Agenda item

This paper provides an overview of the local shared projects supporting delivery of the Health and Wellbeing Strategy against the milestones within priorities one, two and three as of January 2021. It highlights specific areas where work has been adapted and stepped up to respond to the impact of the pandemic and in response to the intelligence provided locally through the Community Impact Assessment and Rapid Needs Assessments which were presented at the December 2020 board meeting. A summary of progress is provided by project in Appendix 1.

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)

Sarah Haywood, Community Safety Policy and Commissioning Lead, Office of the Police and Crime Commissioner for Surrey (OPCC)

Key points raised in the discussion:

1.   The Priority One Sponsor highlighted:

·      Focus Area 3: Ensuring that everyone lives in good and appropriate housing - there were two cabins for Covid-19 symptomatic homeless people and also for winter shelter provision, the license would cease at the end of March but a larger site would be established on 1 April in Surrey Heath.

·      There were 35 projects involving 44 people in the Priority, with real progress being made.

·      The work within the Priority was overseen by the Prevention Board which was a productive multidisciplinary board.

·      Focus Area 7: Living Independently - see item 7, report on Palliative and End of Life Care (PEoLC) Strategy 2021-2026.

·      Focus Area 2: Supporting prevention and treatment of substance misuse, including alcohol and Focus Area 3: Ensuring that everyone lives in good and appropriate housing - Surrey had been shortlisted by the Ministry of Housing Communities and Local Government (MHCLG) for the Changing Futures Fund to help potential projects to address:

-     enhancing and extending a pilot outreach service called Bridge the Gap to include clinical support and reach people in temporary and move-on accommodation.

-     evidence to invest further and develop early intervention and prevention services such as cuckooing and Checkpoint Plus.

-     innovative solutions to fill accommodation gaps across the wider system, including philanthropic, social and community solutions.

2.   The Priority Two Sponsor highlighted:

·      That overall the Priority remained rated Amber as Covid-19 had affected the delivery of workstreams.

·      That there continued to be a high demand for mental health services with high levels of acuity, particularly in crisis services and bed-based services.

-       There had been a rise in crisis services from 33% prior to the pandemic to 80% at present.

-       There was an increase in children reporting poor mental health and eating disorders increased due to the lockdowns. 

-       There was insufficient supply to meet the demands to support children with poor emotional health and Surrey had called for a coordinated national response which had resulted in a response to improve access to bed-based services.

·         Regarding mental health, Surrey and Borders Partnership NHS Foundation Trust (SABP) had set up a weekly Emergency Response team to identify pressure areas which were then escalated to the Surrey Heartlands Covid-19 Incident Management Group.

·         Following the Mental Health Summit last November, an independently chaired Mental Health Partnership Board was established - see item 8: Improving Mental Health Outcomes, Experiences and Services In Surrey. The Partnership Board looked to at ensuring good mental health and reducing health inequalities, as well as benchmarking and best practice, supported by the Centre for Mental Health.

·         The twenty recommendations from the Adults and Health Select Committee’s Mental Health Task Group had been incorporated into the Priority with a progress update to the Select Committee presented yesterday. In line with those recommendations a 24/7 Safe Haven in Woking had been established on 15 February and was funded through Winter Pressures funding, as well as an update on the continued roll out of the Surrey Care Record.

·         NHS England had confirmed funding for the continued roll out of the GP Integrated Mental Health Service (GPIMHS) programme across the county’s eleven Primary Care Networks (PCNs), although ensuring a swift roll out was a challenge.

·         That work was underway with primary care colleagues on the Additional Roles Reimbursement Scheme (ARRS) to put in place mental health practitioners - to be coordinated with GPIMHS.

·         The Tech to Community Connect project was being rolled out across Surrey to support people at risk of or suffering from, digital exclusion.

·         That the Surrey Virtual Wellbeing Hub was launched in December and offered one-to-one support for the workforce and training. There was a good uptake and through the Hub, acute hospitals and their wellbeing teams were linked in, with the formation of a wellbeing network.

·         That risks and challenges included some pauses to workstreams in the First 1000 Days strategy due to Covid-19.

·         The low number of annual health checks for people with a serious mental illness and so locally there was a piece of work to address that in conjunction with the Integrated Care Partnerships (ICPs) and to refine communications and digital reporting.

3.   The Priority Three Sponsor highlighted:

·         That there was not a natural single partnership for the work as it brought disparate pieces of work together to provide coherence.

·         That the impact of Covid-19 on the Priority meant that a period of reassessment was underway, including the key elements of the community safety work and a greater focus on inequality, child poverty and the wider determinants of health.

·         That the Social Progress Index had been expanded to cover new areas post Covid-19, including transport, business, economic recovery and was renamed the Surrey Index and would be on Surrey-I.

·         That work continued with the One Surrey Growth Board and the 2030 Economic Strategy Statement and the 2030 Community Vision for Surrey.

·         Focus Area 1: Supporting Adults to succeed professionally and/or through volunteering - work was underway on skills for young people and the workforce needs and growth sections in a post furlough world, with funding for:

-       £500,000 bid for Health Foundation funding had been submitted for the economies for healthier lives, regarding employment and training pathways for children and young people in Pupil Referral Units.

-       The Apprenticeships and Skills Hub was operational as of mid to late February which was progressing well.

·      Focus Area 2: Supporting children to develop skills for life - some pauses to workstreams on First 1000 Days strategy due to Covid-19.

·      Focus Area 3: Supporting communities to be safe and feel safe - linking in the community safety priorities, the draft Surrey Community Safety Agreement 2021 to 2025 (CSA) had been discussed at February’s informal Board, with a consultation period in April and sign-off at the June Board. 

-       A Board member added that hopefully following sign-off in June, thought needed to be given as to how to incorporate it into the Board’s three Priorities; whether Community Safety needed to be a standalone additional Priority as opposed to Focus Area 3 in Priority Three.

-       The Community Safety Policy and Commissioning Lead (OPCC) noted that the draft CSA would be re-circulated to Board members with the opportunity to provide feedback and that the next steps would be to review the governance and how to deliver its priorities.

4.   A Board member referred to Priority One, Focus Area 2 noting that the Prime Minister was planning an advertising campaign to address drug use by the middle-class by making it socially unacceptable to snort cocaine; it had long been a concern of his and hoped that Surrey would take that national campaign onboard.

5.   A Board member referred to the draft CSA, which referenced the change to the Probation Service with the new model to come into effect in June 2021 and that the section on that service was about delivery but did not seem to reference the partnership working potential opportunities for collaboration; noting that prolific and priority offenders were processed through probation but there was little in terms of actions or support in relation to those perpetrators from a health or a community safety perspective, so asked for further detail and assurance on the issue. 

-       In response, the Priority Three Sponsor noted that he would take that point away regarding priority offenders and the Probation Service which would be fed into the consultation stage. 

6.    A Board Member referred to Priority One, Focus Area 1: Helping People to live healthy lives - around the whole system approach to obesity, she noted that it was important to get the strategy right, particularly following the pandemic. She welcomed the involvement of local people and lived experience from the prioritised populations groups identified in the Community Impact Assessment (CIA) and sought assurance that co-production and co-design meant involving people with lived experience throughout the whole development and implementation of the Strategy.

-       In response, the Priority One Sponsor recognised the complexities and the interdependencies, noting that within the Prevention and Wider Determinants Board many co-dependencies were represented at a professional level and had been a recent area of discussion. Regarding co-production, he would liaise with the Senior Responsible Owner (SRO) for Priority One.

7.    A Board member noted that within Priority Two, Tech to Community Connect was being extended to Black, Asian and Minority Ethnic (BAME) populations in North West Surrey offering support to those in deprived areas; and commented that regarding Priority Three and other opportunities in the county, there was work underway on looking at the role of the system as an anchor institution and that a national anchors network had recently been set up.  

8.    The Board member referred to Priority One, Focus Area 4: Preventing domestic abuse and supporting and empowering victims - noting the ‘White Ribbon’ accreditation. He noted that Board members had received a past presentation on Iris in East Surrey and he asked what progress had been made and whether ICPs could help with that and as part of Covid-19 recovery. 

-       In response, the Priority One Sponsor noted that he would take the point away regarding the Iris rollout. 

9.    Referencing the upcoming electoral cycle and uncertainties ahead for the elected Members on the Board, a Board member:

·         Reflected on the Board’s positive changes since the beginning of the electoral cycle, as it no longer focussed on the frail elderly but felt like a Board about everyone.

·         Welcomed the focus on mental health for young people and allowing people to fulfil their potential. She pleaded that following the upcoming electoral cycle, Board members would continue that focus on young people noting the impact of Covid-19 on 16 to 25 year olds.

·         Noted that an area for a quick win was Priority One, Focus Area 3: Ensuring that everyone lives in good and appropriate housing and that it would be helpful if the Board reminded partners of their duty to apply statutory Corporate Parenting principles in their work. Care Leavers was a vulnerable cohort, noting the inconsistent offer in Surrey as there were still three District and Borough Councils that did not have a Council Tax exemption for Care Leavers aged 18-25 years old and one District/Borough Council did not fulfil its duty to allow care leavers from other parts of the county to apply for local housing.

10.  A Board member commented on Priority Two and yesterday’s Adults and Health Select Committee which had a robust discussion around the findings from the Mental Health Task Group and highlighted two key points:

-       There was strong support for our third-party sector and the importance that they placed ensuring easy access to information across the system.

-       Ensuring a consistent approach in commissioning was a key area of focus.

The Board member noted that she had agreed to update the Select Committee in six months on the progress of the Mental Health Partnership Board on the twenty recommendations.

11.  The Chairman thanked the Priority Sponsors for presenting and noted that genuine progress had been made but there was still work to do. 

RESOLVED:

1.    Noted the progress and adaptations made in response to the pandemic.

2.    Reviewed and approved the draft Community Safety Agreement shared via the recent informal session for wider consultation prior to alignment within strategy priorities, particularly Priority Three.

3.    Agreed the review of focus areas that are currently reported within the three priority areas. This will be to ensure they continue to be relevant, are appropriately located under the priorities and continue to maintain a focus on collaborative work to address health inequalities and the longer term impact of the pandemic.

Actions/further information to be provided:

1.    The Priority Three Sponsor will ensure priority offenders and the Probation Service will be fed into the consultation stage of the draft CSA.

2.    The Priority One Sponsor will liaise with the SRO to seek clarity on co-production, in relation to the whole system approach to obesity.

3.    The Priority One Sponsor will look into the progress made regarding the Iris roll out in relation to domestic abuse.