Agenda item

This paper presents a final draft Terms of Reference for the HWB Board and outlines minor changes to the Key Neighbourhoods.

 

This paper also 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 20 November 2023.

Witnesses:

 

Karen Brimacombe - Chief Executive, Mole Valley District Council (Surrey Chief Executives’ Group) (Priority 1 Sponsor)

Phillip Austen-Reed - Principal Lead - Health and Wellbeing, SCC

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

Lisa Andrews - Public Health Principal, SCC

Sarah Haywood - Serious Violence Programme Lead, Office of the PCC 

Rebecca Brooker - Prevention and Communities Lead, SCC

 

Key points raised in the discussion:

 

1.    The Chair referred to the Board’s Terms of Reference (ToR) in the agenda, noting that due to some recent initial discussions on maximising the alignment of the Board with the Surrey Heartlands Integrated Care Partnership (ICP) and Integrated Care Board (ICB), she proposed that the Board: approves the ToR as interim as it might need to be revisited later in 2024 once the review had progressed. She highlighted the small changes in the boundaries for the Key Neighbourhoods bringing those in line with the ward boundary changes which occurred earlier in the year.

 

Priority 1

 

2.    The Priority 1 Sponsor referred to the spotlight item: Changing Futures Sustainability - Next Steps, to be funded until March 2025 and it was hoped that the programme would continue beyond that.

3.    The Principal Lead - Health and Wellbeing (SCC) detailed the spotlight item:

·         That the work on multiple disadvantage had been brought together with a greater focus due to the alignment of national policy and local prioritisation of the issue. Since 2020 there had been better multi-agency working through the Surrey Adults Matter approach.

·         That in 2021 funding from the national Changing Futures grant had been secured, enabling greater collaboration with (VCSE) Voluntary, Community and Social Enterprise partners; trauma informed outreach was being provided and the data showed the improved outcomes in line with SCC’s ambition of ‘no one left behind’ (NOLB). Funding although flagged as a risk, had been secured for next year; highlighted the positive engagement with the commissioning collaborative and the local joint commissioning group chairs.

·         That the JSNA chapter on multiple disadvantage which would help inform the way forward for the specific areas around trauma informed outreach and multi-agency working, and broader areas under the Board’s remit.

·         That such programmes would be useful to reflect on at the Better Care Fund (BCF) Strategy workshop in February in terms of how such programmes which appear to meet both national and local strategies, could be built into BCF processes and structures in a better way.

4.    A Board member noted that he had been interviewed regarding the work on the multiple disadvantage JSNA chapter, noted that he had visited a centre in Guildford where speaking to people with lived experience was invaluable; stressed that prevention was fundamental.

5.    The Chair noted that not only were the aims important and aligned with the strategies, but so was the data being gathered which could be used elsewhere.

6.    A Board member welcomed the vital work in the preventative space and thanked the team for their work on the multiple disadvantage JSNA chapter.

7.    A Board member recognised the work nationally by systems on supporting such individuals with complex needs. However, noted that if the ask was for the local joint commissioning group chairs to agree to allocate their Better Care Funding towards the project, queried whether there was a risk that there would be place variation or whether it was expected that all the groups would agree the allocation. A Board member responded that as a county-wide initiative it was important to be discussed at the BCF Strategy workshop, to ensure that health inequalities are not exacerbated and such initiatives are sustainable. The potential risk highlighted must be reflected on at the workshop. The Principal Lead - Health and Wellbeing (SCC) noted the importance of the engagement with the commissioning collaborative and the local joint commissioning Group chairs around decision-making.

8.    The Board member added that there was an increasing view on what sat within the BCF and what sat within place-based determination, reiterating the risk of multiple asks on a finite pot of money and how the system collectively agrees what the priorities are. The Chair noted that having that perspective at the BCF Strategy workshop would be vital to ensure money would be spent in the right way.

9.    The Priority 2 Co-Sponsor thanked the Senior Policy and Programme Manager - Changing Futures (SCC) and colleagues, and Dr Jo Jennison, for considering the neurodiversity of the cohort; that would be further explored within the population.

 

Priority 2

 

10.  The Priority 2 Co-Sponsor noted that:

·         The Mental Health: Prevention Board’s (MHPB) role was to enable the right target of the Mental Health Investment Fund (MHIF) and to have oversight of those funded projects; a MHIF Oversight Sub-Group had been convened. Regarding round two of the MHIF, 13 of the 64 bids were successful and covered a broad age range and spread across the county, she would send the Committee Manager (SCC) the website link detailing the bid outcomes to be published early in the new year. The governance needed to be finalised.

·         Regarding the national research on inequalities in mental health care for Gypsy, Roma and Traveller (GRT) communities, one of the report recommendations had been actioned around prioritising the training of members of that community in mental health first aid.

·         Opportunities:

-       The MHPB had agreed its 2024 forward work plan, six actions were detailed in the Appendix and would drive tangible progress such as understanding how the system jointly works with place, focusing on prevention and supporting the development of the JSNA chapters.

-       A joint meeting would be held in January between SCC and Surrey Heartlands ICS to discuss the future funding of the Green Health and Wellbeing programme, she welcomed VCSE Alliance support.

-       Noted that the Strategy Index was being reworked, looking at the Key Performance Indicators in-depth.

-       Noted the positive start on the JSNA chapter on loneliness and social isolation with a high level of engagement.

·         A challenge was that several projects led by community organisations relating to suicide prevention might be impacted by changes in funding processes related to the National Suicide prevention strategy, that had been included in risk registers and would be discussed at Surrey Heartlands ICS.

11.  A Board member referred to the withdrawal of the suicide prevention funding and noted that work was underway to find another source to continue the work that had taken place. The Chair welcomed a future update on the matter. Regarding the MHIF, had recently visited a group called Prospero Theatre who worked with people with learning disabilities into theatre and which received £28,000 from the funding; hoped that the money for round two of the MHIF could be released soon.

12.  A Board member noted that the work around the GRT communities was important noting the impact of the trauma having recently met a member of the community who was homeless and unemployed, and whose friend had committed suicide.

13.  A Board member noted the fantastic work which would deliver good outcomes for people, but queried what the connection was between the programme and special educational needs and disabilities, and schools. The Priority 2 Co-Sponsor would ask the Children and Young People's Convener to provide a response. A Board member responded that the Mental Health Improvement Programme was linked to the work underway for children with additional needs and disabilities via the Additional Needs and Disabilities Partnership, where schools and health colleagues were represented. She noted that some of the most successful work with children's mental health was that conducted with schools via the mental health support teams and the other programmes that had MHIF funding. Where there were opportunities for additional resources or to focus attention that was directed into the work with schools; however, that did not cover all schools at every phase and stage with as comprehensive range of provision as was desired.

14.  A Board member noted the large and vibrant home education community in Surrey, many children were being home educated because schools had been unable to accommodate their needs; sought assurance that the area was being considered. A Board member explained that it was an area being considered however it was more challenging to deliver such individualised interventions.

15.  The Public Health Principal (SCC) detailed the spotlight item: Children and Young People’s Emotional Wellbeing and Mental Health Strategy:

·         That the strategy served as the JSNA for children and young people’s mental health in Surrey and linked with the NHS England’s Local Transformation Plan. The ambition was to undertake a single piece of collaborative work which considers all the relevant levels of information from partners and providers across the county. A workshop held last year looked at how strengths were assessed and what improvements could be made.

·         That the strategy published in September set out six key themes which had been co-developed and produced with system partners, children and young people and their families; work had begun system-wide to understand and address the challenges. The Surrey Healthy Schools approach was a key part of the preventative work enabling schools to develop their provision of personal development and teaching, building culture and there was comprehensive training for mental health leads in schools, via Mindworks Surrey and Personal, Social, Health and Economic (PSHE) education.

·         That there were key groups that were known to be more at risk of poor mental health and additional support was being built in, those electively home educated were a consideration.

·         Work was underway to roll out the i-THRIVE Framework.

16.  The Chair asked who officers were working with regarding the online safety part of the strategy. The Public Health Principal (SCC) noted that they were working with wider system partners such as Mindworks Surrey to understand what the issues are, desktop research had been undertaken to understand the key themes; as part of the broader strategy development group.

17.  The Chair asked whether the PCC had information around the online safety impacts. The Serious Violence Programme Lead (OPCC) noted that there was work underway nationally, the Youth Endowment Fund had published a recent report around the link between violence and what children saw online. The OPCC offered support and was keen to discuss the matter with the Public Health Principal (SCC), she assumed that Surrey Police had specialist teams that had more intelligence around online safety. A Board member in her capacity as PCC added that it had been raised as an issue at the national group and South East regional group. A further Board member noted that Surrey Police had Paedophile Online Investigation Teams (POLIT) which received intelligence as well as investigations relating to online safety. Those teams linked with the regional and national picture and would be a key partner to engage with to look at the thematic elements.

18.  The Chair noted that she had been contacted by more concerned parents than ever before, noting the interaction between harmful forces and their children in different ways yet that was not being reported; she stressed that it was a bigger issue then realised. A Board member responded that from a senior policing point of view the magnitude of the issue was recognised, the challenge around underreporting was resource allocation. She welcomed anything that could be done as a community to encourage reporting and for that to be a simple process, to see the full scale of the issue and understand the magnitude in Surrey.

19.  A Board member would put information into the Teams meeting chat from Surrey Healthy Schools about teaching online safety in schools which was a core part of the PSHE curriculum, taking a safeguarding lens to support children and young people to understand responsible online use and the routes of harm online. The Chair presumed that schools were communicating with parents on the matter. A Board member added that the National Crime Agency flagged that Meta was moving the Facebook Messenger platform to an encrypted format which would have an impact on child safety. A Board member explained that as part of the Surrey Healthy Schools approach there were now four violence against women and girls prevention workers across Surrey who would upskill teachers, with targeted work around online safety; the Chair welcomed detail on that. A Board member added that the University of Surrey had some research on the matter and would share that.

 

Helen Coombes and Liz Williams left the meeting at 2.42 pm.

 

20.  A Board member praised the huge amount of work that had gone into the strategy and highlighted the resources committed, however sought for the Board to understand that it in Children’s Services it seemed that the problems with children's emotional wellbeing and mental health were accelerating faster than its capacity to respond. It was vital to keep the matter under review to ensure that the response keeps pace with the changes in children's lives. The Chair suggested that the issue be broken down and discussed in partnership to understand the work underway across the system, raising it as a higher priority regarding the prevention and early intervention work. A Board member agreed that it needed to be a higher priority as technology was outpacing the response.

21.  The Chair noted that regarding the effort to monitor and gather data to create a Surrey-wide picture, it was incumbent to lobby the Government on what needed to happen going forward. From the PCC perspective a Board member provided assurance that was underway, having had a conversation with the Minister for Policing on the matter; it was a large and rising threat to Surrey - a low crime area.

 

Priority 3

 

22.  The Priority 1 Sponsor in lieu of the Priority 3 Sponsor noted that the work on the Whole System Approach to Poverty would be sponsored by SCC’s Director of Public Health. Through different interventions, the multi-agency NOLB Skills and Employment Network had progressed in the bid to support people who were the furthest away from employment to get back into employment.

23.   The Prevention and Communities Lead (SCC) noted:

·         The positive progress in supporting those most at risk of being left behind from the skills and employment market in Surrey. A £6 million grant from the Department for Work and Pensions (DWP) had been secured to support people with long-term health conditions and disabilities to access work and to stay in work. Community organisations could bid on £2 million of that in the form of grants - used as an opportunity to upskill and provide training, she would circulate information about applying for a grant.

·         The continuation of Naturally Talented Me which was an online recruitment platform for residents that do not have traditional work histories but have a range of life experiences which could be translated into a suitable role, 140 residents had profiles and were looking for work. Research was underway with businesses around their experiences of being an inclusive employer, supporting them to do more around equality, diversity and inclusion (EDI).

·         Working with the Mace Group contracted as SCC’s Facilities Management provider on their social value-funded plan on the access to work scheme for those who may be left behind from the labour market to get jobs with them.

·         That getting people into a job was important but so too was helping people stay in that job and progress, there was a piece of work understanding and mapping the career pathways in facilities management and leisure sectors.

·         That a new piece of work had started around addressing in-work poverty regarding residents who might be working in one or multiple jobs but still needed to access food banks or still found themselves living in poverty.

·         All the work underway was designed in partnership with the NOLB Skills and Employment Network composed of 100 different partner organisations, the work sought to make real life differences to many.  

·         The new opportunity called Work Well about providing holistic support to help people navigate and find the right employment support for them, an application was underway for funding from DWP.

24.  The Chair noted that getting people back into work, reskilling and upskilling was important, particularly for those with neurodiversity; the employment figures for that group was low despite them desiring to work. A Board member noted that the University of Surrey had a piece of work on organisations building in being mindful of neurodiversity in the recruitment process, the Chair praised that positive work.

25.  A Board member referred to the Poverty Strategy Commission, highlighting that it would be good for someone to link into the work by the Founder of Good Company regarding the East Surrey Poverty Truth Commission, it was a positive opportunity for the voluntary sector. The Prevention and Communities Lead (SCC) noted that the team were continuing to work closely with the Founder of Good Company; the Chair noted that it was an exciting opportunity and had attended its launch.

26.  The Priority 1 Sponsor asked whether the team was linked in with the Employment and Skills Hub in Leatherhead. The Prevention and Communities Lead (SCC) noted that the team was trying to link in with all the career hubs and was working with the economic development officers in the district and borough councils; she was happy to follow up on any suggested connections.

27.  A Board member welcomed feedback about the way the Healthwatch and Luminus Insights were presented separately in the Highlight Report. She flagged the feedback on the ground and the theme across the Priorities that there were services in place but navigation was a huge challenge for people. Noted the risk of a creep towards a two-tier system of people with resources able to navigate the system and those without unable and were at risk of being left behind - particularly true with carers. Noted the changes to the dementia support system meaning some people were unable to access some of dementia services that were available before. The biggest issue was access - particularly to primary care - and signposting was vital.

 

RESOLVED:

1.    Approved the Terms of Reference as interim.

2.    Acknowledged the minor revision to 4 Key Neighbourhoods due to boundary changes.

3.    Would use the Highlight Reports and Engagement Slides to increase awareness of delivery against the HWB Strategy and recently published / upcoming JSNA chapters through their organisations.

4.    Noted the opportunities/challenges including:

·         the incorporation of Primary Care Network level data for indicators in HWB Strategy Index.

·         change in sponsor for the work exploring a Whole System Approach to Poverty.

 

Actions/further information to be provided:

           

1.    The Priority 2 Co-Sponsor will send the Committee Manager (SCC) the website link detailing the MHIF round two bid outcomes to be published early in the new year. 

2.    The Priority 2 Co-Sponsor will provide a future update on the withdrawal of the suicide prevention funding.

3.    The Priority 2 Co-Sponsor will ask the Children and Young People's Convener to provide a response on what the connection is between the Mental Health Improvement Programme and special educational needs and disabilities, and schools.

4.    Regarding online safety:

-       The CEO, East Surrey Domestic Abuse Services will provide detail on the work of the four violence against women and girls prevention workers across Surrey via the Surrey Healthy Schools approach.

-       The Board Member will share the research by the University of Surrey.

5.    Regarding the Children and Young People’s Emotional Wellbeing and Mental Health Strategy and ensuring that the response keeps pace with the changes in children's lives, the Public Health Principal (SCC) will follow up the Chair’s suggestion to break down the issue and discuss that in partnership to understand the work underway across the system, raising it as a higher priority regarding the prevention and early intervention work.

6.    The Prevention and Communities Lead (SCC) will circulate information about applying for a grant for community organisations to support people with long-term health conditions and disabilities to access work and to stay in work.