Agenda item

When the Surrey Health and Wellbeing (HWB) Strategy Index was shared with the Board in 2023 it was recognised that further development was needed both in terms of indicators and the geographic levels at which the data is presented. The last iteration had the addition of Primary Care Network (PCN) level data. This latest significant update includes over 20 new indicators (61 in total), aligned to HWB Strategy’s priority populations and to the priorities/outcomes to offer a more comprehensive picture.

In this paper, we summarise the additional indicators introduced (see appendix 2) and share the first iteration of the Scorecard that draws attention to areas where progress or need is particularly noteworthy.

Witnesses:

Ruth Hutchinson, Director of Public Health, SCC

Rich Carpenter, Senior Analyst - Analytics and Insight, SCC

Key points raised in the discussion:

1.    The Chair noted that significant work had progressed to add over twenty new indicators to the Health and Well-Being Strategy Index. The Scorecard provided a baseline to track progress against the three Priorities and their outcomes and to start assessing the impact. Gaps would be addressed and were largely due to the work needed to analyse data or ensure rigour and relevance of existing data.

2.    The Director of Public Health (SCC) noted that last year the Board received a live demonstration of the Index which measures high-level outcomes and many of the programmes meet multiple outcomes. The Index was interactive and she encouraged partners to continue to use it. Through extensive engagement with partners additional indicators were introduced and where available and meaningful, data for different geographical levels was included: district and borough, ward and Primary Care Network (PCN), as well as at county level providing data on the Priority Populations and the overarching life expectancy indicators. Gaps in data on Multiple Disadvantage was partly addressed through the JSNA chapter. The Scorecard was a high-level snapshot of the data, including that in the Index, to be produced annually and progress on the Index reported in the Highlight Reports.

3.    The Senior Analyst - Analytics and Insight (SCC) noted that publicly available data was used so in some cases might be somewhat outdated due to delays in reporting. He highlighted areas in the Scorecard that showed significant changes in performance or progress:

·         Challenge: Overarching indicators: Inequality in life expectancy at birth: Surrey was performing better than the regional and national average between the areas of highest deprivation and lowest but there had been a recent slight increase likely due to COVID-19. However, inequalities at ward level were significant.

·         Challenge: Priority Populations: Employment gap for adults in contact with secondary mental health services: poor result although the indicator definition had changed so the trend was not reliable as the figures were different for the latest period.

·         Opportunity: Priority Populations: Employment gap for adults with a learning disability: that gap had decreased; to improve further through new programmes such as Work Wise.

·         Further opportunities were highlighted for example the chlamydia detection rate was good; regarding further challenges an FAQ document could be provided explaining further the context of some indicators.

4.    A Board member noted that regarding mental health, stable housing was not mentioned yet it looked like there was a significant gap. Regarding employment, he asked if the data was comparable whether that would mean that Surrey was doing relatively better than England or not. He asked whether there was a correlation between the lack of stable housing and the employment gap for people accessing secondary mental health services. The Senior Analyst - Analytics and Insight (SCC) explained that the Index and Scorecard contained data for those in stable and appropriate accommodation, both for learning disabilities and secondary mental health. The Director of Public Health (SCC) noted that the challenges needed to be read in conjunction with the JSNA chapters, which triangulated that data, then sense checking whether enough focus was put on key areas.

5.    The Vice-Chair noted that she is a GP in Spelthorne, an area with poor performance, the focus should be on the HWB’s response to the data and ask of Spelthorne for example through an action plan detailing improvements against the indicators from all relevant partners in the borough, so the HWB can support them. For the Mental Health System Committee to receive that information and question what was being done about employment. Whilst there were several programmes around employment support for people with a mental health diagnosis, there was a lack of knowledge about those services from professionals and a lack of referrals. Triangulation between indicators was needed to enrich the Index.

6.    The Chair noted that it would be interesting to see whether there were patterns in the indicators across Surrey’s boroughs and districts, to understand the interrelated impact of those. The Senior Analyst - Analytics and Insight (SCC) noted that the idea of the Index was to start raising those questions to see the patterns and generate hypotheses, working together to incorporate that into deeper dives through a workshop or similar.

7.    A Board member noted that much of the data was provided as a percentage which did not clearly convey the change in the figures and problem areas. He asked for aspirational figures of Surrey’s targets and how that compares nationally and regionally. The Senior Analyst - Analytics and Insight (SCC) acknowledged the need for clarity as for example the drop in youth unemployment of less than one percent represented about 1,000 young people. He noted that in the Tableau version of the Index on Surrey-i each indicator included the score, rank and actual value, as well as historical data where available. The score for each indicator and overall Priority was between 0 and 100, 0 was the estimated worst outcome and 100 was the best and aspirational targets based on what was the most achievable or as compared to regional and national data could be set. The Director of Public Health (SCC) noted that the Index included trend level data showing the increase or decrease, the team would take the high-level overview of the Index with those challenges to the relevant boards in the system such as the Mental Health System Committee.

8.    A Board member asked what the interrelationship was between the various boards in the system that developed their own strategies and the high-level  indicators. For example, the Carers Partnership Group was developing an outcomes framework based on the Surrey Carers Strategy in co-production with carers; the Index had one indicator concerning carers regarding adequate social contact. If from that work the Group formulated different metrics, would there be a discussion about whether the indicator in the Index needed to change over time. The Senior Analyst - Analytics and Insight (SCC) noted the restriction in how data was published regarding the geographic levels and timeliness, where possible sub-groups had been engaged to identify the overlap and alignment with other strategies. He was happy to discuss the possible inclusion of a new indicator. The Director of Public Health (SCC) added that the Index and Scorecard provided a high-level overview; indicators had evolved reflecting feedback given.

RESOLVED:

1.    Reviewed and would provide feedback to healthandwellbeing@surreycc.gov.uk on the annual HWBS Index and Scorecard and the progress/needs it highlights.

2.    Would promote the HWB Strategy Index and Scorecard to inform organisational and partnership plans where relevant.

3.    Would raise awareness of the HWB Strategy Index and Scorecard at related boards and networks.

Actions/further information to be provided:

1.    The Senior Analyst - Analytics and Insight (SCC) will develop an FAQ document/content to further explain the context of the indicators in the Index and Scorecard.

2.     The SCC team will take the high-level overview of the Index with the challenges raised by the Board to the relevant boards in the system such as the Mental Health System Committee and will incorporate those challenges into deeper dives through a workshop or similar.