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) as of 30 May 2023. The Board is also asked to note the disbanding of the Surrey Local Outbreak Engagement Board.

Witnesses:

Karen Brimacombe - Chief Executive, Mole Valley District Council (Priority 1 Sponsor)

Adam Letts - Public Health Lead, SCC

Kate Barker - Joint Strategic Commissioning Convener, SCC and Surrey Heartlands (Priority 2 Co-Sponsor)

Phill Austen Reed - Principal Lead – Health and Wellbeing, SCC

Mari Roberts-Wood - Managing Director, Reigate and Banstead Borough Council (Priority 3 Sponsor)
Saba Hussain - Strategic Lead – Partnerships, Policy and Commissioning, SCC

Key points raised in the discussion:

Priority 1

1.    The Priority 1 Sponsor chose to focus on the Surrey Breastfeeding Strategy 2023-2028 which was important in terms of supporting the Priority.

2.    The Public Health Lead (SCC) provided an update on the refreshed Breastfeeding Strategy as outlined ‘In the Spotlight’ section which aimed to improve breastfeeding initiation and continuation rates, he added that the detail around changes implemented was included in the action plan; partnership work would be led by the Breastfeeding Strategic Group. It was recognised that not all parents want to or can breastfeed, acknowledging and respecting that was important. Partners were encouraged to champion breastfeeding as a public health priority.

Sue Murphy joined the meeting at 2.11 pm.

3.    The Chair asked whether the Breastfeeding Strategy had a toolkit and communications package. The Public Health Lead (SCC) noted that such information was included within the action plan, which would be implemented gradually over five years; communications and engagement was a key theme.

4.    A Board member noted that the benefits were outlined in relation to the infant and mother in terms of breast and ovarian cancer, and enhanced attachment. Noting that there remained social stigma around breastfeeding, she asked whether there could be more emphasis on the wide range of benefits to mother and child such as breastfeeding’s effect on countering post-natal depression and mental health; to increase that uptake in those lower socioeconomic groups. The Public Health Lead (SCC) welcomed that important point which had been considered at the Breastfeeding Strategic Group, linking closely with mental health specialists and was factored in as peer and general support using the trauma informed approach.

5.    The Chair noted the important point made above around cultural attitudes to breastfeeding and asked whether discussions had taken place with cultural and minority groups, and whether they were involved in the action plan; she requested a copy of the action plan. The Public Health Lead (SCC) confirmed that those groups were being engaged with, the action plan had been widely distributed and partners included the Birth to Five Years Community Health Partnership and Maternity and Neonatal Voices Partnerships, and Surrey Minority Ethnic Forum. Other smaller projects were underway relating to certain population groups in Surrey focusing on the continuation rates. 

6.    The Chair referred to the ‘Challenges this quarter’ section and asked whether the two leads that left had been replaced and whether there was a risk to delivery. The Vice-Chair explained that the cardiovascular lead - two sessions a week - was replaced three weeks ago, the respiratory lead - one session a week - had been advertised for and there had not been any applications yet. If those leads were critical to the delivery of the outcomes, there needed to be a consideration on their resourcing and she noted that the programme leads could liaise with her.

Priority 2

7.    The Priority 2 Co-Sponsor referred to the ‘In the Spotlight’ section adding that:

-     the Green Health and Wellbeing programme was a wider and more embedded programme system-wide following a transition from the Green Social Prescribing pilot since March. Through partnership engagement a logic model was used to develop common outcomes. The Board was asked to provide support to address the critical challenge of funding which was yet to be agreed by key system partners to enable the proposed programme delivery. She praised the impact created by the Chief Executive Officer’s (Surrey Heartlands ICS) video message and ICS support of the aims.

8.    A Board member noted the abundance of open spaces and facilitators to enable mental health groups and nature walks and other benefits to mental health. She noted that there were the resources and funding available and noted that the preventative agenda was strong and so it was a question of allocation. The Chair added to that comment asking whether there was buy in from some partners and who was not buying in. The Principal Lead – Health and Wellbeing (SCC) noted that resourcing had been secured for a year during the transition period, as part of that officers were looking at what was currently available and how to coordinate that, and what the gaps were. He would follow up with partners and share information on the buy in. A Board member noted that she was the executive lead for the pilot when it was a test and learn site for the NHS side and noted that the Green Health and Wellbeing programme was valuable particularly in the prevention space. She noted that more needed to be done to embed it into business as usual within the towns work, working with partners at place level. 

9.    The Chair following up the above point noted that it would be interesting to know the time scale of embedding the Green Health and Wellbeing programme and whether there was an impact assessment of the initiatives and value for money. A Board member noted that was being built into the methodology and there were national examples of that, work was underway using the research available and working with primary care and neighbourhood teams to understand the benefits, value for money and getting buy in for it to be an alternative support.

10.   The Chair referred to the ‘Challenges this quarter’ section and asked for views on the system capacity challenge within the three programmes listed, whereby a lack of capacity was affecting progression. The P2 Co-Sponsor noted that feedback was being collated from the project leads to review the gaps and what the impact would be of having an insufficient capacity in those programmes; as well as understanding what could be provided through the Best Start Strategy which was in the scoping phase; an update could be provided following the next Best Start Strategy meeting.

Priority 3

11.   The Priority 3 Sponsor noted the two collaborative pieces of work underway:

-     Individual (Employment) Placement and Support in Primary Care (IPSPC): SCC and system partners had secured £6.3 million grant by the Department for Work and Pensions to roll out the employment support aimed at adults with a physical disability or mental health need, or long-term condition. Around 3,000 people would be supported between October 2023 and March 2025; targeted support would be provided for those in the top five Key Neighbourhoods and the Priority Populations.

-     Wider Determinants of Health Research Collaboration: working across the system to try to change outcomes for people. Additional funding was being used to undertake research around policy to development to address the wider determinants of health. If successful in stage two of the application, the funding would provide the capacity to put more effort further upstream to address the challenges at the acute end.

12.   The Strategic Lead - Partnerships, Policy and Commissioning (SCC) provided an update on the Community Sparks funding as outlined ‘In the Spotlight’ section, to fund community-led activity primarily across the 21 Key Neighbourhoods, for projects which would make a difference, and where possible were sustainable and had a preventative angle. £10,000 was given to Tandridge so it did not miss out. Infrastructure organisations were asked to support with the delivery of the funding building on their existing networks, working closely with the Community Link Officers, the borough and district councils and health colleagues. Grants of up to £2,000 had been offered and over 50 applications had been received. She highlighted the example of Hilary’s Hut in Spelthorne to tackle social isolation, the funding enabled activity such as chair aerobics, and arts and crafts; to move around the borough based on need. A flexible approach was taken for organisations to work in a way that suited their community. It was hoped that the funding would support the larger funds like Your Fund Surrey and the Mental Health Investment Fund; a review on the impact would be undertaken.

13.   The Vice-Chair reflected on health and care economics and the importance of evidencing impact and the return on investment or a cost-benefit analysis from intervention and prevention work. For example, the IPSPC £6.3 million grant for employment support for just under 3,000 people was equivalent to around £2,000 per person, she asked what the evidence was for its long-term impact; she noted the need to be critical when such programmes are initiated.

14.   The Chair stressed the importance of having impact assessments, measuring, monitoring and evidence behind every initiative. The P3 Sponsor noted that a lot of prevention work such as community development activity was undertaken at district and borough level, such work took a longer period of time to evidence its impact; that was more challenging to do across organisations and system-wide. The activity underway would provide the space and funding to evidence impact.

15.   A Board member noted optimism from a public health perspective about the application for prevention funding and even if unsuccessful it would be essential to continue with the Collaboration to show particularly where the wider determinants of health work has an impact on Surrey’s population and ensuring it has value for money; the Board would be kept informed.

16.   The Vice-Chair wondered how the community led projects were being advertised so that they reached the necessary residents. She was unaware of Hilary’s Hut and as a local GP in Spelthorne noted that she could help to sign-post people to it; adding that and primary care was a good route for communications via their websites and she offered her support in terms of advertising on the websites. The Strategic Lead - Partnerships, Policy and Commissioning (SCC) noted that the Community Sparks funding and available grants had been advertised widely, she noted that there was more work to do about advertising the projects and how people can get involved and she would feed back the Vice-Chair’s comment.

17.   The Chair asked how long an initial grant would sustain a project for and whether she was aware if there was a potential for further funding for the projects once the initial funding was used up. The Strategic Lead - Partnerships, Policy and Commissioning (SCC) noted that it was one-off funding. As in the Hilary’s Hut example it was hoped that the projects would look for other sources of funding. She noted that officers were thinking about how to bring in social value and different ways of supporting something similar in the future.

18.   The Chair referred to the ‘Challenges this quarter’ section around domestic abuse and asked how significant the lack of clarity around the delivery/funding was. A Board member clarified that the Hospital Independent Domestic Violence Advocates service funding would run out in 2024, that service and funding was crucial for people experiencing mental and physical trauma. That was being looked at by the Assistant Director - Safer Communities, SCC.

RESOLVED:

1.    Noted progress against the delivery 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.    Noted the disbanding of the Surrey Local Outbreak Engagement Board.

5.    Noted that with the appointment of a new Chair, the Terms of Reference of the Board would now be reviewed at the September Board meeting.

Actions/further information to be provided:

1.    Priority 1: The Public Health Lead (SCC) will share the Breastfeeding Strategy action plan with the Chair and any Board member that requests it.

2.    Priority 2: The Principal Lead – Health and Wellbeing (SCC) will follow up with partners and will share information on the buy in regarding the Green Health and Wellbeing programme; the time scale of embedding the programme and whether there was an impact assessment of the initiatives and value for money will be shared.

3.    Priority 2: An update will be provided to the Board by the P2 Co-Sponsor following the next Best Start Strategy meeting, regarding the system capacity challenge.

4.    Priority 3: The Director of Public Health (SCC) will keep the Board informed about the work of the Wider Determinants of Health Research Collaboration in evidencing impact and ensuring value for money and the application (stage two) to NIHR Health Determinants Research Collaboration for prevention funding.

5.     Priority 3: The Strategic Lead - Partnerships, Policy and Commissioning (SCC) will feed back the Vice-Chair’s comment on the need to advertise the Community Sparks projects further and will follow up her offer of support in terms of advertising on the primary care websites.