would use local stop smoking services, so the programme has sought to increase demand through local mass media campaigns using behaviour change approaches and building on the tobacco programme in acute trusts and across maternity services. The training provision would be increased for all frontline staff. Performance would be tracked through a Combating Drugs Partnership sub-group. 3. The Chair asked how long the additional funding was for. The Public Health Lead (SCC) explained that it was an annual grant committed to for five years.
Priority 2
4. The Priority 2 Co-Sponsor noted that consultation on the revision of the Surrey Suicide Prevention Strategy was ... view the full minutes text for item 15/24 |
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HEALTH AND WELL-BEING STRATEGY INDEX SCORECARD
When the Surrey Health and Wellbeing (HWB) Strategy Index was shared with the Board in 2023 it was recognised that further development was needed both in terms of indicators and the geographic levels at which the data is presented. The last iteration had the addition of Primary Care Network (PCN) level data. This latest significant update includes over 20 new indicators (61 in total), aligned to HWB Strategy’s priority populations and to the priorities/outcomes to offer a more comprehensive picture.
In this paper, we summarise the additional indicators introduced (see appendix 2) and share the first iteration of the Scorecard that draws attention to areas where progress or need is particularly noteworthy. Additional documents: Minutes: Witnesses:
Ruth Hutchinson, Director of Public Health, SCC Rich Carpenter, Senior Analyst - Analytics and Insight, SCC
Key points raised in the discussion:
1. The Chair noted that significant work had progressed to add over twenty new indicators to the Health and Well-Being Strategy Index. The Scorecard provided a baseline to track progress against the three Priorities and their outcomes and to start assessing the impact. Gaps would be addressed and were largely due to the work needed to analyse data or ensure rigour and relevance of existing data. 2. The Director of Public Health (SCC) noted that last year the Board received a live demonstration of the Index which measures high-level outcomes and many of the programmes meet multiple outcomes. The Index was interactive and she encouraged partners to continue to use it. Through extensive engagement with partners additional indicators were introduced and where available and meaningful, data for different geographical levels was included: district and borough, ward and Primary Care Network (PCN), as well as at county level providing data on the Priority Populations and the overarching life expectancy indicators. Gaps in data on Multiple Disadvantage was partly addressed through the JSNA chapter. The Scorecard was a high-level snapshot of the data, including that in the Index, to be produced annually and progress on the Index reported in the Highlight Reports. 3. The Senior Analyst - Analytics and Insight (SCC) noted that publicly available data was used so in some cases might be somewhat outdated due to delays in reporting. He highlighted areas in the Scorecard that showed significant changes in performance or progress: · Challenge: Overarching indicators: Inequality in life expectancy at birth: Surrey was performing better than the regional and national average between the areas of highest deprivation and lowest but there had been a recent slight increase likely due to COVID-19. However, inequalities at ward level were significant. · Challenge: Priority Populations: Employment gap for adults in contact with secondary mental health services: poor result although the indicator definition had changed so the trend was not reliable as the figures were different for the latest period. · Opportunity: Priority Populations: Employment gap for adults with a learning disability: that gap had decreased; to improve further through new programmes such as Work Wise. · Further opportunities were highlighted for example the chlamydia detection rate was good; regarding further challenges an FAQ document could be provided explaining further the context of some indicators. 4. A Board member noted that regarding mental health, stable housing was not mentioned yet it looked like there was a significant gap. Regarding employment, he asked if the data was comparable whether that would mean that Surrey was doing relatively better than England or not. He asked whether there was a correlation between the lack of stable housing and the employment gap for people accessing secondary mental health services. The Senior Analyst - Analytics and Insight (SCC) explained that the Index and Scorecard contained data for those in stable and appropriate accommodation, both for learning ... view the full minutes text for item 16/24 |
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JOINT STRATEGIC NEEDS ASSESSMENT (JSNA): MULTIPLE DISADVANTAGE
This paper outlines the draft recommendations of the developing multiple disadvantage JSNA chapter in recognition of the impact that the experience of multiple disadvantage has on some of the most vulnerable persons in our county. The production of this JSNA chapter has been led by our local lived experience group.
Additional documents: Minutes: Witnesses:
Ruth Hutchinson, Director of Public Health, SCC Lisa Byrne, Changing Futures Programme Delivery Manager, SCC Steve Saunders, Expert by Experience, Lived Experience Recovery Organisation (LERO) Ella Turner, Programme Manager - Health Determinants Research Collaborative (HDRC), SCC
Key points raised in the discussion:
1. The Director of Public Health (SCC) highlighted the key overarching priority of the Health and Well-Being Strategy: to reduce health inequalities so no one is left behind. Commended all for their hard work to understand the breadth and depth of the challenges faced by those with Multiple Disadvantage. Noted that the chapter and draft recommendations should be read in conjunction with other JSNA chapters on: mental health, substance misuse and housing. The Board should consider its collective action to implement the draft recommendations which needed time to embed, she encouraged participation in the discussion events. 2. The Changing Futures Programme Delivery Manager (SCC) explained that Multiple Disadvantage was where people faced concurrent and compounding challenges: mental health needs, substance use, homelessness, domestic abuse and contact with the Criminal Justice System. In 2015, there were approximately 336,000 adults in England experiencing Multiple Disadvantage, the findings in the JSNA chapter estimated that there were 3,000 Surrey residents experiencing it. The findings came from extensive stakeholder engagement, data analysis and collaboration across sectors, co-produced with the LERO set up in 2023. 3. The Expert by Experience (LERO) noted his background of Multiple Disadvantage due to substance use and he was a SMART Recovery facilitator. He noted that it was vital to highlight lived experiences at decision-making forums and was working to ensure co-production was included. Essex, Middlesbrough and Sheffield had good representation of lived experience people on boards. He called for action on the draft recommendations to put the hard work into practice. 4. The Changing Futures Programme Delivery Manager (SCC) explained that a mixed methods approach was taken and included cross-cutting representation from a range of stakeholders across the system. The chapter was awaiting final sign-off from the JSNA Oversight Group, the full document would be available on Surrey-i in the coming weeks and a summary version would be produced. 5. The Programme Manager - HDRC (SCC) outlined the six key findings: · ways of working: fragmented care was identified from siloed working across the system, statutory services were often equipped to assess and treat only what they considered to be an individual's primary need. · feeling abandoned: identified gaps and unmet needs in service provision, the impact of limited access to mental health services often intensified mental health challenges. Explored how the housing and accommodation support system could be better designed. · misheard and misunderstood: commonly experienced stigma and judgement often due to the lack of understanding around Multiple Disadvantage. A culture change was needed and understanding around trauma and psychologically informed approaches. · one size does not fit all: identified a need for bespoke support that recognises the interconnected nature of Multiple Disadvantage, to focus on relational rather than medical models of support, it should be outcomes led. · overcoming ... view the full minutes text for item 17/24 |
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BETTER CARE FUND (BCF) PLAN 2023-25 (UPDATE FOR 2024/25)
The Board is asked to approve the 2024/25 update to the previously submitted Surrey 2023-25 Better Care Fund (BCF) Plan.
Additional documents: Minutes: Witnesses:
Jonathan Lillistone, Director of Integrated Commissioning, SCC
Key points raised in the discussion:
1. The Director of Integrated Commissioning (SCC) introduced the report noting that the Board was asked to confirm sign-off of the submission, discussions had been had with the Chair and it had been circulated to other decision-makers. 2. The Chair stressed her disappointment in what seem to be the funding reductions for mental health, social prescription, autism and neurodiversity services. She noted that whilst funds might have come from elsewhere in some cases, the funding longevity was not assured. The Director of Integrated Commissioning (SCC) would review the detail and would provide a written response on the impact. The Vice-Chair noted that it would be useful for the BCF team to have a meeting with the Chair to run through the decision-making process at place level. The Chair noted that those discussions were had at the February workshop. 3. A Board member noted that it would be useful to undertake the planning for the next BCF before the end of September, to ensure proper conversations and time to consider what should be done in the next two years. The Director of Integrated Commissioning (SCC) agreed and noted that an additional team member working on the BCF was starting shortly so could pick that up; building on the strategic themes discussed at the workshop to be focused on going forward. 4. The Vice-Chair highlighted the opportunity to look at the next iteration of BCF spend in terms of the various programmes of work that would benefit from a long-term funding solution from the BCF along with statutory funding.
RESOLVED:
1. Noted and agreed the 2024/25 update to the previously approved 2023-25 BCF Plan. 2. Noted the 2023/24 BCF Return which was submitted to NHSE on 23 May. 3. Noted the update following the BCF Strategy Workshop in February 2024.
Actions/further information to be provided:
1. The Director of Integrated Commissioning (SCC) will review the detail and will provide a written response to the Chair on the impact of the funding reductions for mental health, social prescription, autism and neurodiversity services.
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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 Integrated Care System (ICS), and Frimley Health and Care ICS regarding the Integrated Care Partnerships and Integrated Care Boards against the Health and Wellbeing Strategy. Additional documents: Minutes: The Chair explained that the reports from Surrey Heartlands ICS and Frimley Health and Care ICS were included for information.
RESOLVED:
Noted the update provided on the recent activity within the Surrey Heartlands Integrated Care System (ICS), and Frimley Health and Care ICS regarding the Integrated Care Partnerships and Integrated Care Boards against the Health and Wellbeing Strategy.
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DATE OF THE NEXT MEETING
The next meeting of the Health and Wellbeing Board will be on 18 September 2024. Additional documents: Minutes: The date of the next public meeting was noted as 18 September 2024.
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