Agenda and draft minutes

Health and Wellbeing Board - Wednesday, 18 September 2024 10.00 am

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

Contact: Amelia Christopher 

Media

Items
No. Item

21/24

APOLOGIES FOR ABSENCE

    • Share this item

    To receive any apologies for absence and substitutions.

    Additional documents:

    Minutes:

    Apologies were received from Michelle Blunsom MBE - Maria Mills substituted, Fiona Edwards - Nicola Airey substituted, Professor Helen Rostill - Lucy Gate present as MH: PB Co-Chair, Cllr Richard Biggs (remote).

     

22/24

MINUTES OF PREVIOUS MEETING pdf icon PDF 162 KB

    • Share this item

    To agree the minutes of the previous meeting:

     

    ·         Health and Wellbeing Board, 19 June 2024

    ·         Surrey Heartlands Integrated Care Partnership, 24 July 2024

    Additional documents:

    Minutes:

    The minutes of the Health and Wellbeing Board on 19 June 2024, and the Surrey Heartlands Integrated Care Partnership on 24 July 2024 were agreed as a true record of the meetings.

     

23/24

DECLARATIONS OF INTEREST

    • Share this item

    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.

24/24

QUESTIONS AND PETITIONS

    • Share this item

    Additional documents:

24/24a

Members' Questions

    • Share this item

    The deadline for Member’s questions is 12pm four working days before the meeting (12 September 2024).

     

    Additional documents:

    Minutes:

    None received.

     

24/24b

Public Questions

    • Share this item

    The deadline for public questions is seven days before the meeting (11 September 2024).

     

    Additional documents:

    Minutes:

    None received.

     

24/24c

Petitions

    • Share this item

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

     

    Additional documents:

    Minutes:

    There were none.

     

25/24

COMBINING THE HEALTH AND WELLBEING BOARD AND THE SURREY HEARTLANDS INTEGRATED CARE PARTNERSHIP: DRAFT MEMORANDUM OF UNDERSTANDING (MOU) pdf icon PDF 236 KB

    • Share this item

    Further to the decision made at the July 2024 Surrey Health and Wellbeing Board (HWB) and Surrey Heartlands Integrated Care Partnership (ICP), these entities will be combined, and alongside the Surrey Heartlands Integrated Care Board, will create a “Health and Wellbeing Day” from September 2024.

     

    Annex 1 attached is a draft MoU for this combined meeting, which set out the aims, responsibilities and procedural arrangements for this meeting, as well as detail around the membership and roles of each member of the HWB and ICP.

     

    Subject to further discussion and advice from governance / legal colleagues, the meeting will operate as a committees in common meeting.

     

    Agenda item for: HWB, and Surrey Heartlands ICP

    Additional documents:

    Minutes:

    Agenda item for: HWB, and Surrey Heartlands ICP

     

    Speakers:

     

    Phill Austen-Reed, Principal Lead - Health and Wellbeing, SCC

     

    Key points raised in the discussion:

     

    1.    The Chair noted that the ten-year Health and Well-Being Strategy for Surrey was constantly being refreshed but the three Priorities remained the same. The HWB had statutory responsibilities to discharge, the ICP was responsible for the delivery of the Surrey Heartlands Integrated Care Strategy and wider determinants of health, and the ICB owned the clinical aspects.

     

    Borough Cllr Ann-Marie Barker arrived at 10.09 am.

     

    2.    The Principal Lead - Health and Wellbeing (SCC) noted that the ambition of combining the boards was to provide collective oversight and assurance of the delivery of the Health and Well-Being Strategy, which was Ambition One of the Surrey Heartlands Integrated Care Strategy. The governance had been streamlined avoiding duplication and aligning decision-making, with one membership. Public formal meetings were quarterly, followed by deep dives/walkabouts at place level, and private informal meetings to reflect on the discussions at the deep dive and discuss items in more detail. The Memorandum of Understanding included both updated Terms of Reference, outlined the common responsibilities and expectations, and included a second Vice-Chair. He welcomed comments and suggestions for items to be added to the forward plan.

    3.    A HWB and ICP member noted that the Terms of Reference looked clear concerning Surrey Heartlands ICS and noted the need to consider the strategic relationships with other regional ICSs as services are delivered across boundaries. The Principal Lead - Health and Wellbeing (SCC) noted that he was engaging with Frimley ICS colleagues for example in terms of inputting into the HWB and ICP; he would ensure that other ICSs are considered.

    4.    A HWB and ICP member acknowledged the links with Frimley ICS, the issue concerned other ICSs more widely. The Chair highlighted the NHS Confederation ICS Network and the ICP Chairs Forum, and the Surrey Heartlands ICB Chair for example liaises with West Sussex.

    RESOLVED:

     

    1.    That the HWB and ICP members reviewed the draft shared Memorandum of Understanding (MoU) and respective Terms of Reference (ToR) in detail and would feed back to the authors any amendments, questions and concerns.

    2.    A final version of the MoU for the combined meeting of the HWB and ICP and respective ToRs would be brought back to the next formal combined meeting of the HWB and ICP for final approval, including clear route to approval for any required governance changes at SCC and/or Surrey Heartlands to ensure alignment of processes.

     

    Actions/further information to be provided:

     

    1.    The Principal Lead - Health and Wellbeing (SCC) will ensure that the strategic relationships with other regional ICSs is considered and formalised into the MoU and ToRs.

     

     

26/24

ENABLING STRONGER COMMUNITY SAFETY LEADERSHIP AND GOVERNANCE pdf icon PDF 239 KB

    • Share this item

    Following the merger of the Health and Wellbeing Board (HWB) and the Community Safety Board (CSB) in 2020 it has been recognised that whilst it has developed some helpful and good connections, strong strategic oversight and particularly direction on delivery across the various aspects and workstreams of Community Safety has been limited. It is therefore proposed to review the responsibility with regards to Community Safety currently within the HWB with a view to considering what a separate arrangement could be to take this forward. This would be done whilst maintaining links particularly in relation to the wider determinants of health where there continues to be benefits in alignment between programmes.

    Agenda item for: HWB

     

     

    Additional documents:

    Minutes:

    Agenda item for: HWB

     

    Speakers:

     

    Sarah Grahame, Assistant Chief Constable, Surrey Police

    Tim De Meyer, Chief Constable, Surrey Police

    Alison Bolton, Chief Executive, OPCC

     

    Key points raised in the discussion:

     

    1.    The Assistant Chief Constable (Surrey Police) highlighted the merger in 2020 of the HWB and Community Safety Board which delivered on some of the community safety workstreams and provided positive collaboration, but the time dedicated to community safety was limited due to the HWB’s broad agenda. Going forward a shared steering group was proposed to review what a separate arrangement would look like, as the governance landscape had changed since 2020, with the formation of the Community Safety Assembly, the Serious Violence Reduction Partnership, and the Domestic Abuse Executive.

    2.    The Chief Constable (Surrey Police) noted that to be safe is to be healthy and it was right to take a public health approach to tackling crimes, however the activities necessary to address community safety were distinct requiring dedicated focus. He noted the ambitions of the new government to tackling violence and anti-social behaviour, he noted the aspiration for Surrey to be the safest county in the country. Therefore, it was important to consider constituting a Community Safety Board to progress such work, to better share data on comorbidities and more efficiently direct limited resources.

    3.    The Chief Executive (OPCC) noted that the Police and Crime Commissioner for Surrey was keen to have a strategic level where she could engage with partners on community safety matters. She noted the importance of getting the right role and remit for the Community Safety Board, to streamline the governance landscape and reduce duplication and increase effectiveness in tackling violence and anti-social behaviour.

    4.    The Chair noted that the Surrey Safeguarding Children Partnership and Surrey Safeguarding Adults Board Independent Chairs were supportive of having a more structured board.

    5.    A HWB and ICP member asked whether the voice of people with lived experience regarding violence would be represented in the new board and governance structure. The Assistant Chief Constable (Surrey Police) noted that the good practice in place for example around including the voice of those with lived experience would be developed and enhanced in the new structure.

    6.    A HWB and ICP member noted that given that community safety sits within Priority 3, integral to the collective work by the partners on the HWB and ICP, asked whether in the review it could be considered how the HWB and ICP can be kept updated on the work. The Assistant Chief Constable (Surrey Police) noted that yes that would be considered in line with recommendation two.

     

    RESOLVED:

     

    The HWB:

     

    1.      Agreed that responsibility for strategic oversight of community safety is reviewed to enable stronger and clearer leadership of community safety across Surrey with a view to considering what a separate arrangement could be to take this forward.

    2.      As part of the above, supported appropriate continued interface with the HWB and Prevention and Wider Determinants of Health Delivery Board (PWDHDB) to  ...  view the full minutes text for item 26/24

27/24

HWB STRATEGY (HWBS) HIGHLIGHT REPORT INCLUDING HWBS INDEX UPDATE pdf icon PDF 499 KB

    • Share this item

    This paper provides an overview of the progress in the delivery of the Health and Wellbeing Strategy (HWB Strategy) as of 27 August 2024.

     

    Agenda item for: HWB, and Surrey Heartlands ICP

     

    Additional documents:

    Minutes:

    Agenda item for: HWB, and Surrey Heartlands ICP

     

    Speakers:

     

    Mari Roberts-Wood, Managing Director, Reigate and Banstead Borough Council / Chair of Prevention and Wider Determinants of Health Delivery Board (PWDHDB)

    Lucy Gate, Public Health Principal, SCC / Co-chair of Mental Health: Prevention Board

    Ruth Hutchinson, Director of Public Health, SCC

    Jonathan Lees, Managing Director, Good Company

     

    Key points raised in the discussion:

     

    1.    Priority 1: The Chair of the PWDHDB referred to the spotlight section on Active Surrey, which initiated a new Place Partnership in Stanwell. Club4 was the Holiday Activity and Food programme for Surrey, offering over 39,000 places for children on free school meals. Opportunities: the Surrey Cancer Inequalities Programme would address knowledge gaps and highlight invisible inequalities, it was given national best practice recognition. Challenges: the Joint Strategic Needs Assessment (JSNA) chapter on multiple disadvantage (MD) identified 3,000 plus adults experiencing MD in Surrey, the Bridge the Gap prevention service showed a return on investment of 1:4, funding was undecided meaning that the service could be decommissioned. Active Surrey was waiting to see whether funding for Club4 would continue.

    2.    Priority 3: The Chair of the PWDHDB highlighted that the Council made a successful funding bid to Southern Gas Network for £920,000, for Surrey's Fuel Poverty Programme to deliver support to vulnerable residents. Opportunities: Surrey Against Domestic Abuse Strategy 2024-2029 was an opportunity for strong local leadership to transform the way domestic abuse is tackled, the Expert by Experience Network would play a key role. Challenges: funding for some Local Area Coordinators and for the Serious Violence Duty was due to end in March 2025, the funding for the Household Support Fund was until April 2025.

    3.    The Chair noted that the additional funding for domestic abuse ends in March 2025, the Government needed to be lobbied to sustain it.

    4.    A HWB and ICP member noted that Active Surrey was renegotiating for the Council to continue to host it, he highlighted its amazing work to get kids active and it was working to expand that to adults. Highlighted the Active Surrey School Sports Day in the summer at Guildford, asked all in the room to stand up and then sit down as that used one hundred muscles. Active Surrey was constantly looking for sponsors, urged all to support them as they provided great results.

    5.    A HWB and ICP member noted the limited resources and queried whether the focus should be on inactive people rather than encouraging those who do some activity to do more. The Director of Public Health (SCC) noted that the evidence base was strong, that for those who are inactive doing some exercise made a significant difference to their health. It was important that all take part in the Chief Medical Officer guidelines for physical activity, however focus was needed, using the Index Scorecard to target efforts in Stanwell for example focusing on geography and key communities; Active Surrey was a finite resource.

    6.    A HWB and ICP member referred to  ...  view the full minutes text for item 27/24

28/24

ENABLING A SURREY SYSTEM APPROACH TO POVERTY: SIGNING AND ENACTING THE END POVERTY PLEDGE pdf icon PDF 426 KB

    • Share this item

    This paper outlines the existing commitment of the HWB, recommends the adoption of this commitment by the ICP and outlines the support offer from Good Company and those with lived experience to HWB/ICP members’ organisations to sign the End Poverty Pledge for a poverty-free Surrey and take action. It also outlines how progress will be monitored and how activity will inform a Surrey system approach to poverty in the future.

    Agenda item for: HWB, and Surrey Heartlands ICP

     

     

    Additional documents:

    Minutes:

    Agenda item for: HWB, and Surrey Heartlands ICP

     

    Speakers:

     

    Mark Nuti, Cabinet Member - Health and Wellbeing, and Public Health, SCC

    Ruth Hutchinson, Director of Public Health, SCC

    Jonathan Lees, Managing Director, Good Company

     

    Key points raised in the discussion:

     

    1.    The Cabinet Member - Health and Wellbeing, and Public Health (SCC) noted that winter highlighted the need for support in Surrey’s communities, some people would struggle more than others. Poverty was a year-round problem, the HWB signed the Pledge in July, the HWB and ICP were asked to formally adopt the recommendations to support the Pledge, to be taken to October’s Council meeting and hoped it would filter through the boroughs and districts into Surrey’s communities. Mitigating that would raise people’s standard of living.

    2.    The Director of Public Health (SCC) highlighted the examples of how the Index was being used to monitor poverty. Noted the following three key areas of how all could collectively enact the Pledge and start to reduce the levels of poverty. Leadership: the HWB and ICP targets the Priority Populations and Key Neighbourhoods. The upcoming economy JSNA chapter demonstrated the disparity in social economic status across Surrey, the system wrote to the Government around extending the Household Support Fund. Culture: continually engaging those with lived experience of poverty. Accountability: continuing to explore funding sources and sharing good practice and monitoring the progress. Strategic groups had been briefed and system awareness was increasing building key those themes into the ways of working.

    3.    The Managing Director (Good Company) noted that the food bank started twelve years ago and had grown, several projects developed around supporting people in poverty to develop their emotional, physical and financial resilience so they do not need to rely on the Good Company. The Pledge started around eighteen months ago, it was an aspiration which built into a movement. Noted the Pantry project, where people went to get food but also for companionship and Advice Cafés followed, bringing people together. Highlighted the resources available, signing the Pledge was the first step in collectively making a difference. Invited all to attend the second Poverty Truth Commission celebration event on 27 November, which brought people in poverty together with system leaders exploring why someone ended up in that situation.

    4.    A video was shared on the Pledge, it presented case studies of people in poverty and how they rebuilt their lives, not having to rely on food banks and services. The video encouraged partners to think about the culture of their organisation, how they interact with those struggling and requiring support, using CLEAR: Communication, Listening, Empathy, Agency, Respect.

    5.    A HWB and ICP member asked whether there was a possibility that the Good Company could expand to operate in the west of Surrey. The Managing Director (Good Company) noted that there were no immediate plans for expansion, the Good Company worked with the other eight Trussell Trust food banks, the nine food banks in total covered over 60% of Surrey. He noted that  ...  view the full minutes text for item 28/24

29/24

BETTER CARE FUND UPDATE pdf icon PDF 242 KB

    • Share this item

    The HWB and ICP are asked to note this progress update to the paper that was discussed at the HWB on 19 June 2024 regarding the Surrey 2023-25 Better Care Fund (BCF) Plan.

     

    This paper provides a general update, 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. 

     

    Agenda item for: HWB, and Surrey Heartlands ICP

     

     

    Additional documents:

    Minutes:

    Agenda item for: HWB, and Surrey Heartlands ICP

     

    Speakers:

     

    Jon Lillistone, Director of Integrated Commissioning, SCC

     

    Key points raised in the discussion:

     

    1.    The Chair noted that the Better Care Fund (BCF) should be used where possible to focus on preventative activity and early intervention. Noted the recommendation from the Hewitt Review, that 1% of the NHS budget be ringfenced for prevention. Stressed the need to contain the demand for services.

    2.    The Director of Integrated Commissioning (SCC) noted that the next steps were informed by the outcome of February’s workshop. Highlighted the focus on independence and well-being, and keeping people at home for longer; and that people receive care in the right place. Noted the key relationship with district and borough colleagues around the Disabled Facilities Grant discharge work, and the protection of Adult Social Care. Noted the lack of clear direction from the Government, however Lord Darzi’s report highlighted areas of focus. Stressed the need to focus on outcomes and to strengthen the evidence base around the decision-making on what the BCF is invested in.

    3.    A HWB and ICP member asked whether the Surrey and Borders Partnership NHS Foundation Trust could be engaged, considering how it could be prioritised for the prevention agenda. The Director of Integrated Commissioning (SCC) noted that he would ensure that it would be a key stakeholder engaged with.

    4.    A HWB and ICP member encouraged that recommended communication to happen with the Independent Carers Lead for Surrey as noted in the report, carers were central to the many items discussed on the agenda. 

    5.    A HWB and ICP member supported the Chair’s challenge that more could be done and done better with the BCF. The prevention agenda was key, partners needed to challenge themselves regarding the way in which their programmes of work are structured, the BCF workshop highlighted the enthusiasm for different ways of working; maximising the budget and joint ways of working was vital.

    RESOLVED:

     

    The HWB and Surrey Heartlands ICP:

     

    1.    Confirmed and endorsed the four areas for development from the February 2024 HWB BCF event.

    2.    Agreed the direction of travel (especially in relation to ongoing demands upon social care and the NHS as well as the ambition to develop further our preventative approach).

    3.    Noted the contribution of the BCF in protecting Adult Social Care, health and the voluntary sector services, and its importance in facilitating integrated working.

     

    Actions/further information to be provided:

     

    1.    The Director of Integrated Commissioning (SCC) will engage with the Surrey and Borders Partnership NHS Foundation Trust as a key stakeholder.

     

30/24

LIBRARY OF EXPERIENCES UPDATE pdf icon PDF 263 KB

    • Share this item

    The “Library of Experiences” approach was agreed by the Integrated Care Partnership (ICP) at its meeting on 27 April 2024 to identify, capture and share the lessons from work with communities across the county to reduce health inequalities.  These lessons can inform and improve future work. The approach will continue to be developed so it contributes to further improvements in the design and delivery of work with communities to reduce health inequalities, address the wider determinants of health, and enable local community led improvements across towns and villages and the key neighbourhoods they encompass.

     

    Agenda item for: HWB, and Surrey Heartlands ICP

     

     

     

     

    Additional documents:

    Minutes:

    Agenda item for: HWB, and Surrey Heartlands ICP

     

    Speakers:

     

    Dan Shurlock, Strategic Lead - Thriving Communities, SCC

    Jo Cogswell, Executive Director Strategy and Joint Transformation, Executive Lead for Guildford and Waverley, Surrey Heartlands ICB

     

    Key points raised in the discussion:

     

    1.    The Chair explained that the Library of Experiences captured experiences and produced a guide about what might be found in a town, using that to build supportive infrastructure.

    2.    The Strategic Lead - Thriving Communities (SCC) noted that there were pockets of good practice, the focus must be on how to use the lessons learned, looking at how to engage with communities and co-design with people with lived experience. Thanked colleagues in Horley and North Leatherhead as those were two of the site visits. Referred to the SharePoint site, open to partners providing them access to the learning and examples, making it easier to find out information about specific places and using that to collaborate with communities.

    3.    The Executive Director Strategy and Joint Transformation, Executive Lead for Guildford and Waverley (Surrey Heartlands ICB) highlighted the great work done in capturing the work undertaken. Noted that the name of the approach captured the level of energy, about sharing experiences to create a community of practice. Hoped that the Surrey Heartlands Expo would provide an opportunity to demonstrate the passion and commitment from those that want to share their lived experience. Noted the challenge of recreating that, working with local community networks to advance the work fundamental to the ambitions in the Health and Well-Being Strategy and the Integrated Care Strategy.

    4.    A HWB and ICP member praised the approach, however noted that it focused around the workforce within the ICB and the Surrey Heartlands Expo would have a small group of people in attendance. Noted that there were hundreds of micro examples of good practice and stressed the need to be more ambitious about how the small groups are reached out to, whether indirectly through the larger charities, or also through the schools’ networks, or informal networks of carers; as there was a risk that those small group would feel disconnected. The Executive Director Strategy and Joint Transformation, Executive Lead for Guildford and Waverley (Surrey Heartlands ICB) shared that ambition and welcomed further feedback on how to progress the work, stressed that the approach was not solely for statutory organisations.

    5.    A HWB and ICP member highlighted Voluntary Support North Surrey and noted that there were small umbrella groups, those were being brought together in an upcoming meeting with the Community Foundation for Surrey.

    6.    The Chair noted that it was the ambition to get down to the granular level, testing the data in the JSNA. Noted the challenge of connecting the small charities together, there were over 16,000 charitable and voluntary organisations; the approach sought to establish support infrastructure within each of the communities, attracting those organisations that want to engage.

    7.    A HWB and ICP member welcomed the approach and noted the many connections into the  ...  view the full minutes text for item 30/24

31/24

INTEGRATED CARE BOARD UPDATE: SURREY HEARTLANDS ICB AND FRIMLEY HEALTH AND CARE ICB pdf icon PDF 252 KB

    • Share this item

    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.

     

    Agenda item for: HWB, and Surrey Heartlands ICP

    Additional documents:

    Minutes:

    Agenda item for: HWB, and Surrey Heartlands ICP

     

    Speakers:

     

    Ian Smith, Chair, Surrey Heartlands ICB

    Karen McDowell, Chief Executive, Surrey Heartlands ICB and ICS

     

    Key points raised in the discussion:

     

    1.    The Chair (Surrey Heartlands ICB) highlighted a decision to be taken under Part 2 in private around the Children’s Community Services Procurement. 

    2.    The Chief Executive (Surrey Heartlands ICB and ICS) referred to the Independent investigation of the NHS in England, noting that there were no surprises in Lord Darzi's report. As part of the ten-year planning process the NHS would need to plan how it would deliver those recommendations.

    RESOLVED:

     

    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.      

     

32/24

DATE OF THE NEXT MEETING

    • Share this item

    The next public meeting of the Health and Wellbeing Board, and Surrey Heartlands Integrated Care Partnership will be on 11 December 2024.

    Additional documents:

    Minutes:

    The date of the next public meeting was noted as 11 December 2024.

     

    The Chair noted the seamless operation of the combined meeting, he thanked the Principal Lead - Health and Wellbeing, and Health Integration Policy Lead for their work.