Agenda item

In January 2022 Surrey County Council announced as part of the county’s No One Left Behind agenda, an extra £8m of focused investment in Early Intervention and Prevention mental health interventions in Surrey.

Senior Officers from across the system have met to draft the proposed criteria and principles for consideration by the HWB and elected Members at the Adults and Health Select Committee.

Witnesses:

Liz Bruce - Joint Executive Director, Adult Social Care and Integrated Commissioning, Surrey County Council and Surrey Heartlands ICS

Kate Barker - Joint Strategic Commissioning Convener, Children and Young People, Surrey County Council and Surrey Heartlands ICS

Sinead Mooney - Cabinet Member for Adults and Health, Surrey County Council

Key points raised in the discussion:

1.    The Joint Executive Director, Adult Social Care and Integrated Commissioning (SCC and SH ICS) noted that:

-       The £8 million early intervention and prevention in mental health investment via a 1% uplift in Council Tax, supported the delivery of the Surrey County Council’s strategic priority of ‘No one Left Behind’.

-       Ensuring clarity in the bidding process and its criteria, implementation plans and outcomes was vital; so that those with mental health needs receive better outcomes.

2.    The Chairman noted that Surrey Heartlands ICS had also contributed £4 million and the Community Foundation for Surrey had provided some match funding.

3.    The Joint Strategic Commissioning Convener, Children and Young People (SCC and Surrey Heartlands ICS) noted that:

-       Public accountability and co-production regarding the Mental Health Investment Fund (MHIF) was fundamental, there was a commitment to use the resources to translate the outcomes already co-designed through the mental health alliance and the independent networks into measurable outcomes for residents.

-       The aim was for the funding process to be inclusive, building on the successful Contain Outbreak Management Fund (COMF) process.

Dr Russell Hills left the meeting at 3.04 pm.

-       The report sought the Board’s support on the proposed criteria, principles and governance framework, so that it is assured that the co-designing process would contribute to the outcomes in the HWS. With short-term investment those proposals would enable innovation with measurable outcomes in relation to mental health identification, early intervention and prevention and that business intelligence evidence would be used to measure what the costs would be to reduce the demand on statutory services, to understand the lived experience of residents and to look at the long-term cost to sustain good innovation.

-       Whilst the scope of the proposed investment covered all ages, teenage suicide was a key focus as was the mental health and wellbeing of men aged 18 to 30 years, support for those with eating disorders, carer support for families, and support in schools and community settings.

-       Support had been provided from Democratic Services in outlining the governance processes, ensuring that there is the appropriate accountability on the spending decisions around the MHIF. Spending might commence in autumn following approval through the governance bodies within Surrey County Council, the ICSs and the VCSE partners.

-       Ensuring alignment with partners and administrative support would be crucial.

-       The Board was to consider how it would contribute to future decision-making concerning the MHIF, how it would like to be kept informed of the developing outcomes and whether there was any additional evidence required for assurance that the proposals would align with the HWS.

4.    The Cabinet Member for Adults and Health (SCC) noted that:

-       The report was thought-provoking and outlined system working to improve the mental health service provided in Surrey; it followed on from the work undertaken by the Adults and Health Select Committee’s Task Group on Mental Health in 2019 with over thirty recommendations, the two Mental Health Summits and the creation of the Mental Health Improvement Board.

-       Funding had been recognised as a priority to improve mental health services and the Leader of Surrey County Council had a few months ago announced the creation of the MHIF to tackle health inequalities.

-       She agreed with the proposed principles in the report which balanced the focus on personalised improvements and better outcomes.

-       Acknowledged that more work needed to be done and it would be good to see engagement with service users and to ensure the clear and streamlined process for approvals for accessing the MHIF.

-       It was vital for the Board to recognise the importance of elected Members - through the Surrey-Wide Commissioning Committees in Common for example - taking public decisions around the MHIF noting the ring-fenced funding from the Council Tax rise.

5.    The Chairman commended the Cabinet Member for Adults and Health (SCC) for championing the MHIF, mental health issues had risen and it was a priority to residents and important that the rise in Council Tax for mental health was ring-fenced, with funding decisions to be made in public. The MHIF would accelerate important projects to support residents’ mental health.

6.   The Vice-Chairman considered the question around Board member support and assurance on the right decisions to be made on the MHIF, agreeing with the proposed purpose which must focus on mental health early intervention and prevention; she would like to see granular detail on where the gaps are and whether there was mapping on the gaps so that the MHIF could be targeted. She asked whether a part of the MHIF should be ring-fenced for children and young people. She also asked how the Board would prove impact through the MHIF and whether there was best practice on the matter.

7.   A substitute Board member noted SABP’s support of the ambitious approach to tackle mental health early invention and prevention for all ages and the importance of early identification particularly for those with eating disorders or neurodivergent disorders for example. He emphasised that it would be vital to go beyond the traditional provision of support and services, towards the innovative work already underway in Surrey. Whilst it would be important to demonstrate that the money would be well spent, the governance over it should not be too constrained, so to allow a flexibility approach and creative response. 

8.   A Board member noted the support from the Public Health team (SCC), referring to the ‘Proposed Criteria & Principles’ outlined in Annex 1 and point about supporting the implementation of the HWS Priorities, she noted that it felt lost in the scope and it was an opportunity in the bidding criteria to emphasise those, aligning with the assessment of the HWS outcomes and linking in with the health inequalities programme.

-       In response, the Joint Strategic Commissioning Convener, Children and Young People (SCC and Surrey Heartlands ICS) noted that the evidence base could be strengthened around health inequalities and the Community Vision for 2030. The report was high-level concerning the principles around the governance and the decision-making; and hoped that in the next few weeks the interdependencies with other strategies would be developed and that areas requiring support would be identified.

Liz Bruce left the meeting at 3.22 pm.

9.   A Board member flagged the interest in the MHIF from Surrey’s schools, welcoming the investment in all ages and highlighted the importance of ensuring children's voices and their practitioners are heard. She noted the comment made in the meeting chat by the Joint Strategic Commissioning Convener, Children and Young People (SCC and Surrey Heartlands ICS) which clarified that schools could meet the criteria for making a bid and that schools would be engaging with successful bidders in the delivery of the services to their children and young people. She queried how schools could be engaged with more broadly in the MHIF process, other than through her representation as the Executive Director for Children, Families and Lifelong Learning on the Board.

-       The Joint Strategic Commissioning Convener, Children and Young People (SCC and Surrey Heartlands ICS) noted that regarding the engagement with schools, she would engage with the Children, Families and Lifelong Learning leadership team and the Director for Education and Lifelong Learning (SCC) to consider the appropriate forum to start that conversation and to identify what support partners might need as part of the application process. She explained that work on the communications around the MHIF was needed and mapping was underway on the resource budget.

10.  The Chairman provided assurance as the Leader of Surrey County Council that the Council’s governance procedures would not delay decisions, as ensuring that the projects move forward as quickly as possible would be crucial and more detail on the MHIF would follow in due course.

RESOLVED:

Reviewed and commented on the proposed criteria, principles, and governance.

Actions/further information to be provided:

1.    More detail will be provided on the MHIF in due course by the Joint Strategic Commissioning Conveners (SCC and Surrey Heartlands ICS) once the criteria, principles and governance arrangements of the MHIF have been approved through the governance channels.

2.    The Joint Strategic Commissioning Convener, Children and Young People (SCC and Surrey Heartlands ICS) will engage with the Children, Families and Lifelong Learning leadership team and the Director for Education and Lifelong Learning (SCC) to consider the appropriate forum to start that conversation around engagement with schools and to identify what support partners might need as part of the application process to the MHIF.