At the September Board we discussed an approach to the development of metrics that would enable an understanding of how effectively we are delivering the Health and Well-Being (HWB) Strategy. In this update, we discuss how we have taken this approach forward and developed a visual means for Board members, partners and Surrey residents to view how the metrics are contributing to the key priorities. The HWB Strategy Index is constructed using a methodology similar to the Surrey Index and will be presented as an interactive dashboard at the March Board meeting. It will then be available publicly via Surrey-i.
Uma Datta - Assistant Director - Data and Insights, Surrey County Council
Richard Carpenter - Data Scientist, Surrey County Council
Key points raised in the discussion:
1. The Assistant Director - Data and Insights (SCC) noted that:
· Since the September Board, the indicators had been reviewed and some merged if similar. The focus had been on where there was good data that could be monitored and refreshed regularly, mapped to the three priorities and priority populations. The Strategy Index was constructed similarly to the Surrey Index, whereby the indicators were mapped to a priority, giving a priority level score and the three priority level scores added up to a Surrey level score, which could be monitored over time. Feedback was welcomed on the ease of navigating the Strategy Index and on how it was constructed.
2. The Data Scientist (SCC) provided a demonstration of the draft Strategy Index:
· From the long list of indicators, a draft Index at the borough or district level had been created using the easily available indicators. The draft Index was organised into the three priorities in the Strategy, within each priority there were different outcomes and indicators, each indicator had a percentage value, a score - 0 to 100 and had a traffic light colour system - and a rank - 0 to 11. The values for all the indicators within an outcome were added up, giving an outcome score and rank. The outcomes within a Priority were added up and gave an overall score and rank for that Priority.
3. The Chairman noted that as the draft Index website was publicly available, he asked what for example the Active Adults indicator showed to a resident.
- The Data Scientist (SCC) explained that due to the space restrictions, the full description of indicators was not included on the titles, hovering over the coloured circles provided the information on the indicators for example Active Adults: the percentage of adults doing more than 150 minutes of physical activity a week; assigned a value, score and rank. The draft Index was built by taking all the indicators and the best and worst case scenario for each indicator was looked at, bad scores were closer to 0 and good scores closer to 100. Like the Surrey Index, on the home page of the final version of the Strategy Index, information would be provided on how to interpret the results.
- The Assistant Director - Data and Insights (SCC) added that there would be a readme document available for the final version, information could be downloaded to make calculations and compare data.
4. Regarding the ability to compare data between borough and district level, the Vice-Chairman queried what if all had bad scores and she asked whether there was national benchmarking in terms of what a good score would be. To show progress, she noted that it would need to be developed adding up and down arrows. She queried whether the index presented at the Health Protection Board should overlay with the Strategy Index.
Joanna Killian joined the meeting at 2.50 pm.
- The Assistant Director - Data and Insights (SCC) recognised the need to focus on what good looks like, who does Surrey compare itself to, for example via a national average and then a county average. A target would then need to be set on where Surrey wanted to be and how far away it was from that, it was a continuing discussion.
- A Board member noted that there was a suite of resources and intelligence, and that it would be useful to outline in the explanation page how the Strategy Index aligned to the JSNA and other publicly available dashboards and to show progression. She noted that currently the Strategy Index was at the borough and district level, as with the JSNA where the data could be toggled down to the Lower layer Super Output Areas (LSOAs), Primary Care Networks and towns; she noted that it would be useful to flag that other geographical levels would be coming soon to the Strategy Index. When indicators were ranked as red, there needed to be a mechanism to cross reference between the two sub-boards and how those related to the priorities.
5. A Board member enjoyed the interaction with the draft Index and asked whether residents had been engaged with as part of its development on how easy it was to use, thinking particularly about vulnerable residents.
- The Data Scientist (SCC) noted that the indicators included were those with readily available data. He noted that the list of indicators reflected what the Board felt was relevant for residents. Whilst residents had not been engaged with on its design and content the learning from the Surrey Index was used to inform the Strategy Index, engagement had been undertaken on the Surrey Index around its design and operability via engagement sessions. Concerning vulnerable residents there was an accessible version available.
6. A Board member made a plea for co-design on the Strategy Index and offered to provide support on that, particularly if it was to be genuinely usable by residents and to show them performance against the Health and Wellbeing Strategy, holding the Board accountable for that. Asking residents what it means for them and to have some visible links with the indicators back to what residents said was important to them years ago when the Strategy was first developed.
7. A Board member reflected on the so what point, noting that the focus should be on the individual characteristics of a person who might have a whole range of issues or a single issue. For example, the system reflected that it was doing badly on alcohol, so responded with providing a reducing drinking service; she stressed that it was not right to take a siloed approach to some of those indicators. She was concerned that the data did not inform about individual cases and what they need, often there were complex problems and that required complex whole system solutions as opposed to a simple response and solutions.
8. A Board member welcomed the simplicity of the tool, however she noted that unless the deprivation data was layered across that, the draft Index would not provide a real picture of how well the system was performing or what the target should be for some of those vulnerable communities - for example people with learning difficulties where there was a large gap around life expectancy - so that there is a more level playing field. She also asked whether officers were receiving the Frimley data to feed into the Surrey Heath part of Surrey.
- The Assistant Director - Data and Insights (SCC) confirmed that the Strategy Index would be looked at it in terms of the lowest possible geography where the data was available, which was LSOAs and that was based on deprivation. Regarding vulnerable communities, where available the data would be looked at for those with serious mental illnesses for example within the priority populations. She noted that she could provide an update in the quarterly Highlight Report on the intelligence being gathered at lower geographical levels.
- The Data Scientist (SCC) confirmed that the Frimley data was included and noted that a lot of different data sources had contributed to the draft Index.
9. A Board member queried how the draft Index could be used in terms of triangulating it with the Graphnet dashboard to then identify those groups of people that the system could start to work with on the ground. He welcomed the bird’s-eye view through the tool but asked how it connected to the work being undertaken by the health system.
- A Board member noted that the draft Index had the potential to do two things. Firstly, to alert the Board to where things were going well and where they were not. Secondly, where to look even further especially as the draft Index provided a bird's-eye view, cross referencing needed to be done to other parallel and complementary data sources such as the JSNA or tools like Graphnet, to enable a deeper dive.
10. The Chairman emphasised the need to have one place to go to rather than trying to look at multiple databases and so on, building the data around the towns footprint would be useful as it was a key geography for the delivery of services.
1. Reviewed, provided feedback and promoted awareness of the metrics within their organisation to enable a common understanding and assessment of progress.
Actions/further information to be provided:
1. The Assistant Director - Data and Insights (SCC) will outline in the explanation page how the Strategy Index aligned to the JSNA and other publicly available dashboards and will show progression; she will flag that other geographical levels such as the Lower layer Super Output Areas (LSOAs) will be coming soon to the Strategy Index.
2. The Assistant Director - Data and Insights (SCC) will follow up the offer by the Board member (Kate Scribbins) regarding co-designing the Strategy Index with residents.
3. The Assistant Director - Data and Insights (SCC) will provide an update in the quarterly Highlight Report on the intelligence being gathered at lower geographical levels, such as Primary Care Networks and towns.