Agenda item

The COVID-19 pandemic is unprecedented in its impact on the health and economic situation locally, nationally and internationally so effective recovery will require working differently. Changes to how we work includes how we provide population health intelligence to prioritise partnership actions. This paper sets out a plan for the delivering the early population health intelligence response to support recovery which will inform the refresh of the Surrey Joint Health and Wellbeing Strategy and other strategies. The ways in which these proposals relate to previously agreed plans for the refresh of the Joint Strategic Needs Assessment are described.

Witnesses:

Dr Julie George - Consultant in Public Health (SCC)

Satyam Bhagwanani - Head of Analytics and Insight (SCC)

Key points raised in the discussion:

1. The Consultant in Public Health introduced the report noting that proposals for refreshing the Joint Strategic Needs Assessment (JSNA) and the Social Progress Index were received last by the Board in March. Due to Covid-19, the approach would need to change to deliver the early population health intelligence response to support recovery in order to inform the refresh of the Surrey Health and Wellbeing Strategy and the Board’s priorities for the next six months.
2. The Head of Analytics and Insight outlined the work of the Community Impact Assessment which was split into the following areas:

·         Overarching Thematic Assessment - different types of impacts on communities, including physical health impacts to those who had contracted Covid-19 or died from it and wider indirect impacts such as mental health, housing and transport issues.

·         Vulnerability and Impact Assessment - the geographical analysis of impact to understand areas in Surrey most impacted directly as well as indirect effects such as a rise in unemployment and domestic violence.

·         Place-Based and Population Based Strength and Needs Assessments - engagement with people, focus groups, linking back to communities and target groups in the Health and Wellbeing Strategy. Fifteen priority groups had been shortlisted and were provided to the Recovery Coordinating Group (RCG) and feedback from Board was welcomed. The qualitative approach was being finalised to identify the right people and partners with expertise to liaise with.

Dave Hill left the meeting at 2.55 pm

1. The Consultant in Public Health commented that work was already progressing in some of the fifteen priority groups identified, many of which overlap with the priority areas or target populations in the current Health and Wellbeing Strategy.
2. She summarised the findings from the ‘Covid-19: Review of disparities in risk and outcomes’ report recently published by Public Health England, through graphs which were separated by ethnic groups for males and females on the inequality in mortality over the past five years and over the ongoing Covid-19 pandemic. There was a large difference in mortality due to Covid-19 in non-White ethnic groups such as Asian, Black Mixed and Other for both men and women - more pronounced in men.
3. A Board member welcomed the Board’s focus on health inequality. He noted that he and the Consultant in Public Health represented the Surrey Heartlands Integrated Care System (ICS) at the NHSE/I Southeast BAME Population Mortality Improvement Board. He reported on examples of good practice elsewhere in the Southeast. These included Slough, where over half of its population belonged to BAME groups, where a population health management approach was being taken and West Sussex who were working through their primary care networks.
4. A Board member highlighted that the grouping of children with Special Educational Needs and Disabilities (SEND) was too wide a priority group. There was evidence that young people with autism found it difficult to deal with Covid-19, which should be a focus given the high cases in Surrey. In response, a Board member noted the national work on autism and the gap exposed by Covid-19. Surrey were involved in that work through the Surrey and Borders Partnership NHS Foundation Trust Chief Medical Officer Dr Justin Wilson.
5. The Consultant in Public Health recognised that the identified population groups needed refinement and would evolve as the community impact work is refined. Additional groups also identified were those with substance misuse issues and elderly residents whether in care homes or receiving domiciliary care. She suggested that members provide feedback on the fifteen populations groups identifying any gaps or more refined group definitions.
6. A Board member explained that a third of her workforce were BAME and queried whether there were active discussions by public sector employers to address Covid-19 inequalities. In response, a Board member noted that Surrey Heartlands ICS had a well-developed action plan to address risks for the BAME workforce issue, including implementing a risk assessment with large providers across Surrey Heartlands but also General Practices, care homes and wider primary care sectors. Weekly coordination calls had been set up with representation from across different organisations to address BAME inequalities. Work was ongoing to establish a BAME Alliance, to oversee the workforce and the population health work and would have wide representation across public sectors. 

RESOLVED:

1. Agreed the approach to population health intelligence to support recovery.
2. Confirmed that the Board agrees that it is a suitable approach to providing Joint Strategic Needs Assessment for the next six months.

Actions/further information to be provided:

Board members are encouraged to provide feedback on the fifteen population groups, identifying any gaps or group definitions requiring refinement.