Surrey Health and Wellbeing Board: January 2017 Update

“Through mutual trust, strong leadership, and shared values, we will improve the health and wellbeing of Surrey people”

About the Health and Wellbeing Board

Surrey’s Health and Wellbeing Board is a forum for health and social care leaders in Surrey to come together and improve the health and wellbeing of the people of Surrey. The Board holds a meeting in public or a business meeting in private every month. It has several responsibilities:

Leadership: The Board leads partners in improving the health and care of Surrey residents

Integration: The Board encourages health and social care organisations to work together and produce more joined-up, co-ordinated services.

Understanding Needs: The Board identifies the health and social care needs of Surrey’s residents.This information informs its strategy.

The Health and Wellbeing Board: January 2017

The Surrey Health and Wellbeing Board held a business meeting on 12 January 2017. This update provides a summary of the meeting.

What was discussed:

·  Focus on health inequalities

·  Integrated approach to identifying and assessing carer health and wellbeing

·  Joint Health and Wellbeing Strategy priority update: Developing a preventative approach and

·  Joint Health and Wellbeing Strategy priority update: Promoting emotional wellbeing and mental health

Who was there:

Councillor Helyn Clack (co-chair), Cabinet Member for Wellbeing and Health, Surrey County Council

Dr David Eyre-Brook (co-chair), Guildford & Waverley Clinical Commissioning Group

Helen Atkinson, Strategic Director of Adult Social Care & Public Health, Surrey County Council

Dr Andy Brooks, Surrey Heath Clinical Commissioning Group

Tim Evans, Cabinet Associate for Adult Social Care, Wellbeing and Independence, Surrey County Council

Garath Symonds, Assistant Director Commissioning and Prevention, Children, Schools and Families, Surrey County Council

Dr Claire Fuller, Surrey Downs Clinical Commissioning Group

Peter Gordon, Healthwatch Surrey

Kate Scribbins, Healthwatch Surrey

Dr Elango Vijaykumar, East Surrey Clinical Commissioning Group

Presenters:

Mary Burguieres, Surrey County Council

Phillip Austin-Reed, Surrey County Council

Kim Rippett, Guildford Borough Council

Annette Snell, Epsom and Ewell Borough Council

Edward Fram, public health volunteer, Surrey County Council

John Bangs, Surrey County Council

Debbie Hustings, Guildford and Waverley CCG

Sonya Sellar, Surrey County Council Area Director for Surrey Downs CCG area

Helen Atkinson, Strategic Director of Adult Social Care & Public Health, Surrey County Council

Rachel Gill, Surrey County Council

Diane Woods, North East Hants and Farnham CCG

Liz Uliasz, Surrey County Council

Adam Whittaker, Surrey County Council

Peter Gordon, Healthwatch Surrey

Kate Scribbins, Healthwatch Surrey

Board Business

Health and social care pressures

The Health and Wellbeing Board had a discussion relating to the pressures on health and social care that have recently reported in the national press. Surrey is experiencing similar pressures to those reported nationally in accident and emergency departments (A&E) and general practice (GP) alongside funding stresses. However, in Surrey due to partners working as one system across health and social care, some of these difficulties have been mitigated by ensuring the system is kept flowing. An update on this will be provided at the beginning of the 2 February 2017 meeting.

Protocol: Health and Wellbeing Board, Children and Young People’s Partnership, Safeguarding Adults and Children Boards and Community Safety Board

This protocol sets out working arrangements between the various Boards and partnerships mentioned above. At the meeting on 8 December 2016, Health and Wellbeing Board members requested further detail. The protocol has since been amended and the Board approved the updated protocol.

Board member update – Surrey Police Board representation

Surrey Police representation on the Health and Wellbeing Board has been changed. The Chief Constable of Surrey Police and the Police & Crime Commissioner (PCC) have agreed that the latter should represent Surrey Police on the Board. Nick Ephgrave has therefore stepped down from the Board and has been replaced by David Munro. Nick has been a valuable asset to the Board over the past year and the Board would like to thank him for his contribution.

Having the PCC on the Board will further enhance the close relationship between the Police and the health and social care community in Surrey, in particular strengthening the links between the Community Safety Board and the Health and Wellbeing Board.

The Health and Wellbeing Board welcomes the Police and Crime Commissioner David Munro and looks forward to seeing him at future Board meetings.

Focus on Health Inequalities

Presented by:

Mary Burguieres, Surrey County Council

Phillip Austin-Reed, Surrey County Council

Kim Rippett, Guildford Borough Council

Annette Snell, Epsom and Ewell Borough Council

Edward Fram, public health volunteer, Surrey County Council

What was discussed:

Focusing on reducing health inequalities is a key principle that underpins the Health and Wellbeing Board’s activity. The Board heard the outcomes of the Homelessness Needs Audit 2016 and discussed what more could be done to reduce these inequalities. A summary of the audit in Surrey can be found online here.

The Board heard how often people who suffer inequalities experience several problems at the same time, such as mental ill health, homelessness, drug and alcohol misuse, offending and family breakdown. These are known as complex individuals. The Board heard case studies of ‘complex individuals’ and the impact they have on the health and social care system. Examples of work underway in Surrey by Boroughs and Districts to address these complex needs include the outreach for rough sleepers such as Homeless Outreach and Support Team (HOST) and East Surrey Outreach Service (ESOS) / Single Homeless Alliance West Surrey (SHAWS); Severe Weather Emergency Protocols; new funding for mental health and wellbeing workers in Guildford, Woking and Waverley; and joint training.

The Board concluded these inequalities were unacceptable in Surrey and a person centred approach should be taken to realise improvements.

What was agreed:

·  To take a person-centred approach towards the inequalities highlighted

·  Liaise with Surrey Homelessness Alliance on evidence of what approaches have worked and to provide clear recommendations as a strategic board

·  A focus on health inequalities, including homelessness and complex individuals will be taken forward as part of the ‘developing a preventative approach’ priority

Joint Health and Wellbeing Strategy priority update: Developing a preventative approach

Presented by:

Helen Atkinson, Strategic Director of Adult Social Care & Public Health, Surrey County Council

Rachel Gill, Public Health Consultant, Surrey County Council

What was discussed:

The Board heard updates on delivering the prevention priority through the Surrey Sustainability and Transformation Plans (STPs) and an update on the work around Air Quality.

Achievements over the last six months of the prevention priority include:

·  Embedding of prevention within Surrey Heartlands STP

·  Collaborative working across other 2 STP areas

·  Prevention Plan Dashboard continues to be updated with progress on metrics

·  Creation of Surrey Air Alliance to address air quality through multi-agency working

Prevention in STPs

The public health team have been working to embed prevention across all 3 STP areas which cover the Surrey population; Surrey Heartlands; Sussex and East Surrey; and Frimley Health. There are many common themes in the STPs which support prevention across the life course, including initiatives to support behaviour change and healthy lifestyles, strengthening prevention and early detection of long term conditions (for example implementation of the National Diabetes Prevention Programme), embedding prevention initiatives in secondary care and supporting workplace health and wellbeing initiatives.

Air Quality Update

Strong evidence was presented to suggest an association between poor air quality and deaths from cardiovascular disease, respiratory disease and lung cancer. Read the recent report by the Royal College of Physicians here.

There has been no change in Air Quality Management Areas (AQMAs) across Surrey since the presentation to the board in May 2016. All Surrey AQMAs are declared due to the national air quality objectives for nitrogen dioxide or both nitrogen dioxide and particles (PM10) not being met in those areas. The source of both these pollutants in Surrey is road traffic.

Over the last six months, partners in Surrey have set up the Surrey Air Alliance, a strategic group to lead the work on air quality. The Alliance has developed a proposal for detailed air quality modelling across Surrey and submitted a bid to Department for Environment, Food & Rural Affairs (DEFRA) to create a shared Electric Vehicle Strategy for Surrey.

Next steps for Air Quality are to align the air quality work with other relevant Surrey County Council strategies and to develop a multi-agency action plan to support collective action through the Surrey Air Alliance.

What was agreed:

• The Board endorsed the prevention priority progress and next steps and will receive an update on the prevention priority in 6 months. This will include:

• Update on prevention progress in STPs

• Key messages and evidence-based recommendations to be taken forward in relation to air quality and health inequalities (from earlier item)

• The Surrey Air Alliance will develop a multi-agency action plan aiming to reduce the negative health impacts of air quality on local residents. This will be taken forward as part of the prevention priority.

Joint Health and Wellbeing Strategy priority update: Promoting emotional wellbeing and mental health

Presented by:

Diane Woods, North East Hants and Farnham CCG

Liz Uliasz, Surrey County Council

Adam Whittaker, Surrey County Council

What was discussed:

The Board reviewed progress made since June 2016 on delivering the ‘Promoting emotional wellbeing and mental health’ priority action plan.

Key achievements include:

·  Surrey is ahead of the curve with new technology for mental health – on-line IAPT, e-therapy SABP, face to face on-line support for carers

·  Reduced Section 136 people in custody down from 19% to 3%

·  Increase in Section 136 Health beds (+25% capacity)

·  3 Bids successful bringing in £2.4million across Surrey agencies to improve mental health crisis care

·  All 5 safe havens cafés now open across Surrey & NE Hampshire

·  Peer support workers in place

·  New Independent service user and carer network established

·  Healios carers support pilot extended showing positive outcomes

·  Anti-stigma work of Time to Change rolled out reaching more than 1600 people through the mental health ambassadors

·  Suicide prevention plan developed

·  Domestic abuse training in CCGs prevention plans

·  Ahead of the curve with new technology for mental health – on-line IAPT, e-therapy SABP, face to face on-line support for carers

·  Crisis care concordat plan refreshed and upload to national website

·  Reviewed Protocols and Improved working between agencies, SABP/Police/111/Ambulance

·  Conveying of people on S136 by ambulance introduced

·  Crisis provision for children and adolescents extended HOPE commenced

·  Develop a Single Point of Access for MH Crisis (co-design started)

·  Mental health staff in police call centres 7 night service

·  GP Education for MH Advanced Diploma commissioned

·  Accommodation and Support group established

The Board received an in depth presentation around the evaluation of the crisis care program. This is due to be published in December 2017 and we will share when available.

The Board recognised the significant progress made since the implementation of the Joint Mental Health Strategy and action plan in 2014 in improving mental health and emotional wellbeing in Surrey. The Board encouraged all partners to ensure that mental health and emotional wellbeing continue to be embedded in the plans of all organisations going forward. This will ensure sustainability of this priority post July 2017 when the strategy and action plan ends and will ensure that mental health is ‘everybody’s business.’

What was agreed:

·  Mental health and emotional wellbeing to be included in all health and social care plans from July 2017.

·  Member training in June on Mental Wellbeing Training for the new cohort of County Councillors. The invite to be extended to Health and Wellbeing Board members if they wish to attend

Spotlight On: One You

One You helps adults across the country avoid future diseases caused by modern

lifestyles. Everyday habits and behaviour - such as eating too much unhealthy food,

drinking more alcohol than is recommended, continuing to smoke and not being active enough - are responsible for around 40% of all deaths in England, and cost the NHS more than £11 billion a year.

One You encourages people to reappraise their lifestyle choices, put themselves first and do something about their own health. It reminds people that it’s never too late to improve their health - making small lifestyle changes such as eating well, drinking less alcohol, quitting smoking or being more active can double your chances of being healthy at 70 and beyond.

The campaign encourages adults to take part in a free online health quiz, called ‘How Are You’, to identify where they can make small changes. The quiz provides personalised recommendations and directs people to tools and advice created by experts to help them take action where it’s most needed.

Take the quiz here to see how you score.

A toolkit has been developed and circulated to local partners – CCGs, Districts and Boroughs, hospitals and health and Wellbeing lead with localised digital assets, such as ‘How are you, Guildford?’,

‘How are you, Runnymede?’ The focus is on ‘How are you?’ health quiz, which is here to help you get back to a healthier you.

Feedback

If you have any questions or comments about this update, please contact us:

Email:

Phone: 03456 009 009

Text: 07527 182 861

What the Board will focus on next

The Board will hold a business meeting in private on 2 February 2017. Items on the agenda include:

·  The impact of good information and signposting in a health and social care pathway

·  Public consultations and engagement

·  Entry to the System update

·  Joint Strategic Needs Assessment (JSNA) and Joint Health and Wellbeing Strategy Review

·  Sharing Budget Forecast Position

·  Transforming Care Plan

Find out more

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Read the minutes

To read the minutes of previous formal Board meetings, visit the Surrey County Council Website: http://tinyurl.com/py5kwex

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The Board regularly holds meetings in public. Anyone is welcome to observe these meetings, and ask the Board members questions about the items discussed. To find out details of the next meeting, visit the Board’s page on the Surrey County Council website: