Agenda item

Purpose of the Report: This report provides the Select Committee with the opportunity to consider and comment on the draft Joint Health and Wellbeing Strategy for Surrey.

Declaration of Interests:

None

Witnesses:

Matthew Tait, Joint Accountable Officer, Surrey Heathlands ICS

Helen Atkinson, Executive Director of Public Health

Matthew Parris, Healthwatch Surrey

Key points raised during the discussion:

1. It was explained that the draft Joint Health and Wellbeing Strategy for Surrey was currently out for public engagement and the purpose of the meeting was for the Committee to comment on the draft strategy as well as to put forward specific questions.
2. There was concern around the governance arrangements as part of the monitoring of the strategy delivery. Members commented that there did not seem to be clear lines of accountability within the strategy for the outcomes identified. The Executive Director of Public Health stated that the governance for the draft strategy sat with the Health and Wellbeing Board which both ICSs, Surrey Heartlands and Frimley Health and Care, and the East Surrey & Sussex STP are Members of. Work would be undertaken over the next month to collate engagement feedback and map out priorities alongside existing provision. This mapping of services will be used to review current governance arrangements. The final strategy will be signed off by the Health and Wellbeing Board in April. Sponsors from the Board would be sought to champion priorities and outcomes within the strategy. 
3. The Joint Accountable Officer reassured the Committee that work on governance within the strategy was Surrey-wide. The officer was keen to ensure the right challenge with regards to responsibility for delivery was in place alongside the strategy.
4. The Joint Accountable Officer stated that the deliverables in the strategy were cross-organisation and the challenge would be how to get stakeholders working together in partnership. It was added by the Executive Director of Public Health that there had been unprecedented partnership working when developing the strategy.
5. In regard to NHS property, the Joint Accountable Officer explained that the culture of work across the NHS had improved and this would support any property discussions taking place. Devolution would allow for more discussions to take place around NHS property decision making as so far limited progress had been made.
6. It was queried what steps would be taken to ensure the strategy is delivered to residents on the ground. The Joint Accountable Officer stated that by having a better joined up strategy, outcomes for the population in Surrey would be improved. Challenges around mental health had been raised but working together had resulted in a better approach and better outcomes. The Executive Director of Public Health stated that the strategy was a long term plan which would target deprived groups within the population.
7. A concern was raised around the five population groups contained within the draft strategy and in particular the fact that people with mental health were not specifically identified as one of the five population groups. It was added that the system capabilities section of the draft strategy was difficult to grasp with many high level statements being made.
8. Members recognised that the overall responsibility of the draft strategy sat with the Health and Wellbeing Board but felt that the various organisations who sat on the Board should take a lead in delivering various aspects of the draft strategy. The Joint Accountable Officer agreed that this observation was being addressed but cross-organisational challenge was essential for the draft strategy to be a success.
9. There was consensus amongst the Committee that there did not seem to be much mention about mental health in the draft strategy and it was further queried if this would be refined. It was mentioned that the NHS long term plan clearly identifies funding for mental health and hence the strategy should follow on and make clearer the plans for mental health. The Executive Director of Public Health commented that mental health had been included as part of the overarching second priority in the draft strategy, ‘Supporting the emotional wellbeing of people in Surrey’. Officers had looked at the Joint Strategic Needs Assessment and evidence from this showed that mental health had a great impact on Surrey residents, hence why it had been included within the second priority. It was explained that throughout all five population groups mental health is implicitly referred to. There was an agreement that mental health should be made more explicit throughout the strategy.
10. It was commented the building capabilities for each of the population groups within the strategy seem largely generic and queried if they would be refined before the strategy is approved.
11. In terms of the identification of the five population groups, the Executive Director of Public Health clarified that data underpinned the five population groups chosen and that these groups had the biggest impact in terms of the population.
12. There was a suggestion that there should be more information in the draft strategy around funding for mental health and an explanation as to how this funding would be used. The Joint Accountable Officer agreed that mental health investment would be embedded in the response of commissioners to the NHS 10-year plan and stated he would take away the comments raised by the Member about inclusion of funding within the draft strategy.    
13. The Healthwatch representative queried if there was a legal duty to consult on the draft strategy, how information from the public engagement would be used to influence the strategy and if there were more detailed plans in place to speak to various other population groups. The Executive Director of Public Health explained that a public engagement exercise was being undertaken with the draft strategy and not a public consultation. A public consultation would be required for the next phase of the strategy. It was added that engagement would be key when co-designing services as part of the delivery of outcomes within the strategy. A great amount of work had been undertaken with stakeholders including patient groups and residents to ensure this feedback is taken on board.

Cllr Mary Angell left the meeting at 12:15

14. In terms of the target performance levels included for each outcome identified, it was commented that these seemed very ambitious and it was queried what methodology had been used to arrive at these target levels. The Executive Director of Public Health explained that these target levels were just a starter and as work began metrics would become more defined. Existing national indicators had also been used to support the target performance levels.
15. It was queried if the indicators in the strategy would be adapted to local challenges. In response, it was explained that a performance dashboard would be used with live data. Local evidence would be used to support this dashboard. It was explained that target performance levels were based on national comparators and had also been tested at workshops. A financial model also supported the target performance levels.
16. It was explained that the strategy would be reviewed when the social care green paper was published. 
17. It was explained that the implementation and delivery of the strategy would be scrutinised by the Select Committee going forward. The Chairman proposed that a letter with the Select Committee’s comments on the draft strategy is sent to the Chairman of the Health and Wellbeing Board for consideration.      

Actions/further information to be provided:

None

Resolved:

For the Health, Integration and Commissioning Select Committee to write a letter to the Chairman of the Health and Wellbeing Board with comments raised on the draft Joint Health and Wellbeing Strategy for Surrey.