Agenda item

This paper provides an overview of the progress in the delivery of the Health and Wellbeing Strategy (HWB Strategy) as of 27 August 2024.

Agenda item for: HWB, and Surrey Heartlands ICP

Agenda item for: HWB, and Surrey Heartlands ICP

Speakers:

Mari Roberts-Wood, Managing Director, Reigate and Banstead Borough Council / Chair of Prevention and Wider Determinants of Health Delivery Board (PWDHDB)

Lucy Gate, Public Health Principal, SCC / Co-chair of Mental Health: Prevention Board

Ruth Hutchinson, Director of Public Health, SCC

Jonathan Lees, Managing Director, Good Company

Key points raised in the discussion:

1.    Priority 1: The Chair of the PWDHDB referred to the spotlight section on Active Surrey, which initiated a new Place Partnership in Stanwell. Club4 was the Holiday Activity and Food programme for Surrey, offering over 39,000 places for children on free school meals. Opportunities: the Surrey Cancer Inequalities Programme would address knowledge gaps and highlight invisible inequalities, it was given national best practice recognition. Challenges: the Joint Strategic Needs Assessment (JSNA) chapter on multiple disadvantage (MD) identified 3,000 plus adults experiencing MD in Surrey, the Bridge the Gap prevention service showed a return on investment of 1:4, funding was undecided meaning that the service could be decommissioned. Active Surrey was waiting to see whether funding for Club4 would continue.

2.    Priority 3: The Chair of the PWDHDB highlighted that the Council made a successful funding bid to Southern Gas Network for £920,000, for Surrey's Fuel Poverty Programme to deliver support to vulnerable residents. Opportunities: Surrey Against Domestic Abuse Strategy 2024-2029 was an opportunity for strong local leadership to transform the way domestic abuse is tackled, the Expert by Experience Network would play a key role. Challenges: funding for some Local Area Coordinators and for the Serious Violence Duty was due to end in March 2025, the funding for the Household Support Fund was until April 2025.

3.    The Chair noted that the additional funding for domestic abuse ends in March 2025, the Government needed to be lobbied to sustain it.

4.    A HWB and ICP member noted that Active Surrey was renegotiating for the Council to continue to host it, he highlighted its amazing work to get kids active and it was working to expand that to adults. Highlighted the Active Surrey School Sports Day in the summer at Guildford, asked all in the room to stand up and then sit down as that used one hundred muscles. Active Surrey was constantly looking for sponsors, urged all to support them as they provided great results.

5.    A HWB and ICP member noted the limited resources and queried whether the focus should be on inactive people rather than encouraging those who do some activity to do more. The Director of Public Health (SCC) noted that the evidence base was strong, that for those who are inactive doing some exercise made a significant difference to their health. It was important that all take part in the Chief Medical Officer guidelines for physical activity, however focus was needed, using the Index Scorecard to target efforts in Stanwell for example focusing on geography and key communities; Active Surrey was a finite resource.

6.    A HWB and ICP member referred to the Surrey Heartlands Clinical Strategy, targeting preventative action to its populations that experience the worst outcomes and health, that was where the focus of the HWB and ICP’s activity should be. For example, keeping people active was vital to preventing dementia.

7.    The Managing Director (Good Company) noted that most people the Good Company works with in energy poverty were £1,000 in debt on average. He called for developing consistent preventative work around energy poverty, as grants such as the Household Support Fund were short-term. The Good Company was trying to support people to reduce consumption and their debt.

8.    A HWB and ICP member referred to the prevention framework, the focus was on the primary prevention space, but also proactively identifying and targeting communities, those people with less favourable outcomes or have challenging living circumstances. Targeting those people with the Voluntary, Community and Social Enterprise (VCSE) sector or appropriate partner, looking at self-help, referral, advice; reducing the number of crises and emergencies. The Chair noted that prevention would be discussed concerning the Better Care Fund.

9.    A HWB and ICP member noted that there were several funding streams due to end, queried what the governance arrangements were for discussions around what is prioritised and how to best use the funding available to deliver for residents, working in partnership. Whether the HWB and ICP can lobby the Government. The Chair noted the need to have those conversations and lobby.

10.  A HWB and ICP member noted that there were more than 100,000 carers she represented that might be inactive, when working with partners who deliver services, it was vital to consider promoting activity and access for carers. A HWB and ICP member noted the upcoming work with Mobilise regarding carers, he would have a conversation with the HWB and ICP member on the matter.

11.  A HWB and ICP member highlighted those people in low paid jobs, working long hours, it was important that all organisations think about their staff’s wellbeing and to consider providing accessible access to facilities and support. The Chair noted that the End Poverty Pledge item would outline the work underway, noted that getting the right prioritisation would be challenging.

12.  A HWB and ICP member supported the areas identified in the second recommendation, particularly the Bridge the Gap prevention service, which works with vulnerable residents; there were successful outcomes. Queried how the HWB and ICP would seek to obtain more sustainable funding going forward. The Chair noted that there would be discussions with the Government on the Fair Funding Review, once there was clarity partners needed to come together; it was unlikely that Surrey would receive more money.

13.  Priority 2: The Co-chair of Mental Health: Prevention Board noted the Opportunities: the Mental Health Investment Fund (MHIF) was being coordinated by the Community Foundation for Surrey to allocate the money, £1.7 million remained; that was match funded. Asked HWB and ICP members to share the information on the first round, the deadline for applications was 16 October. Regarding the spotlight section on the loneliness and isolation JSNA chapter, it was unique and included experiences from over 2,000 practitioners and residents. Loneliness and isolation caused worse physical and mental health outcomes, and costed £2.5 billion a year of sickness absences. A key recommendation was for system partners to recognise that chronic loneliness was a structural inequality, a shared plan was being developed at system level. The amended Suicide Prevention Strategy had extensive engagement with over 600 recommendations being considered. Challenges: highlighted the work by Surrey Police in surveillance and responding to deaths by suicide or serious attempts, enabling prevention work to happen in real time. Noted the risk of scaled back activity if funding for the suicide prevention post does not continue.

14.  The Director of Public Health (SCC) noted that the Health and Wellbeing Strategy Index was publicly accessible to review and measure progress against the high-level outcomes. The quarterly Highlight Reports show the delivery of the Health and Well-Being Strategy, the annual Index Scorecard provides a summary of the data in the Index. The Challenges were being picked up by the two sub-boards and were being turned into action plans. The JSNA chapters contained the detail of each topic and there were governance arrangements.

15.  The Chair clarified that the original MHIF was over £11 million, the £1.7 million referred to was the remaining balance.

16.  A HWB and ICP member asked whether a dashboard could be produced with Red, Amber, Green ratings of where time and effort should be focused. The Director of Public Health (SCC) noted that was the aim of the annual Index Scorecard, it was scheduled in the forward plan and showed positive outcomes and areas that required more focused efforts. She noted that the sub-boards review the delivery against the recommendations in the JSNA chapters.

17.  A HWB and ICP member noted the importance of working in partnership with the boroughs and districts, which have skills for tackling loneliness and social isolation. Noted that continued efforts were needed and that friendships were the biggest cure for loneliness. The Chair noted that there was a piece of work being undertaken looking at the teams around communities, looking at optimising the various resources at local government and health system level.

18.  A HWB and ICP member welcomed the work underway but noted concern in the funding, the amount of money had reduced dramatically; asked what was being done to ensure future funding to carry on the work. The Chair noted uncertainty around funding from the new government and therefore prioritisation was key, it would first have to address the continued funding of Adult Social Care. There would be some clarity once the budget is announced in October. Regarding the recommendation on unmet needs, work had been done through the JSNA and towns and villages piece to identify the most vulnerable people and provide support. The four tools ensured the right people were being targeted.

19.  A HWB and ICP member stressed the need to look for alternative sources of funding, some of that would come from the philanthropic sector. A lot of work around loneliness was done by the VCSE sector. The match funding for the MHIF for example made the delivery go further. Requested that the VCSE sector be involved in the development of the work on loneliness. The Chair noted the good track record of doing that with the Community Foundation for Surrey, hoping that as the VCSE Alliance matures it could be the point of entry to provide input at an early stage.

20.  A HWB and ICP member stressed the need to bear in mind the arts and cultural sector when thinking about social isolation and the work around physical activity, noted the grassroots work underway, some of which was funded philanthropically, but also through other programmes. Highlighted the new ten-year cultural strategy for the county ‘Surprising Surrey’ which focuses on the outcomes; he offered his support.

RESOLVED:

The HWB and Surrey Heartlands ICP:

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

2.    Would respond to the significant challenges which include the following:

·         The unmet needs highlighted in the HWB Strategy Index Scorecard, particularly regarding inequalities between communities of geography and identity.

·         Critical funding issue for Surrey prevention programmes that have been evaluated locally as extremely effective in addressing need and reducing demand but are not resourced beyond March 25 – eg some Local Area Co-ordinator roles and Changing Futures’ Bridge the Gap service.

·         Funding continuation uncertainties for other Surrey programmes that are Government funded – Household Support Fund (extension only to April 2025), Serious Violence Duty programme (end December 2024), Active Surrey programmes (various, end December 2024), Suicide Prevention Adviser in Surrey Police (end July 2025).

Actions/further information to be provided:

1.    The Chair will undertake the conversations with partners concerning how best to use the funding available and around what is prioritised; and will lobby the Government on the critical funding issue for Surrey prevention programmes and funding continuation uncertainties as noted in recommendation two.