Agenda item

Purpose of the report: To provide an update to the Adults and Health Select Committee on progress since the June 2022 meeting.

Witnesses:

Rachel Crossley, Joint Executive Director for Public Service Reform (Surrey County Council and Surrey Heartlands ICS)

Lucy Clements, Health Integration Policy Lead (Surrey County Council and Surrey Heartlands ICS)

Kate Barker, Joint Strategic Commissioning Convenor – Children

Liz Williams, Joint Strategic Commissioning Convenor – Learning Disability and Autism and all age Mental Health

Clare Burgess, Chief Executive of Surrey Coalition of Disabled People

Key points raised during the discussion:

1. The Joint Executive Director explained that the Mental Health Investment Fund (MHIF) was all age and there was delegated authority for both health and the Council, and therefore, it was run as a joint fund. The MHIF did not need to be spent completely in the current financial year (2022-23); some larger procurements may be supported. The first round of the grant process was expected to take place prior to Christmas (2022) and to then run every two to three months. Opportunities could include early help projects for winter pressures. The work would also be linked in with the key neighbourhoods of the Health and Wellbeing Strategy (HWB Strategy).

2. The Chairman asked about other organisations that were approached to be involved in the MHIF and their responses. The Joint Executive Director explained that the Council approached Surrey Heartlands ICS (Heartlands) and Frimley Health and Care Integrated Care System (Frimley). Frimley were supportive but did not have the finances to invest in the fund at the time and the conversation remained open for future opportunities. Heartlands had funding available and contributed £4 million to the fund. District and Borough Councils did not formally want to pursue the opportunity. Community Foundation Surrey was able to raise a substantial amount of funding. Private sector funding was not explored and the Police and Crime Commissioner nor the Chief Constable did not indicate interest.

3. The Chairman asked how the priorities of the MHIF synergised across the organisations involved. The Joint Executive Director explained that the fund was separate to allow focus on the Mental Health Improvement Plan (MHIP), however, prioritises would be assessed against priority two of the HWB Strategy.

4. The Chairman queried whether there were plans to increase the funding available in the MHIF and asked about the length of funding. The Joint Executive Director explained that they were looking at seed funding, where they would get a project off the ground which would enable them to access longer term funding elsewhere. The Council could look to agree a different approach to the ring-fencing of the funding, which would enable more opportunities. The Joint Strategic Commissioning Convenor for Children added that there were two parallel work programmes, one on prevention and one on intervention, but a collaborative decision was taken to merge the work programmes, and this has resulted in improvements.

5. In response to a question on the amount of money available for investment at a time of increasing demand, the Joint Executive Director responded that officers shared the concerns. In terms of prevention work, this money increased the capacity and opportunity. They needed to think about maintaining some funding going forward, whilst recognising the other pressures on the Council’s budget.

6. A Member asked about the criteria used to reach out to individuals to identify projects that are suitable for funding. The Health Integration Policy Lead explained that it was early stages of reaching out and there would be various different channels of communication when it goes out to public. Officers had linked in with the Mental Health Service Delivery Board (MHSDB) and asked them to identify areas for early support, as well as speaking to place leaders at ICS level who would liaise with their Alliance Partnerships to identify areas of need. The Joint Strategic Needs Assessment (JSNA) would also inform this process.

7. A Member questioned how often the Allocation Panel would meet. The Health Integration Policy Lead shared that they had taken advice from other fund programmes, and they would take place on a quarterly basis. They would work with the Cabinet Member for Adults and Health to ensure that the Panel was representative and there would be those with lived experience on it. The Joint Executive Director added that they would work with the Voluntary, Community, and Social Enterprise (VCSE) sector to ensure they were represented on the Panel, whilst recognising when conflicts of interest could occur. The Select Committee could be advocates of the Panel.

8. The Chairman asked how the MHIF would not impinge on the priorities of the MHIP. The Joint Strategic Commissioning Convenor for Children explained that the MHIF was linked to the priorities and were looking for projects which could be scaled up to bring significant benefit to the population. The Joint Strategic Commissioning Convenor for Learning Disability and Autism (LD&A) and all age Mental Health added that the JNSA would provide a source of evidence and priority setting would be based on evidence and impact. Programme one of the MHIP would set the priorities of the fund.

Cllr Robert Evans left the meeting at 1pm.

9. A Member asked about the potential innovative forms of mental health support the MHIF could support. The Joint Executive Director explained that these could be digital solutions, such as the use of artificial intelligence or predictive analytics. In terms of the workforce, it could explore what healthy work looks like post-pandemic. The Joint Strategic Commissioning Convenor added that there had already been school-based group work around transition points which was a 6-to-12-week course that allowed young people to have a trusted safe space to discuss with peers. The early indications had been positive, and this was an example of a low-cost scheme which produced a high impact.

10. Responding to a question on demographics that could be overlooked, the Joint Executive Director explained that there were six key neighbourhoods identified in the Health and Wellbeing Strategy, as well as full insight packs on 21 neighbourhoods. There would be work with District and Borough colleagues to balance the services which already existed. The JSNA would provide information on some of the priority population groups as well.

11. A Member asked about plans to increase awareness amongst partner organisations of services funded through the MHIF. The Health Integration Policy Lead explained that there would be significant public facing communication through their website, an engagement event, and they would be working with community organisations, such as libraries. Information for Members to share with their residents to promote the MHIF would also be provided.

12. In response to a question on parameters of the allocation of the direct award to Community Foundation Surrey, the Joint Executive Director explained this was because they match funded. Their award would be focused on 0- to 30-year-olds and it was a scale-up fund which was identifying programmes that were working well in communities and could be scaled up across the county.

13. A Member asked about how the MHIF would help to reduce health inequalities through early access to support. The Joint Executive Director explained that there were immediate capacity gaps and unmet need, with communities not currently being supported. The MHIF aimed to resource the voluntary sector appropriately. Employees were being supported through welfare hubs and through the cost-of-living crisis work. The Joint Strategic Commissioning Convenor for LD&A and all age Mental Health explained that there was a Centre for Mental Health evidence base which did not include social isolation within the support. The Chief Executive for Surrey Coalition of Disabled People added that there was evidence to show that public living rooms reduced loneliness and social isolation. A meeting was taking place with Camerados to discuss bringing it to Surrey.

14. The Chairman asked whether initiatives would be IT based and link to patient health records, as well as capture data. The Joint Executive Director shared that patient health records were being improved and anything new should fit and if not, would be conscious of alternatives.

15. The Chief Executive of Surrey Coalition of Disabled People queried whether there was a potential risk of the MHIF having to prop up the system during the winter, due to reduced mental health funding for winter pressures. The Joint Executive Director explained that there were a number of risk areas, but they had not been tasked with reimagining the MHIF.

Actions/requests for further information:

1. The Joint Executive Director for Public Service Reform to provide a full list of organisations approached for collaboration on the Mental Health Investment Fund and their responses.

2. To have a discussion with the Chairman & Vice-Chairmen of the Adults and Health Select Committee to agree a future role of the committee in the Allocation Panel of the Mental Health Investment Fund. The Chairman expressed concerns for any potential to redirect the funds towards winter pressures and should this potentially occur,  the Committee should be kept informed.

Recommendations:

For the Joint Executive Director for Public Service Reform & the Joint Strategic Commissioning Convenors:

1. To continue to work closely with Frimley Health and Care Integrated Care System and other relevant organisations to participate in funding contributions for the Mental Health Investment Fund in the future.
2. To ensure that the decision-making parameters and priorities of the Mental Health Investment Fund, are closely aligned with priorities determined by the Mental Health Improvement Plan.
3. To formulate a focused list of criteria to determine the priorities and geographical spread involved in making parameters for the Mental Health Investment Fund.
4. To recognise that tackling social isolation is amongst the key priorities of the Mental Health Investment Fund, and that measures are taken to tackle such isolation.
5. To provide a report and future update to the Adults and Health Select Committee on progress made on all the above in a formal select committee meeting.