Agenda item

This paper provides an overview of the progress of local shared projects and communications activity supporting delivery of the Health and Wellbeing Strategy (HWB Strategy) in the priority populations as of 29 November 2022. The Highlight Report provides an overview of each HWB Strategy Priority, describes what has been achieved in the previous period against outcomes and how collaborative working has aided this progress. It also has a section on key items (‘In the Spotlight’).

The Highlight Report now includes a section on the progress of the review of the Joint Strategic Needs Assessment (JSNA) – chapters already published, chapters to be published by the end of the financial year and chapters that are in development.

Witnesses:

Mari Roberts-Wood - Managing Director, Reigate and Banstead Borough Council (Priority 3 Sponsor)

Liz Williams - Joint Strategic Commissioning Convener, Learning Disability and Autism and all age Mental Health, Surrey County Council and Surrey Heartlands ICS (Priority 2 Co-Sponsor)

Key points raised in the discussion:

Priority One

1.    The Priority Three Sponsor in lieu of the Priority One Sponsor noted that:

·         Progress had been made under the outcome: ‘the needs of those experiencing multiple disadvantage are met’, whereby the Changing Futures Lived Experience Group was meeting monthly and co-production work was being undertaken with those with lived experience.

·         In addition to the information within the ‘In the Spotlight - Uptake of Diabetes Prevention Programmes by Ethnically Diverse Communities’ section: there was a stark difference in the likelihood of developing type 2 diabetes between people from white backgrounds and those from ethnically diverse communities; 3.8% of people from white backgrounds live with type 2 diabetes compared to 5% of people from ethnically diverse communities. People from ethnically diverse communities might also develop diabetes at a younger age than their white counterparts. Culturally appropriate interventions and co-designing were vital.

2.    The Vice-Chairman recognised that there had been a huge success with the three pilots - Epsom, Woking and Staines - and wondered whether there was funding or an appetite for Active Surrey to roll that out more widely to other areas with a high number of ethnic minorities, depending on the population health data. She noted that it would be helpful to see the data to assess whether the people participating in the prevention programme maintain their average blood glucose levels and do not develop diabetes.

-       In response, the Priority Three Sponsor confirmed that the intention was for a wider roll out following the successes had, however funding was a challenge and discussions were underway. She would liaise with the contact at Active Surrey who might be able to provide the Board with an update on future plans for the particular programme. She agreed that tracking the outcomes were critical and she would look into the data.

Priority Three

3.    The Priority Three Sponsor noted that:

·         £20,000 in funding had been awarded from the Police and Crime Commissioner for Surrey to a charity called the Skill Mill as set out under the third outcome; the outcomes would be tracked and it was hoped that it would make a difference to some people's lives.

·         In addition to the information within the ‘In the Spotlight - Cost of Living’ section: the borough and district councils, and Surrey County Council had been busy with partners to provide advice on support with energy bills and other utilities, facilitating Warm Hubs across Surrey and signposting to grants and delivering communications through a Surrey-wide leaflet; working collaboratively with the Voluntary, Community and Faith Sector (VCFS) to provide targeted support through food banks and debt advice for example and gathering local intelligence on the most vulnerable.

4.    A Board member highlighted the Canal Watch (Woking) which was a problem-solving exercise involving a wide range of partners and volunteers; it had won the prestigious Tilley Award, the pre-eminent problem-solving award nationally and it meant that the partnership group goes forward to the international Herman Goldstein Award. He thanked all those involved as a real impact had been made.

5.    The Chairman thanked the borough and district councils, and the Voluntary, Community and Social Enterprise (VCSE) Alliance for their work on addressing the cost of living, he reiterated that the leaflet sent to all households in Surrey provided signposting to support. He welcomed that the Government had provided funding for financial support over Christmas. 

Priority Two

6.    The Priority Two Co-Sponsor noted that:

·         The Mental Health: Prevention Oversight and Delivery Board (MHPODB) first met in October and it provided coordinated oversight of delivery integrating Priority Two of the Health and Wellbeing Strategy with the early intervention and prevention workstream of the Mental Health Improvement Plan (MHIP); it was pleasing to see that the approach aligned with the Integrated Care Strategies, focusing on prevention and the wider determinants of health.

·         In addition to the information within the ‘In the Spotlight - CYP EHWB Questionnaire’ section: the results of the 2022 Surrey Health Related Behaviour Questionnaire indicated a worrying 7% increase in the number of primary school children worrying about five or more issues and an increase of 3% of those worrying quite a lot or a lot about one issue. Secondary school students indicated a drop in percentage of both having access to an identified trusted adult and they had less happiness with life, it was striking that they indicated that they were worried about the mental health of someone in their family. It would be vital for the MHIP, the Mental Health Investment Fund (MHIF) and wider system partners to use those insights as well as the wider report findings to inform current and future delivery models.

7.    A Board member asked whether there was evidence of a national trend that secondary school pupils felt a greater loss of access to a trusted adult, or whether it was a Surrey issue. He asked to what degree there was evidence to suggest the correlation between loss of access to a trusted adult and poor emotional health and wellbeing; whether it was a causal factor.

-       The Priority Two Co-Sponsor explained that she would liaise with the Public Health Lead on the matter, seeking further details particularly on the national picture, as it would be helpful for the system to understand that.

8.    A Board member commented on the findings and connected them explicitly with some of the findings from other areas of research in the work underway in other partnerships, noting that the information reported was not surprising as all services were hearing that from children when they sought access to support and further help from Surrey’s services and when they shared their views in their schools and other settings. She noted that it was important that the report and feedback reinforces what all knew as a priority for Children’s Services and the Surrey Safeguarding Children Partnership. Alongside the Director of Public Health (SCC), she had introduced a recent session defining the future workshop for emotional wellbeing and mental health; she noted positive feedback from a young person who shared their lived experience on the issues faced locally, that the attendees were passionate about making a change and were listening. She commended the engagement work with Surrey’s young people and hoped that all would continue to support it together.

9.    The Vice-Chairman noted that the survey highlighted the significant need out there around early intervention and that needed to be a consideration when thinking about the impact of financial hardship on Surrey’s providers and how that would be resolved as well as looking at the current offer for emotional health and wellbeing in schools. She asked whether any of the findings in the report would be reflected into the Joint Strategic Need Assessment (JSNA), especially the Core 20 PLUS 5 children and young people.

-       In response, a Board member noted that the survey was repeated every two years and whilst it was not nationwide there was comparative data that she would put in the Teams meeting chat. She noted that when the JSNA chapter on Mental Health of children & young people was reproduced, various sources of data and information were signposted. The findings from the ongoing insight work would also feed into the Emotional Wellbeing and Mental Health Strategy, the Healthy Schools approach and the delivery of work within schools; she noted that it was an iterative process.

10.  Given the current workforce issues and lack of provision which was exacerbating some of the issues reported in feedback from children in Surrey’s schools, a Board member asked what the action plan was to reduce any deficits and whether the MHPODB’s summary implementation plan which sought to align efforts, reduce duplication and ensure a common set of collaborative programmes to be prioritised; would be able to expose the need, the deficits and the actions that would be taken to address that. 

-       In response, a Board member noted that the MHIP would seek to address those deficits and highlighted the challenge of the overwhelming level of need that exceeded the resources available to fully address those issues. Early intervention work was crucial, supporting children to feel better amongst themselves through their ordinary lives would reduce the demand. Going forward there was a need to map out a twin plan, addressing the need today in the short-term and addressing the need in the future in the long-term through strategic work to improve early intervention to reduce the source of the need; alongside the MHPODB, the Board would play a decisive role in terms of setting out that strategic work. 

RESOLVED:

1.    Noted progress against the three priorities of the Strategy in the Highlight Report.

2.    Utilised the links to the refreshed Health and Well-being Strategy and Highlight Reports to increase awareness through their organisations and elicit support for reducing health inequalities.

3.    Ensured members/member organisations were utilising the HWB Strategy engagement slide deck on the SCC Community Engagement sharepoint site to provide active leadership around the mission to reduce health inequalities within their own organisations and across the system.  

Actions/further information to be provided:

Priority One

1.    The Priority Three Sponsor will liaise with Charlotte Long at Active Surrey:

-       who might be able to provide the Board with an update on future plans for a wider roll out of the physical activities set up concerning the diabetes prevention programmes.

-       she would look into the data to track the outcomes to assess whether the people participating in the prevention programme maintain their average blood glucose levels and do not develop diabetes.

Priority Three

2.    The Priority Two Co-Sponsor will liaise with Adam Letts, Public Health Lead (SCC) seeking further details on:

-       the national picture whether there was evidence of a national trend that secondary school pupils felt a greater loss of access to a trusted adult, or whether it was a Surrey issue.

-       to what degree there was evidence to suggest the correlation between loss of access to a trusted adult and poor emotional health and wellbeing; whether it was a causal factor.

3.    The Board member (Ruth Hutchinson) will put the comparative data around the survey which was repeated every two years - Health Related Behaviour Questionnaire - in the Teams meeting chat.