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 21 February 2023. It also has a section on communication activity associated with the HWB Strategy’s priority populations and priorities and a section on the progress of the review of the Joint Strategic Needs Assessment (JSNA) – chapters already published/in development. The draft Frimley Integrated Care Strategy - ‘Creating Healthier Communities’ is also provided for information.
Karen Brimacombe - Chief Executive, Mole Valley District Council (Priority 1 Sponsor)
Ruth Hutchinson - Director of Public Health, Surrey County Council
Professor Helen Rostill - Deputy Chief Executive Officer, Surrey and Borders Partnership NHS Foundation Trust / Senior Responsible Ownerfor Mental Health, Frimley ICS (Priority 2 Co-Sponsor)
Mari Roberts-Wood - Managing Director, Reigate and Banstead Borough Council (Priority 3 Sponsor)
Sarah Haywood - Partnership and Community Safety Lead, Office of the Police and Crime Commissioner for Surrey
Key points raised in the discussion:
1. The Priority 1 Sponsor noted that:
· The report produced by the Surrey Coalition of Disabled People on the cost-of-living crisis and the true cost for disabled people outlined negative experiences: 97% said that the crisis had impacted them, 45% reported having gone without food, 76% said that they did not turn their heating on, 43% were no longer able to meet the additional costs as a disabled person, 62% were relying on community fridges, warm hubs and food banks, and 35% had borrowed money to help pay their bills. Compared to Surrey County Council’s recent survey on the cost-of-living, where around 8% reported that they had not eaten for a day because they did not have enough money and around 13% had gone a day without using energy.
· The Coalition was asking partners to recognise that disabled people had been disproportionately impacted by the crisis, for the County Council and borough and district councils to bear disabled people in mind when allocating household support funding. The Coalition asked for more communication about where the warm hubs and community fridges were in Surrey and to indicate if the warm hubs were accessible.
2. The Director of Public Health (SCC) noted that:
· Regarding the ‘In the Spotlight: Bridge the Gap outreach service’ section, that cohort with multiple disadvantages faced challenges with engaging with services, yet that population was known to many services but helped by few. Outcomes showed that the service was a prevention programme helping to reduce health inequalities for those vulnerable populations and saved money for the system. The Alliance sought support beyond March 2024.
3. A Board member noted that upon hearing the insights from the disabled people, it would be helpful to have a standardised offer particularly in Surrey’s libraries, but in every borough and district in Surrey around community fridges and warm hubs. Greater visibility and awareness of knowing where to go for support was essential and needed to be developed. She asked whether there was support and funding beneath the ‘Bridge the Gap’ layer with 60 vulnerable people, for the large cohort that did not qualify for that level of intervention.
- The Director of Public Health (SCC) reiterated that ‘Bridge the Gap’ was part of the Changing Futures programme which was aligned to Surrey Adults Matter (SAM) that worked closely with a larger cohort of people and both programmes were complementary. There were more residents that needed intensive support compared to the resources available, that was part of the evaluation of how to be more efficient as a system going forward.
- The Priority 1 Sponsor noted that between the County Council and the borough and district councils, there was a good coverage of warm hubs and community fridges. She noted that the problem was that vulnerable cohorts were not being targeted for that support offer and she would follow up with the communications officers across the councils to liaise with each other to discuss the need for targeted communications and indicating accessibility.
- The Vice-Chairman requested that the councils’ communications officers link up with the NHS communications officers.
4. A Board member noted that she had previously visited the inspiring team at ‘Bridge the Gap’ and people benefiting from that intense support provided and those around them. She highlighted that focusing on the outreach support to homeless people and their mental health, was a benefit of that service.
5. A Board member welcomed the ‘data, insights and challenges’ column in the Highlight Report drawing insights from a range of organisations, however after each of those sections she noted that the reporting was inconsistent as to whether there was any action plan attached; some had an action plan and a contact name and others did not. How to take insights forward within the system was crucial, and she asked whether there could be consistency on how insights were taken forward, with a link to the action plan; also indicating that there was not an action plan was useful so the Board could follow those insights up.
6. The Priority 2 Co-Sponsor noted that:
· The Mental Health: Prevention Oversight and Delivery Board’s (MHPODB) work plan was agreed in January and sought to drive forward the programmes in the four areas, identifying and addressing gaps in primary prevention or under resourced areas, looking at existing programmes and thinking about measuring impact within the system. The evidence and good practice gathered would be reported at June’s Board meeting. There also had been close learning with the Mental Health Investment Fund.
· Regarding outcome one around ensuring that those with or at risk of anxiety, depression or mental health issues get the right help, men's mental health was an important area, it was underreported and three quarters of suicides in the UK were committed by men. Resources available for men had been mapped and a mental health champion had been identified.
· Regarding outcome two about supporting the emotional health of parents, babies and children, AFloaT was a new service providing support for individuals who had negative mental health experiences related to maternity.
· Regarding the ‘In the Spotlight: Your Life Beyond Care’ section, the report was focused on the feedback from 128 Looked After Children and 180 Care Leavers, positives were that Looked After Children felt safe in their placements and trusted their families and social workers, 93% of Care Leavers felt they had been fully involved in the pathway planning of leaving care and that they had access to their leaving care workers. Areas for improvement for those children and young adults concerned friendships as making and maintaining friends was a challenge compared to their peers, especially those placed outside of county.
7. A Board member noted that it was extremely important to hear the voices of children and young adults in Surrey who had care experience and to learn from their feedback. She noted that it was vital to connect what the report was saying with other strategies and work in progress such as the sufficiency strategy around children's placements, responding to what had been identified in the survey and ensuring that there are enough foster carers and children's residential homes in Surrey to meet those children's needs. Returning to Surrey from out of county placements can interrupt friendships, so too in the case of children moving around several placements; young people required a place to stay where they could create stable bonds and connect to their communities.
8. Regarding Looked After Children and Care Leavers a Board member wondered whether all the organisations across the county with placements supporting those young people or that they had moved on from, whether those children and young people could be connected via an electronic pen pal arrangement so they could have similar social media type conversations as their peers.
- A Board member agreed with the importance of supporting young people to try and maintain their friendships and connections. Social media was a mixed blessing and needed to be carefully managed, she highlighted the emotional wellbeing and mental health challenges for those young people, some of which were driven by social media. She supported that suggestion of enabling young people to maintain their connections through whatever means works best for them.
9. Referring to the mapping exercise of existing mental health and wellbeing support specifically around men, in terms of general mental health and wellbeing support, a Board member asked whether that map was overlaid where the levels of high incidents were occurring so gaps could be identified and interventions deployed such as social prescribing and other partnership collaboration work; to have an insightful understanding of where that work needed to be focused.
- The Priority 2 Co-Sponsor noted that the MHPODB was undertaking that work, looking at the heat map generated through the Joint Strategic Needs Assessment (JSNA), which showed where the areas of highest need were and looking at the work already underway within those areas through the priority neighbourhoods work. That would be collated and gaps identified, reported back to the Board later in the year.
10. A Board member highlighted that mental health issues had a disproportionate impact on the LGBTQ+ community, regarding the mapping exercise he asked for that population to be captured.
- The Priority 2 Co-Sponsor welcomed that comment, noting that all the priority populations would be considered when undertaking that mapping.
11. A Board member highlighted an example in the third sector which was an exciting new project by Home-Start supporting dads’ mental health, particularly in the perinatal period, that would be launched in April looking at attachment, bonding and parental mental health, and signposting to services.
12. The Priority 3 Sponsor noted that:
· Regarding outcome four ‘people are safe and feel safe’, the new Serious Violence Duty required all specified organisations to work together to prevent and reduce serious violence: police, probation, prison service, fire and rescue service, integrated care boards, borough and district councils, the County Council and schools. No lead authority was specified, it was up to all to define the governance structure, Police and Crime Commissioners in September were given notice they would receive funding to support the implementation of the Duty.
13. The Partnership and Community Safety Lead (Surrey OPCC) noted that:
· The two pieces of work to be completed were: a strategic needs assessment and a strategy. Data and evidence were being gathered for the strategic needs assessment to create a picture of what serious violence looks like in Surrey and to identify what the causal factors and wider determinants are that lead people to become offenders or victims of violence. More evidence was needed in some areas particularly around youth violence and place-based violence. Board members and organisations were asked to get in touch if they wanted to be part of the operational group or if they had any data or information useful to that work. The strategy was to be completed by 31 January 2024, however as there was funding attached to the Duty it was likely that it needed to be completed within the financial year. She was happy to circulate a presentation providing more detail on the Duty.
· The Community Safety Assembly (CSA) was to meet on 17 April and it was looking to agree the partnership agreement which had to be returned to the Home Office, that would set out the governance structure and what the individual roles and responsibilities are around the Duty. Board members were welcome to contact her for more information on the CSA.
14. The Chairman sought clarification on whether that document to be sent to the Home Office should be signed off by the Board.
- The Partnership and Community Safety Lead (Surrey OPCC) responded that she would come back with several documents over the course of the year, the partnership agreement would be received by the Board to approve after being reviewed by the CSA; followed by the strategic needs assessment and the strategy. She noted that the Home Office was clear that it was down to local determination to design the governance structure, to set out how the requirements of the strategic needs assessment would be met and how the strategy would be set.
15. Regarding the request around data sharing, the Vice-Chairman noted that the health system had a lot of data some of which was confidential, she did not know what could or could not be shared in relation to creating that strategy of what serious crime looks like in Surrey, she would be happy to put the Partnership and Community Safety Lead (Surrey OPCC) in touch with the correct people in the NHS system for those conversations to be had. Hospitals admitted people daily who had been victims of serious crime and in some cases the police would not be aware of those victims especially in the case of domestic violence.
- The Partnership and Community Safety Lead (Surrey OPCC) responded that the police was not always aware of those victims as for example exploited people would not necessarily disclose that to them. She was happy to liaise with the relevant contact provided by the Vice-Chairman.
16. Regarding recommendation three on the sharing of the Health and Wellbeing Strategy engagement slide deck, she noted that the Voluntary, Community and Social Enterprise (VCSE) Alliance was keen to share it with their membership and suggested that could be done via a webinar which they would set up. She sought support from Board members to present the slide deck to the VCSE Alliance.
- The Priority 3 Sponsor was happy to liaise with the Board member on that.
1. Noted progress 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 member organisations are 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.
4. Undertook to complete the Health and Wellbeing Board/Strategy Delivery review survey by the deadline of 24 March 2023.
5. Noted the consideration of the Towns as a spatial layer for partnership working to reduce health inequalities by the Surrey Heartlands Integrated Care Partnership.
6. Agreed the proposal by the Health and Wellbeing Strategy’s System Capability Lead for Empowered & Thriving Communities (Marie Snelling, Executive Director Customer & Communities, Surrey County Council) that Dr Gillian Orrow (Growing Health Together Director in East Surrey & GP) takes on the role of clinical lead for the Empowered and Thriving Communities system capability.
Actions/further information to be provided:
1. The Priority 1 Sponsor will follow up with the communications officers across the councils - County Council and district and borough councils - and the NHS communications officers to liaise with each other to discuss the need for targeted communications and indicating accessibility of warm hubs and community fridges.
2. The Priority 2 Sponsor will ensure that the evidence and good practice gathered by the MHPODB will be reported at June’s Board meeting.
3. The Priority 2 Sponsor and Board member (Rachael Wardell) will follow up the Board member’s (Rosemarie Pardington) suggestion of having an electronic pen pal arrangement for Looked After Children and Care Leavers.
4. The Priority 2 Sponsor will report to the Board later in the year around the findings from the mapping exercise of existing mental health and wellbeing support; to include all priority populations including the LGBTQ+ community.
5. Board members and organisations will contact the Partnership and Community Safety Lead (Surrey OPCC) if they want to be part of the operational group or if they had any data or information useful to the work around the Serious Violence Duty, and if they want more detail on the Community Safety Assembly.
6. The Partnership and Community Safety Lead (Surrey OPCC) will circulate a presentation providing more detail on the Duty.
7. The Partnership and Community Safety Lead (Surrey OPCC) will update the Board on several documents over the course of the year including the partnership agreement, the Duty’s strategic needs assessment and the strategy.
8. The Vice-Chairman will provide the Partnership and Community Safety Lead (Surrey OPCC) will the relevant contact concerning data sharing regarding the Duty.
9. The Priority 3 Sponsor will liaise with the Board member (Rosemarie Pardington) on resolution three on the sharing of the Health and Wellbeing Strategy engagement slide deck, presenting the slide deck to the VCSE Alliance.
10. The three Priority Sponsors will follow up the ask by the Board member (Kate Scribbins) around including in the ‘data, insights and challenges’ column in the Highlight Report whether there was or was not an action plan and including a link to that if available and the relevant contact name, ensuring consistency.