Agenda item

The Health and Wellbeing (HWB) Strategy is a critical element of delivering Surrey’s overall 2030 Vision. The report describes the status of projects in the Health and Wellbeing Strategy against previously agreed milestones as of October 2020, providing an overview across all the priorities, highlighting progress being made whilst also continuing to recognise where there is a continued and ongoing impact resulting from the COVID-19 pandemic. A brief update on the overall health and wellbeing metrics is provided. Also provided is the outline of the adoption of longer-term oversight of relevant work identified within the Voluntary, Community and Faith Sector (VCFS) strand of the Recovery Coordinating Group.

Witnesses:

Rod Brown - Head of Communities and Housing, Epsom and Ewell Borough Council (Priority One Sponsor)

Professor Helen Rostill - Director for Mental Health, Surrey Heartlands ICS and SRO for Mental Health, Frimley ICS (Priority Two Sponsor)

Rob Moran - Chief Executive, Elmbridge Borough Council (Priority Three Sponsor)

Key points raised in the discussion:

1.      The Priority One Sponsor noted that although the Priority covered a broad area with seven focus areas and thirty-five targeted projects it was progressing. He noted:

·         the work within the Priority was overseen by the Prevention Board which was developing positively with increased membership and board members were proactively bringing assistance and working with other Priority leads to join up work and tackle challenges.

·         the natural connectivity emerging between focus areas such as focus area 1 concerning excess weight working closely with focus area 5 concerning the incidence of serious conditions and diseases.

·         that housing was a major factor, good progress had been made as for example two sites for homelessness cabins in Surrey were being established which would help alleviate winter pressures and some accommodation would be put aside for Covid-19 positive homeless so they could self-isolate.

·         that due to Covid-19 several projects on domestic abuse had been accelerated such as the provision of additional domestic refuge capacity. The Priority Board were due to consider a fuller report on focus area 4 on domestic abuse and empowering survivors early next year, as well as reports on focus areas 5 and 6 later next year.

·         that Covid-19 brought challenges such as in focus area 3, project 1: ‘tackling fuel poverty, as a Senior Responsible Owner still needed to be identified and he welcomed suggestions; progress had been hindered in other areas but there were signs of those projects picking up momentum.

2.      Discussing focus area 3 and project area 1 ‘tackling fuel poverty in Surrey’ within Priority One, a Board member noted that there were various schemes across the county for those to donate their Winter Fuel Payment to charity who did not need it, but was struck by the small amount donated with only £19,000 donated last year in Waverley. He asked whether the Board could look into the matter to increase those donations.

-       In response, the Chairman explained that the Board would take that point away and look to work with charities.

-       The Priority One Sponsor added that he would look into the matter.

3.      Discussing focus area 3 and project area 4 ‘supporting people who hoard in Surrey’ within Priority One, a Board member asked for further detail on the matter and whether there was an impact on policing.

-       In response, the Priority One Sponsor would look to provide more detail.

4.      The Priority Two Sponsor noted the shift seen concerning mental health in the last few weeks and system partners working closely together. She noted:

·           that the Surrey Mental Health Summit 2020 in November energised and renewed commitments to work in partnership to improve outcomes for residents. The Summit discussed the community impact of Covid-19 on mental health as highlighted by the CIA; as well as initiatives in the workplace such as in Australia promoting good mental health and its impact on productivity and partnership working in West Yorkshire promoting acts of kindness in communities. 

·           the outputs from the Summit included concern over the ongoing resourcing of mental health, the importance of wellbeing and early intervention, training, partnership working and supporting carers of people with mental health. The next steps would be considered by the Surrey Heartlands Health and Care Partnership System Board in December.

·           the Adults and Health Select Committee’s Mental Health Task Group report which took a bottom-up approach by looking at the journey for service users, carers and those who commissioned services. The Task Group were embedding recommendations within the Priority with further progress to be tracked.

·           the use of the CIA’s insights and cross-checking priorities to target affected groups such as the recently unemployed or at risk of losing their job due to the pandemic through a working group with the Department for Work and Pensions, Citizens Advice and Richmond Fellowship.

·           that pressure continued in mental health, recent benchmarking showed a surge in demand with a 22% increase in demand for children’s services nationally with the impact being felt in Surrey. The increase in acuity for adults continued around the crisis pathway and inpatient services.

·           the green social prescribing Expression of Interest submitted to the Department for Environment, Food and Rural Affairs to scale up existing local projects in Surrey including community gardens, community sheds and walking for health. Surrey was invited to submit a full application; to secure part of the £4 million funding.

·           the completion of the first phase of the GP Integrated Mental Health Service (GPIMHS) programme across the county’s eleven Primary Care Networks (PCNs) which had helped over 3,000 people. Development of an enhanced pathway for people with Personality Disorder (PD) traits was underway, development of the 18 to 25 Young Adults’ pathway was also underway - with a bid submitted to NHS England for further funding to phase rollout across all PCNs.

·           the small amount of funding awarded from NHS England to develop a workforce wellbeing hub to address Covid-19’s disproportionate effects on the health and care workforce, to accelerate the promotion of prevention and self-care offers through a single gateway with an enhanced Improving Access to Psychological Therapies (IAPT) offer and 1:1 support.

·           the key risks included health inequalities and risks around physical health checks for people with serious mental illness and for those with learning disabilities with targets set through the NHS Long Term Plan not being reached nationally. There was a real focussed effort with NHS England nationally and regionally to increase the number of people getting those psychical health checks, as well as work with ICPs and PCNs to put together a local action plan.

5.    The Chairman endorsed the comments on the Surrey Mental Health Summit 2020 which was a good opportunity to reinforce the key priorities and review the current model; partners recognised that there needed to be a real focus on prevention and early intervention work.

6.    The Priority Three Sponsor summarised the progress in the three focus areas:

·         focus area 1 - the 2030 Economic Strategy Statement and the county’s approach to skills and unemployment were key and were covered in the next item. The SPI also was also a crucial piece of work and was covered in the previous item.

·         focus area 2 - overseen by the Women and Children’s Transformation and Assurance Board and key work included the First 1,000 days initiative.

·         focus area 3 - as a result of the Community Safety Board’s merger with the Health and Wellbeing Board in March 2020, the community safety priorities have been merged with the Strategy fulfilling Surrey Police’s vision for communities to be safe and to feel safe. Next February the Board would hold an informal session to agree key themes around the Community Safety Agreement and the relationship between health and policing, undertaking a risk-based and partnership approach to crime and disorder prioritisation and residents’ perceptions of crime. The Board would receive an update on the milestones and programmes of work at its next meeting.

7.    A Board member was glad that work on community safety was moving at pace as it was the foundation of many of the workstreams.

8.    The Vice-Chairman noted Public Health England’s insightful guidance document ‘Health Matters: Cold Weather and COVID-19’ which highlighted the impacts of the cold on vulnerable people with Covid-19 amplifying cold-related risks. The document noted the link between the risk of cold outdoor temperatures and winter weather with the increased incidence of heart attacks and strokes. Therefore, the message of keeping warm - particularly for vulnerable residents - was important and was included in Healthy Surrey’s communications ‘keep warm, keep well’ linking to the County Council’s ‘Winter advice 2020-21’, with similar communications and guidance prepared by the NHS.

9.    The Chairman noted the positive progress across the three Priorities which were all interlinked.

RESOLVED:

That the Health and Wellbeing Board:

1.      Noted the positive impact a sustainable economy, enabling a greener future and empowering communities to support each other, can have on reducing inequality and endorse a focus on these through the work of the Health and Wellbeing Board.

2.      Considered and approved the Community Safety Agreement focus areas as described under Priority 3.

3.      Noted the shared progress described across the three strategy priorities in adapting and responding to the impacts of the pandemic.

4.      Noted the adoption of longer-term oversight of relevant work identified within the VCFS strand of the Recovery Coordinating Group which should inform relevant work and the system capability discussion at the March Board.

Actions/further information to be provided:

1.      The Board will continue to identify a Senior Responsible Owner regarding Priority One, focus area 3, project 1: ‘tackling fuel poverty in Surrey’.

2.      The Priority One Sponsor on behalf of the Board will look to work with charities concerning increasing donations of the Winter Fuel Payment to charities.

3.      The Priority One Sponsor will look to provide more detail on hoarding in relation to the policing impact.

4.      Following the informal session to agree key themes around the Community Safety Agreement and the relationship between health and policing focus area 3, the Board will receive an update on the milestones and programmes of work at its next meeting.