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 29 August 2023. The Highlight Report provides an overview of activity against Health and Wellbeing Strategy’s Summary Implementation Plan projects and programmes, describes what has been achieved against the outcomes, how collaborative working has aided this progress and identifies new data and insights that have been released in the previous quarter. 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) and a section on the implementation of the Health in All Policies (HiAP) implementation plan.

Witnesses:

Poppy Middlemiss - Public Health Speciality Registrar, SCC

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

Jane Hunt - Mental Health Investment Fund Manager, SCC

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

Dan Shurlock - Customer and Communities Strategic Lead, SCC

Key points raised in the discussion:

1.    The Chair noted that there were several initiatives which had been piloted, she asked the Board to familiarise itself with those and the evaluation their impact. For example, the Green Health and Wellbeing programme cost £225 per person compared to the average of £493 for Improving Access to Psychological Therapies and had a higher level of success for the targeted cohort. The Chair noted that when discussing initiatives to be funded for example by the Better Care Fund there needed to be a real understanding about initiatives’ impact.

Becky Whale joined the meeting at 2.09 pm.

Priority 1

2.    The Public Health Speciality Registrar (SCC) outlined the spotlight item: ‘A Smokefree Surrey’ noting that:

·         The Surrey Tobacco Control Strategy was refreshed based on more recent data and changes in national and local policy and emerging themes such as vaping; it had been widely consulted on with partners since January.

·         An action plan had been developed to deliver the four priorities, to be delivered by the Surrey Tobacco and Alcohol Control Alliance.

·         The Strategy’s launch would coincide with the national campaign ‘Stoptober’.

·         The recent 2022 prevalence of smoking data showed that Surrey increased to 11.9% compared to 7.8% in 2021; this increase was being looked at with the Office for Health Improvement and Disparities (OHID) to check the data’s reliability.

3.    A Board member noted that smoking prevalence is higher in routine and manual workers, those with a long-term mental health condition, and those that used drug and alcohol services. To meet the ambition of ‘no one left behind’, smoking remained a focus, via the four priorities of the Strategy and action plan, she thanked all the partners that contributed to the Strategy.

4.    The Chair referred to the communications, resourcing and financing behind the Strategy asking whether those were sufficient to reach the target audience of smokers. The Public Health Speciality Registrar (SCC) noted that whilst the Strategy was high-level, the detail was included in the action plan, for example the recommissioning the local stop smoking service will ensure it reaches the target audiences.

5.    The Vice-Chair was interested in the increase of smokers in 2022 as that was a significant jump for Surrey and was similar to the UK prevalence; she asked whether smoking included vaping. The Public Health Speciality Registrar (SCC) noted that the Strategy did not include vaping. She noted that the variables could have been wrong, it might be an artificial increase due to OHID’s change in methodology during the Covid-19 pandemic, it was an estimate and had a wide confidence interval; that was being investigated further.

Tracey Faraday-Drake joined the meeting at 2.17 pm.

6.    The Chair asked how that 2022 figure compared to the pre-pandemic figure and whether the increase was due to more mental health problems post Covid-19. A Board member highlighted that between 7.8% and 11.9% of Surrey’s population were smokers, that the data needed to be investigated to identify who was smoking, how they could be supported to quit and to prevent people from starting smoking. The Strategy’s ambition was to reduce that figure to 5% by 2026.

7.    A Board member welcomed the involvement of the Trading Standards Service in the Strategy and hoped that resource could be levered as it was intelligence based when responding to issues that required enforcement for example. She noted that the proliferation of vape shops across Surrey showed the huge uptake and consumption which would probably manifest itself in respiratory diseases and conditions; extracting that data would be vital to see the impact on communities as vaping was not harmless. The Chair welcomed more granular details on the work.

8.    The Vice-Chair reflected on the apparent increase in smoking in Surrey, noting that there was nicotine in vapes which was addictive and wondered how many people including children start on a vape and then move on to smoking.

9.    A Board member sought assurance that there was an element of co-design, incorporating lived experience particularly in the communities targeted in the production of any communications materials to ensure that they would be effective with those groups, understanding their behaviours and challenges faced. She noted the in-depth work by Surrey Combatting Drugs Partnership around a communications campaign. The Public Health Speciality Registrar (SCC) noted the close working with partners on communications in the Surrey Tobacco and Alcohol Control Alliance; she would raise that point at the Alliance’s meeting.

Priority 2

Borough Councillor Ann-Marie Barker joined the meeting at 2.21 pm.

10.  The Priority 2 Co-Sponsor noted the recent busy summer and acknowledged the continued engagement and commitment of the Voluntary, Community & Social Enterprise sector to co-designing the review of the Mental Health: Prevention, Oversight & Delivery Board’s (MHPODB) purpose and ToR - there would be a co-design workshop on 5 October. She welcomed the involvement of the Vice-Chair and the new adult mental health convener - interim until March. 

11.  The Mental Health Investment Fund Manager (SCC) outlined the spotlight item: Mental Health Investment Fund (MHIF) – Successful Round 1 Projects noting that:

·         Round one took place in December 2022, the award process was done through the Mental Health Advisory Panel. Of the 55 bids submitted, 9 were awarded funding which totalled £530,000. The schemes were one to two years in length and covered a broad age range and geographical location.

·         A sub-group of the MHPODB had been set up to oversee the delivery of those schemes against the outcomes.

·         Round two awards were imminent, the evaluation process had taken place and the report contained information around other MHIF allocations made.

12.  The Chair referred to the table detailing the allocations agreed by CiC, she asked whether any of those allocations were for statutory services. The MHIF Manager (SCC) explained that the MHIF funding and allocations agreed by CiC were for non-statutory services. Allocation had been given by CiC to integrated commissioning to close the gap identified in round one of MHIF funding to support existing contracts in place with commissioners. The Chair noted concern regarding the additional allocations as £4.3 million had been divested. The MHIF Manager (SCC) explained that different processes had different rules for example: £2 million had been allocated to integrated commissioners as noted above, £1 million was match funding allocated to the Community Foundation for Surrey. The Chair requested the granular spend on those schemes and how the additional allocations by CiC had an impact against the MHIF’s original aims.

Priority 3

13.  The P3 Sponsor noted the establishment of a Surrey Youth Commission on Policing and Crime partly sponsored by the OPCC in conjunction with Leaders Unlocked. The Youth Commission conducted peer research looking at: cybercrime, substance misuse, relations with police, mental health, and Violence Against Women and Girls (VAWG). The findings showed the high volume of VAWG reported, many respondents felt reluctant to report instances of VAWG due to fear of not being taken seriously or being blamed. Going forward the findings would be used to focus on a preventative approach through education.

14.  The Customer and Communities Strategic Lead (SCC) outlined the spotlight item: Empowered and Thriving Communities HWB Strategy Outcome and System Capability – Local Area Co-ordinators (LACs) update noting that:

·         The LACs were community-based roles, multidisciplinary workers which operated at a local level around 5,000 - 10,000 population area maximum. Their task was to work with anyone to support them with anything, there was no criteria or eligibility as those roles were intended to be accessible locally.

·         The LACs provided a £4 return on £1 invested.

·         Following Board endorsement, the recruitment of the LACs had been progressed by Surrey County Council in partnership with district and borough council colleagues and NHS partners with joint funding.

·         There were five LACs currently. Its benefits were the amount of time spent with individuals, individuals feeling empowered and therefore enabled to support others in the community and the roles complemented other community-based roles. He noted the joint work by an individual with the LAC in Hurst Green to develop their own peer support group. 

·         Due to the positive impacts, the LACs were being extended to further locations in the year with community involvement in the recruitment.

·         A formal evaluation would be reported to the Board early next year.

·         It was vital to further promote the role of the LACs in communities and to connect with other professionals such as Bridge the Gap outreach workers.

15.  The Chair welcomed that offer to visit the LACs. She asked how long the LACs were being funded for and requested the evaluation criteria. The Customer and Communities Strategic Lead (SCC) noted that the project had been running for a year, the funding arrangement was for the rest of this and the next financial year. 

16.  A Board member noted that he had met the Sheerwater and Maybury LAC when they first started, she was enthusiastic and approachable. It was a simple idea yet the role was invaluable. It was positive to see someone who was integrated into a community and it was important for Members to have that intelligence to better understand their communities. He hoped that the project could be expanded across Surrey because every area needed one. The Chair noted that they were particularly relevant in areas with a low number of active community groups.

17.  A Board member noted the testimonies not just from the LACs, but from the people they were supporting and asked where the next locations were. The ambition was to have a LAC in every Key Neighbourhood and to have confidence around that match funding from partners coming forward to roll LACs out at pace.

The Customer and Communities Strategic Lead (SCC) noted the upcoming locations of the LACs: Goldsworth Park, Stanwell, Upper Hale, Bellfields and Slyfield. Regarding the next locations the Board’s priority list of Key Neighbourhoods was a focus looking at existing community-based infrastructure, dispersal across Surrey and parity across the NHS place alliance areas.

18.  A Board member was struck by the case study of Hurst Green where the community itself had come together to create that network. Central to the work was health inequality, focusing the resources on the Key Neighbourhoods which lacked resources and agency. The localised approach builds community capacity needed to address the inequalities experienced, moving beyond a time-based project into a sustained project changing the nature of the community itself. The work was vital but would take time to build those skilful local relationships, it also takes the wider community which included Board members to make it work.

19.  A Board member noted that it was exciting and timely coinciding with the move from the discovery phase to inform the future transformation of children and families health and care. Thinking about where money in the system was being committed to reduce recommissioning and use the insights from communities to act earlier, using local experts and building trust with Surrey’s commissioners.

20.  A Board member noted that there weremany parts of the system, particularly the voluntary sector involved in signposting guidance and navigation. She sought to explore how to ensure that all those parts of the system were sufficiently coordinated to identify themes and feed those through into interventions, harnessing different avenues effectively to improve access points. She noted that the Healthwatch Surrey helpdesk was seeing increased levels of frustration from individuals having explored many different avenues; other voluntary sector colleagues were seeing an increased level of need. She noted the need for a shared effort maybe through an information and signposting forum to ensure that people are not signposted to organisations that do not have the capacity to support them; so that the work across the system could be maximised.

21.  A Board member commended the work undertaken. He noted that the Sheerwater and Maybury LAC was integrated into North West Surrey (ICS Place) Alliance, he welcomed having LACs across Surrey praising that interaction and partnership working.

22.  The Customer and Communities Strategic Lead (SCC) welcomed the comments, noting the need to keep building on the project and investing in the LACs. He acknowledged the need to work on people's mutual understanding of who was available, the different roles and what they could offer, avoiding lots of signposting and no support. The insights work started within Surrey County Council needed to be done across the partnership around localities to understand the total insights, combining data sets with local intelligence to act differently together.

23.  The Chair reflected on the ‘Opportunities/Challenges’ section of the Highlight Report cover paper, noting that there seemed to be a challenge around the Joint Strategic Needs Assessment (JSNA), Health and Well-being Strategy Index, and Mental Health Improvement Plan was the difficulty in obtaining data from some organisations. Data and digital was one of the key solutions within the Integrated Care Systems (ICSs) moving forward and was vital concerning the Board’s focus on prevention and early intervention. Obtaining data had been a problem at the Adults and Health Select Committee particularly around mental health. She sought the Board’s support in ensuring that each organisation supplies the necessary data.Regarding Priority 1 and 2, there were initiatives where grants were obtained and work was done and evidence of effectiveness exists but there were continuing issues with trying to get commitment for sustained funding. For example, the Green Social Prescribing pilot (Annex 2) had been successful and funding was being sought; she urged Board members to review that. She urged Board members to take part in the Better Care Fund workshop in October, as there were projects that, if funded, would save a lot of time, effort, resources and produce better outcomes.

RESOLVED:

1.    Noted progress against the delivery of the Strategy in the Highlight Report.

2.    Would use the Highlight Reports to increase awareness through their organisations of delivery of the strategy.

3.    Continued to use the HWB Strategy engagement slide deck to ensure awareness of the strategies, ambition and priorities that relate to reducing health inequalities.

4.    Supported the sharing of data and development of the JSNA chapters highlighted over the next quarter.

5.    Supported engagement with Green Health and Wellbeing lead officers to explore possibilities for pooled funding for the longer term co-ordination of the programme plan (following further details provided on effectiveness following discussion at June HWB).

Actions/further information to be provided:

1.    The Public Health Speciality Registrar (SCC) will provide the Chair with more granular details around the work underway concerning the Surrey Tobacco Control Strategy.

2.    The Public Health Speciality Registrar (SCC) will raise the Board member’s (Kate Scribbins) comment around ensuring co-design and lived experience in the production of any communications materials, at the Surrey Tobacco and Alcohol Control Alliance’s meeting.

3.    The MHIF Manager (SCC) will provide the Chair with the granular spend on those schemes and how the additional allocations by CiC had an impact against the MHIF’s original aims.

4.    The Customer and Communities Strategic Lead (SCC) will provide the Chair with the LAC evaluation criteria; and will report back the findings of the formal evaluation on the LACs early next year.