The Health and Well Being Strategy priorities and related outcomes were endorsed in September; this report provides an update on the refresh of the implementation plans and on the metrics that show progress against the three priorities. The plans provide a summary of programmes supporting delivery of the strategy. Together these inform what is included in the regular highlight reports that are provided each quarter to the Board.
In addition, further to the agreement at the November informal Board meeting, this report provides confirmation of the endorsed Key Localities for Working with Communities and HiAP (Health in All Policies) propositions that will be adopted to support the greater focus on reducing health inequalities.
Ruth Hutchinson - Director of Public Health (SCC)
Key points raised in the discussion:
1. The Director of Public Health (SCC) noted:
· that the report outlined the fourth and final stage of the Health and Wellbeing Strategy review and refresh, following the Board’s endorsement of stage three in September of the revised priority populations, the system capabilities and the principles for working with communities.
· the alignment of the metrics around health inequalities across the system through intelligence and monitoring under the Surrey data strategy, ensuring that the current metrics or shared public indicators reflect the refreshed Strategy; aligning to the Surrey HWB Strategy Dashboard through the Surrey Index with data measured down to small geographical levels, for example through the Index of Multiple Deprivation (IMD).
· the importance of recognising that organisations across the system have their own health inequalities indicators and dashboards including non-public dashboards; flexibility was needed through the alignment with the national Health Inequalities Dashboard and Surrey’s population health management programme.
· that the proposal was to have a new overarching metric for Surrey’s health inequalities ambition “difference (inequality) in Life expectancy across Surrey”:
- Inequality in life expectancy at birth (Female) for Surrey;
- Inequality in life expectancy at birth (Male) for Surrey.
· that the aim was to reduce the gap in life expectancy between males and females in Surrey (the highest and lowest Local Super Output Areas (LSOAs))and the South East region, the overarching indicator was available in the public domain via Public Health England’s Fingertips website.
· that regarding the implementation plans and the programmes, the aim was to publish an updated Surrey Health and Wellbeing Strategy in January 2022, utilising Board feedback gathered through stages one-three of the Strategy review and refresh.
· that the Board’s Highlight Reports - published quarterly - demonstrated progress through the regular review of the Strategy’s three priorities, with operational delivery through the following boards:
- Priorities 1 and 3 - Prevention and Wider Determinants Board;
- Priority 2 - Mental Health Delivery Board.
· that the new Strategy would need to be dynamic and future programmes would be considered ensuring how they:
- aim to reduce health inequality;
- focus on priority populations;
- require collaborative support of health and wellbeing partners;
- demonstrate milestones and short/medium term indicators to contribute to relevant outcomes within the Strategy.
· that next steps included:
- continuing to work in an evidence-based way through the population health triangle, composed of:
- service-level interventions through robust programme management;
- community-level interventions through the Key Localities proposition beginning with five out of eighteen localities;
- civic-level interventions through the Health in All Policies approach (HiAP).
- the development of the Surrey HWB Strategy Dashboard - aligning that with the Surrey Index - cutting across the population triangle.
2. A Board member thanked the Director of Public Health (SCC) for her leadership and the Public Health team (SCC) for its work across Surrey over the past year. He noted the importance of aligning the Board’s work with the NHS Core20PLUS5 approach to reducing health inequalities, which looked at the most deprived quintiles of the national population, identified by the national IMD.
3. The Board member referring to the first recommendation, noted that one way to reduce differences in life expectancy was to see a reduction in the life expectancy at the upper end. The pandemic has meant that Surrey has experienced excess deaths. The Board member suggested that the Health and Wellbeing Board needs to be clear that it aims for all residents to reach the higher life expectancy rather than solely reducing the gap in life expectancy between males and females.
- In response, the Director of Public Health (SCC) recognised the impact of the Covid-19 pandemic; noting that alongside the overarching metric of the “difference (inequality) in Life expectancy across Surrey”, it was important to view this metric in conjunction with ensuring healthy life expectancy as a metric for all Surrey residents.
- The Chairman added that the aim was to increase life expectancy, one of the four priority objectives in the Community Vision for Surrey in 2030 was “Tackling health inequality”; and was happy for the first recommendation to reflect the above point.
4. A Board member referred to Appendix 3 where the priority populations are cross-checked against the draft implementation and asked whether work was underway within those priority populations which were not highlighted in yellow.
- In response, the Director of Public Health (SCC) explained that due to the volume of priority populations, those highlighted in yellow were the initial areas of focus with the rest to be followed up in due course.
1. Agreed the “difference (inequality) in Life expectancy across Surrey” as a common overall long term impact indicator to reflect the strategic focus on reducing health inequality in conjunction with ensuring healthy life expectancy as a metric for all Surrey residents.
2. Noted the developing set of metrics as a reflection of the greater focus on reducing health inequalities and wider determinants of health.
3. Agreed to locating the HWB Strategy metrics and dashboard as part of the Surrey Index as part of ongoing work to better align related dashboards.
4. Noted the range of current and developing programmes currently within the updated draft HWBS implementation plans which support the strategy priorities and outcomes.
5. Formally agreed the next steps outlined in the November informal meeting with regards to taking forward the Health in All Policies (HiAP) and the Key Localities proposition.
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