Agenda item

This paper shares the findings of the survey that eleven of the thirty-two Health and Wellbeing Board (HWB) members responded to earlier in the year. The Board is also required to review its terms of reference regularly, hence the need to update the Board’s Terms of Reference (ToR) given that its membership and purpose have changed since the last review, with the refresh of the HWB Strategy and the Health and Care Act 2022. 

This paper proposes recommendations to further develop the activities and operations of the Board based on the current board arrangements, the feedback of the members of Board received and the updated legislation and guidance that relates to Health and Wellbeing Boards. 

Witnesses:

Olusegun Awolaran - Policy and Programme Manager (P3) - Health and Wellbeing, SCC

Key points raised in the discussion:

1.    The Chair noted that it was disappointing that only eleven of the thirty-two Board members responded to the HWB Members Survey, however she had spoken to a few others who did not respond and it appeared that the eleven responses reflected the consensus. The Board’s Terms of Reference (ToR) had been updated, based partly on the feedback provided, she welcomed further feedback.

2.    The Policy and Programme Manager (P3) – Health and Wellbeing (SCC) noted that:

·         The HWB Members Survey asked Board members about their views about the Board’s activities and progression of the Health and Wellbeing Strategy.

·         Positives: respondents were well-engaged with the clear vision and mission of the Board, with prevention at its core; and they recognised the work that had been done to track progress.

·         Opportunities: for more work to be done to integrate priorities and outcomes in each of the Board members’ organisations; and the need to move investment upstream into prevention.

·         The Board’s ToR was refreshed to align with changes in the Board’s membership and purpose, the refresh of the Health and Wellbeing Strategy and the formation of the Integrated Care Board (ICB) and Integrated Care Partnership (ICP) under the Health and Care Act 2022. Board member feedback included: more time for discussion and to focus on items about reducing health inequalities, to continue to support a focus on progress being made alongside issues and challenges through the lens of Priority Populations including Key Neighbourhoods, and to utilise informal engagement.

3.    A Board member referred to Section 3.3.8 of the ToR ‘ensure a focus on prevention and the movement of funding upstream in the system to facilitate this’. She noted that the Board already had a focus on prevention, she asked for a measure to be added to that to strengthen and quantify it, ‘significant increase’ in the focus on prevention for example, as the Board was not elevating its prevention work as much as it should be. The Chair agreed, noting that proactivity was needed emphasising the action to be taken by the Board; she would review that. 

4.    The Chair noted that an aim was to use the channels the Board had more for example through the informal sub-committees and possible working groups to undertake deep dives looking at granular information. She noted that whilst discussions may be happening elsewhere, the Board brought together many organisations in one place to have a collective discussion; some smaller players on the Board did not always feel that the Board was discussing things that impacted on them. She stressed the need for all Board members to have an equal voice in discussions and to feel as though they could contribute and raise issues, with support provided by other Board members to use their connections and power to have joined-up discussions to resolve issues. She would follow that up.

5.    A Board member noted that from her practical experience in the public protection domain and as a representative on safeguarding, reducing reoffending and VAWG boards, the landscape had changed in terms of those areas since the Board’s merger with the Community Safety Board. The Community Safety Assembly did offer a significant opportunity. However, she felt that community safety elements did not get sufficient airtime on the Board due to the heavy health focus. Appendix A in the ToR - Annex 2a (Community Safety Agreement) - was out of date, she noted that there needed to be a strengthening of the accountability and line of sight and consolidation of governance; for there to be a review of the mechanisms to rebalance community safety and prevention elements. The Chair noted that she was in the process of setting up a meeting with the chairs of the new borough and district council Crime and Disorder Committees, the Police and Crime Commissioner for Surrey and Surrey Police representatives to look at community safety. She noted the need to make time on agendas to discuss community safety items.

6.    The Chair asked the Board’s permission to add a new member to the Board, the Chairman of the Surrey Carers Partnership Board to ensure that their voice would be heard and specific issues discussed; Board members approved that addition.

7.    A Board member noted that there were several committees and boards such as the CiC which worked alongside or complemented the Board, she noted that it would be useful to have a map of the governance arrangements so all were clear about the Board’s role regarding decision-making and influence. She noted that the line of sight or golden thread between the Board and Surrey’s communities did not come through in the updated ToR; Board members represented their communities, not just their organisations. The culture and spirit of contributing and working together to encourage those contributions from all Board members was missing from the ToR. The Chair wanted to have closer relationships with various bodies ensuring that they had a say in decision-making; she would look at articulating that further in the ToR.  

8.    The Vice-Chair supported the request to map the governance system. She noted the work locally at place-level and the need to ensure that the Board has sight of that work and is connected; for example the local health and wellbeing board chairs sit at each place and might be an interesting addition to the Board’s membership. She noted that she was awaiting feedback from the ICS Chief Finance Officer so at present could not approve the updated ToR.

9.    A Board member noted that last week the Civic University Agreement between the University of Surrey and Surrey County Council was signed. There had been a workshop discussing the collaboration underway where it was flagged that the breadth of work with partners across the county needed more structure so that the University’s contribution could be maximised. The Executive Director – Partnerships, Prosperity and Growth (SCC) would follow that up.

10.  A Board member noted that the Board had committed to the ‘Principles for Working with Communities’ or ‘Four Cs’ and that should be a golden thread running through all it does. She noted that it was easy to tick those off on the Board’s reports under ‘Reference Information’, however there was never any narrative or evidence to provide assurance that the Four Cs had been delivered. That needed to be strengthened alongside the insight from the JSNA, showing the connections with communities in the Board’s reports as well as reflecting on those at Board meetings. The Chair agreed noting that she had been discussing how the Board’s reports could focus the narrative on its wider priorities.

11.  A Board member noted Board members’ professional objective in their organisations regarding their relationship with or responsibility for one of the Four Cs. Several Board members referenced local or community schemes that they visited, organisations permitted at least one volunteer day a year and she questioned whether there should be a commitment to that in the ToR. The Chair would take that point away.

12.  A Board member noted that Surrey had a diverse population and issues varied across the county. Whilst there was Board member representation of the borough and district councils with one Leader and Chief Executive, he wondered whether that should be expanded to community development officers within each borough and district or a geographic range to ensure their voice is heard as they did not feel connected to the Board yet were impacted by the Board’s work.The Chair would follow that up, noting for example that there could be a revolving community development representative to attend Board meetings depending on the agenda items.

RESOLVED:

1.    Reflected on the findings of the survey and considered that they were a true reflection of the current position of the Board in terms of progress and opportunities to develop.

2.    Supported the proposed changes to Board meetings and activities.

3.    Considered the changes to the Terms of Reference in relation to the Board’s purpose, roles, responsibilities and focus; Board member feedback would be reviewed and approval of the updated ToR sought at December’s Board.

Actions/further information to be provided:

1.    The Chair will review Board members’ comments on the ToR around:

-     Section 3.3.8 of the ToR around a measure to be added to that to strengthen and quantify it, ‘significant increase’ in the focus on prevention.

-     Feedback from smaller players on the Board who did not always feel that the Board was discussing things that impacted on them.

-     community safety elements not getting sufficient airtime on the Board due to the heavy health focus; and the need for a strengthening of the accountability and line of sight and consolidation of governance; for there to be a review of the mechanisms to rebalance community safety and prevention elements.

-     Having a map of the governance arrangements.

-     Further articulating the line of sight or golden thread between the Board and Surrey’s communities, the culture and spirit of contributing and working together to encourage those contributions from all Board members, and her comment around having closer relationships with various bodies.

-     The Board having sight of the local work at place-level, for example adding the health and wellbeing board chairs at each place to the membership.

-     Including narrative and evidence in the Reference Information section of cover reports, ‘Principles for Working with Communities’ or ‘Four Cs’, providing assurance that the Four Cs had been delivered, and reflecting on those at Board meetings; and using the insight from the JSNA.

-     A commitment to be included around Board member’s using their one (at least) volunteer day a year.

-     Expanding the borough and district councils’ representation to include community officers within each borough and district or a geographic range.

2.    The Committee Manager (SCC) will ensure that the Board’s ToR is updated to include the new member: the Chairman of the Surrey Carers Partnership Board.

3.    The Executive Director – Partnerships, Prosperity and Growth (SCC) will follow up the Board member’s (Monique Raats) comment around the breadth of work with partners across the county needed more structure so that the University’s contribution could be maximised.