Agenda item

This report provides an overview of the progress of local shared projects supporting delivery of the three Health and Wellbeing Strategy priorities as of mid-August 2021.

Before introducing the item, the Chairmanreflected on the upcoming changes regarding the Health and Care Bill 2021 which was working its way through Parliament, expected to become legislation in April 2022.

He noted that the current Integrated Care System Boards would be combined with the Clinical Commissioning Groups, to form a single NHS-centric Integrated Care Board, its focus would be on the delivery of healthcare across the system. Alongside that Board, there would be an Integrated Care Partnership, which it was envisioned in Surrey would either overlap with or take the place of the Health and Wellbeing Board; which already had a broad membership. Discussion would be had on the future changes including the terms of reference and transition arrangements, ensuring the continued collaborative approach to improving the health and the wellbeing of Surrey’s residents.

Witnesses:

Rod Brown - Head of Housing and Community, 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)

Ruth Hutchinson - Director of Public Health (SCC) 

Key points raised in the discussion:

1.      The Priority One Sponsor highlighted:

·      The importance of collaborative working across different partners.

·      That progress had been made on embedding the social prescribing model through the Green Social Prescribing Working Group.

·      That joint working amplified key messages, partners such as Catalyst, Family Centres, and District and Borough Councils had shared national alcohol and tobacco campaigns to prevent substance misuse.

·      That over the last month the Council had been awarded £2.8 million in funding through the Changing Futures programme to provide additional tailored support in partnership to those facing multiple disadvantage, including homelessness, substance misuse, poor mental health, domestic abuse, and contact with the Criminal Justice System.

·      That active travel was a key area of focus with the Council currently consulting on the new draft Transport Plan including plans to reduce carbon emissions by 46% and redesigning neighbourhoods; the consultation survey would end on 24 October 2021.

·      Local Cycling and Walking Infrastructure Plans (LCWIPs) were being undertaken across Surrey to support active travel, with plans in each District and Borough to be developed by 2023.

·      The Surrey Safer Travel Team had secured an additional £175,000 travel demand management grant from the Department for Transport, of which some funding had been directed to supporting secondary schools.

·      The agenda item on the Movement for Change strategy to 2030 for tackling physical inactivity and inequality whereby co-production was central.

·      That it had been a privilege to serve on the Board, thanking the Chairman and colleagues in Priority One.

2.      The Priority Two Sponsor highlighted:

·         The challenge of delivering significant improvement whilst facing ongoing demand within the mental health system, an emergency response group had been set up in January to mitigate the pressures.

·         That one key initiative that developed out of the emergency response group included the accommodation task and finish group led by the Council in partnership, it looked at more sustainable accommodation options for people with mental health needs and those discharged from acute hospitals or those in crisis, as well as in-home support.

·         That another key initiative set up in June by the Mary Frances Trust and Catalyst, was an in-reach initiative into Surrey’s acute mental health wards, supporting individuals and their families pre- and post-discharge and connecting them to other community assets.

·         The enhanced paediatric offer regarding wraparound support with acute hospitals, out of hours mental health services, weekend services and the children’s crisis line; to support the increasing number of children going into Accident and Emergency with mental health crises.

·         That Surrey was being supported by NHS England to set up a Tier 4 unit for those children who were most unwell and facing crises, a twelve bed unit in east Surrey was anticipated to be open by early summer, ensuring that children did not have to travel outside of the county.

·         That the Mental Health Delivery Board had a workshop to review the recommendations concerning the Mental Health Improvement Plan and as a result ten workstreams had been established and three cross-cutting themes identified.

·         The programme infrastructure was being developed to drive the Improvement Plan forward and an Interim Programme Director and workstream sponsors were in place.

·         That under the first workstream of Early Intervention & Prevention Vision and Strategy, the Independent Mental Health Network had led a piece of consultation work alongside Catalyst with service users and carers to gather their views on the Vision; as a result of the consultation, lunch and learn sessions were being set up to ensure co-production.

·         Regarding the improving access and preventing service gaps workstream, the different access points within the complex mental health landscape were being reviewed and Public Health (SCC) had been working to map those different points and support partners to look at how those points could be brought together to make access easier for local people; three workshops would be run in September led by Public Digital.

·         That an emotional wellbeing conference was hosted for local employers in June, the workforce wellbeing collaboration was led by the Council with third sector partners and the Surrey and Borders Partnership NHS Foundation Trust (SABP), as a result a follow up programme was underway with employers.

·         That services launched to support new parents included the new Maternal Mental Health Service and a psychotherapy in-reach into the neonatal services.

·         That the Surrey Dementia Strategy had been refreshed to provide enhanced support, noting the gap in the provision of post-diagnostic support. Funding had been used for Admiral Nurses and noted the use of the Technology integrated Health Management (TiHM) monitoring service.

·         The Behaviour & Intentions workstream included the commissioning of the Independent Mental Health Network, Surrey Minority Ethnic Forum and Healthwatch Surrey to lead a three-month piece of work on user-led design beginning with SABP, ensuring users were at the centre of governance structures.

·         Regarding the Integrated System working workstream, a pilot was underway in Epsom to align the community mental health services into Primary Care, and the continued rollout of the GP Integrated Mental Health Service (GPIMHS) programme.

·         That SABP had allocated executive leads at place level, to be followed by operational and clinical leads, helping develop the Communications & Engagement workstream.

·         That the Time to Change Surrey programme had been relaunched, lived experience champions were in place working with the public to look at attitudes to mental health and to challenge the existing stigma.

·         That work was underway to align some of the mental health improvement work alongside the Health and Wellbeing Strategy refresh.

3.    On behalf of the Priority Three Sponsor, the Director of Public Health (SCC) highlighted:

·         That as a result of the Health and Wellbeing Strategy refresh there would be a particular focus on the wider determinants of health.

·         The Board’s whole system approach to poverty, focusing on aspects of the Community Impact Assessment which highlighted the disproportionate affected of Covid-19 on certain population groups. 

Borough Councillor Nick Prescot joined the meeting at 10.58 am

·           That Appendix 3: Digital Inclusion Programme Initiation Document (PID) was a key system capability for reducing health inequalities through the digital inclusion programme, the deadline for any initial comments was 24 September 2021.

·           That Appendix 2: All Age Autism Strategy 2021-26 reflected the partnership working across Surrey and the ambition to achieve an autism-friendly approach; involvement with children, young people, adults, families and carers and key community groups was fundamental.

·           That within the Strategy there were five workstreams with clear objectives, including the understanding and awareness of autism education.

4.    The Chairman welcomed the updates which highlighted the interlinkages between programmes concerning skills and access to information, noting the importance of the interlinkages between the Board and the Growth Board.

5.    Regarding the All Age Autism Strategy 2021-26 and reference to Independent Living, a Board member asked whether the evidence of some people being admitted to hospital because there were not the right specialist residential placements was included in the Strategy to be addressed.

-       In response, a Board member explained that:

-       there was a commitment which was backed up with a substantial part of the capital programme to roll out supported living for all client groups.

-       there were two complicating factors to address, the first was around ensuring that hospital admission would not result in people losing their existing accommodation; and the second factor related to the offer made under the Care Act 2014 to people with autism which related to a proportion of that population.

-       people with autism were better supported when they were children then when they are adults, a change in legislation was vital to ensure a comprehensive offer for people with autism.

6.    A Board member highlighted the successful organisation of holiday camps for children over the summer holidays that the Council launched and ran, to which she visited. Although universally available, the clubs were targeted at children from disadvantaged groups and those facing food poverty - exacerbated by the pandemic. Lunches were provided and she added that the clubs focused on catch up learning and healthy living, the activities were enjoyable, and she hoped that the camps would continue in the future.

RESOLVED:

1.    Noted the progress against the Strategy.

2.    Board members would share the Highlight Report across their networks (direct links to quarterly highlight reports available at www.healthysurrey.org.uk/about).

3.    Endorsed (informally) the All Age Autism Strategy as a system-wide strategy for Surrey including the priority actions set out in the implementation plans in Year 1 and supported their delivery across the system.

4.    Board members were encouraged to provide feedback from their organisations on the Local Transport Plan and the Digital Inclusion Programme Initiation Document.

Actions/further information to be provided:

None.