December 2022 highlight report

Contents

• Priority 1 - supporting people live healthy lives
• Priority 2 - supporting mental health and emotional wellbeing
• Priority 3 - supporting people to reach their potential
• Communications highlights
• Joint Strategic Needs Assessment: progress as of November 2022

Priority 1 - supporting people live healthy lives

Impact summary

Improved physical health through the prevention of physical ill-health and the promotion of physical well-being.

Outcomes by 2030

• People have a healthy weight and are active
• Substance misuse is low (drugs/alcohol & smoking)
• The needs of those experiencing multiple disadvantages are met
• Serious conditions and diseases are prevented
• People are supported to live well independently for as long as possible

Who is leading this?

Priority sponsor:
Karen Brimacombe. Chief Executive, Mole Valley District Council

Programme Manager:
Helen Tindall, Policy and Programme Manager, Surrey County Council

For more information on the performance of individual programmes and projects within this priority such as progress against key milestones please contact the relevant programme manager via healthandwellbeing@surreycc.gov.uk

What will be different for people in Surrey?

The Community Vision for Surrey describes what residents and partners think Surrey should look like by 2030: By 2030 we want Surrey to be a uniquely special place where everyone has a great start to life, people live healthy and fulfilling lives, are enabled to achieve their full potential and contribute to their community, and no one is left behind.

In light of the Community Vision and the vital role, communities and staff/organisations in the health and care system play in its delivery, the Strategy sets out Surrey's priorities for improving health and wellbeing across the priority populations for the next 10 years. It identifies specific groups of people who experience poorer health outcomes and who may therefore need more support. It also outlines how we need to collaborate so we can drive these improvements, with communities leading the way.

Priority 1 currently focuses on enabling residents to lead physically healthier lives. This priority area is focused on prevention, removing barriers and supporting people to become proactive in improving their physical health. Priority 1 programmes include those which focus on:

• Working to reduce obesity, excess weight rates and low levels of physical inactivity
• Supporting prevention and treatment of substance misuse, including alcohol, and smoking cessation.
• Ensuring that the needs of those experiencing multiple disadvantages are met.
• Promoting prevention to decrease incidence of serious conditions/diseases
• Living independently and dying well

How has collaborative working between HWB board organisations added value and contributed to the achievement of the outcomes?

A Food Summit took place at the end of September and an invitation was extended to new members- businesses, food banks, farmers and many other stakeholders. The summit offered an opportunity to co-produce the Food Strategy that is being developed in Surrey. Speakers at the summit included Sustainable Food Places and Marisa Heath, Cabinet Member for Environment. As part of the summit, a Food System Mapping exercise took place to identify gaps and strengths in different areas in the food environment in Surrey. Stakeholders were given the opportunity to talk about the main challenges they're facing. This information will be invaluable in shaping an initial draft of the strategy which should be ready by the end of December 2022. Consultation will then begin on the strategy in January 2023.

A new Community of Practice (CoP) for Wellbeing Roles has been set up for Surrey Downs Place, building on the success of the Northwest Surrey CoP. Members are from across health, care, SCC and the voluntary, community and social enterprises (VCSE), employed by numerous employers across sectors but all working in that prevention space. The first meeting was held at the end of September and included 24 professionals, covering a range of roles such as social prescribing link workers, community link officers, community connectors, dementia navigators, and communities and prevention coordinators.

A new Combatting Drugs Partnership Board has been established in Surrey. The Partnership will help to drive through the priorities highlighted in the Dame Carol Black Review and most recent national 10 year Drug Strategy From Harm to Hope. The Partnership will also oversee spending on substance misuse in Surrey and is comprised of members from across the local authority and health, as well as voluntary, community and frontline sector (VCFS) organisations.

Applied Behavioural and Social Science 'ABSS' introductory workshops have taken place to strengthen the delivery of the HWB Strategy, launched with mostly Priority One Senior Responsible Officers (SRO) so far. Further training and a support programme to be rolled out through winter 2022/23.

Data, insights and challenges - patient feedback on the pinpoint cancer test

The PinPoint Test is a new blood test which uses artificial intelligence to produce a calibrated probability that a patient has cancer. This test will be offered to patients who have cancer symptoms and are being referred urgently for cancer investigations. Once the test is implemented fully, it will be used to support hospital clinical teams to triage their patients. PinPoint asked Healthwatch Surrey to recruit 15 Surrey residents to join a focus group and to facilitate the session so they could introduce the PinPoint test and get feedback from a patient perspective on acceptability of the use of the test, terminology used and to understand questions people may have. The focus group was part of a much larger project which has received £1.7m NHS funding: PinPoint worked with cancer alliances in 5 key areas of the UK to gather feedback about the proposed test.

Healthwatch reached out to local Cancer support groups that they have relationships with and ran some targeted social media adverts to ensure they had a good mix of Surrey residents. Some participants were having Cancer treatments, had experience of tests and investigations for Cancer and some has an interest in health. Healthwatch Surrey facilitated the group discussion and monitored the online chat, as well as noting any questions and comments to send to PinPoint after the focus group. Each participant was emailed after to thank them for their contribution and were sent a gift voucher as a thank you for their time. Information gathered from this focus group will be collated with other findings from focus groups carried out across the UK and will help shape the delivery of the PinPoint service for GPs and medical practitioners in the future.

What has been achieved this quarter under refreshed priority 1 outcomes?

People have healthy weight and are active

• A service specification is in development for the University of Surrey to embed the whole system approach to obesity framework for young people. The University will be working with organisations to provide support for them with the adoption of the framework.
• A new appointment in Surrey County Council's Public Health team will be developing and promoting the Eat Well Start Well scheme to early years settings in Surrey.

Substance misuse is low (see above – Combating Drugs Partnership)
The needs of those experiencing multiple disadvantage are met

• Currently seeking formal commitment from partners for Sustainability Funding for the Changing Futures Programme.
• Changing Futures have been invited to represent Multiple Disadvantage on the newly formed Combatting Drugs Partnership Board.
• The Changing Futures Lived Experience Group is now meeting monthly with a membership of 13. Members have been invited to strategic meetings and genuine co-production work is being undertaken with members renumerated for sharing their time and expertise.
• Fifteen specialist Trauma Informed Outreach workers are now in post and supporting beneficiaries.
• Graduate Management trainee has joined the Changing Futures team to lead on the development of a common data framework and case management system for people with multiple disadvantage.

Serious conditions and diseases are prevented (see below – Diabetes Prevention)
People are supported to live independently for as long as possible

• Initial findings, options and recommendation presented to the transition team and other key stakeholders on a reablement offer for the transitions client group which is currently being developed.
• Scoping document in progress reporting findings on what a reablement night service could look like in Surrey.
• 'As Is' reablement customer journey workshops completed and written up. Reablement option paper was presented to the SCC Adult Leadership Team on 25 October 2022.
• New shared workspace created for Surrey social prescribing link workers and service managers on the Future NHS Collaboration Platform, creating a forum for networking, peer support, peer learning and shared resources. The workspace has been running for four months now and has 51 members.
• Revised social prescribing reporting to incorporate green social prescribing data and demographics, and to improve VCSE provision insight data.
• Developing peer support and Action Learning Sets for social prescribing link workers in partnership with the Personalised Care team at Surrey Heartlands with £20K of NHS England (NHSE) funding.
• Developing an online mapping tool for social prescribing services with £5K NHSE funding. This will be an interactive map available online so anyone can see where social prescribing is offered, by whom,what the referral pathway is.
• D&B/VCSE employers of link workers will receive support from Surrey Heartlands Information Governance team to complete the NHS Data Security and Protection Toolkit – completion expected by June 2023. This will facilitate access by social prescribing teams to Population Health Management data and the Surrey Shared Care Record.

In the spotlight - uptake of diabetes prevention programmes by ethnically diverse communities

Surrey Heartlands' Diabetes Delivery and Oversight Committee funded Active Surrey to explore the views of ethnically diverse communities (EDC) on type 2 diabetes (T2D)/prediabetes and lifestyle habits, in order to encourage better take up of diabetes prevention programmes and management of the condition. The research focused predominantly on communities from Black African, African Caribbean and South Asian (Indian, Pakistani, Bangladeshi) backgrounds in Epsom, Woking and Staines. 54 individuals took part in the survey/ focus group.

The research findings highlighted issues around a need for:

• Help with technology in self-management of the condition and attending online clinical appointments.
• Better access to information (in different languages and with cultural sensitivity).
• Improved cultural understanding amongst health professionals (including that T2D is almost expected by this demographic, and that women especially do not allow time for themselves).
• Earlier education of the condition – targeting school aged children to help influence habits and promote the benefits of leading an active and healthy lifestyle.
• Removing barriers associated with physical activity, with the use of local champions to advocate the benefits of low impact, low cost, accessible sessions.
• Better awareness of the long-term health issues associated with the condition with cultural sensitivity – marketing imagery, healthy recipes adapted for local cuisines etc.

Key recommendations for those working in the area of T2D are therefore:

• Continue to raise awareness of the long-term health issues of T2D prior to diagnosis, so appropriate behaviour changes can be made earlier.
• Start education at an earlier age – work with local schools to influence young people's habits about the benefits of an active and healthy lifestyle.
• Recognise that key influencers are individuals in the community and influence the influencers!
• Integrate increased cultural awareness into future programme development whether this be imagery used, adapted recipes from local cuisine or translated materials. Coproduction is key.
• Recognise levels of tech illiteracy and lack of access to a computer /device within communities and consider alternatives to communicate messaging.
• Improve access to technology and digital training sessions to upskill - to allow more self-management of the condition for people who are able.
• Have more frequent face-to-face appointments with GP's and Diabetes Nurses. Due to language barriers, patients have issues with information online and via the phone. Allow options for family and friends to attend appointments and education sessions to help give additional support.
• Educate on the importance of self-care – making 'earlier' lifestyle choices, rather than accepting diabetes is genetic / culturally accepted.
• Remove the barriers associated with physical activity- promote low impact, low cost, accessible sessions that get people moving more on a regular basis. Local community champions should be used to help advocate activities and be role models within their communities.
• More local support groups are needed where people can meet others living with diabetes or prediabetes, to support each other and share learnings. Consider library settings as a place to meet that is a neutral space, and which potentially could have computer access too.
• Improve understanding of a healthy diet and how to adopt new behaviours with a focus on refined and complex carbs, portion sizes, healthy snacks and meal timings (ensuring culturally sensitive).
• Utilise national campaigns such as Undefeatable to share stories and advocate for the importance of an active lifestyle.

Varied physical activities have been set up in Woking, Epsom and Staines plugging gaps identified by the report. Virtual education sessions also have taken place in November addressing issues identified by the report and will be led by professionals from EDCs. For more information, contact Charlotte Long at Active Surrey on charlotte.long@surreycc.gov.uk

Priority 2 - supporting mental health and emotional wellbeing

Impact summary

Improved mental health through prevention of mental ill-health and the promotion of emotional well-being.

Outcomes by 2030

• Adults, children and young people at risk of and with depression, anxiety and other mental health issues access the right early help and resources
• The emotional well-being of parents and caregivers, babies and children is supported
• Isolation is prevented and those that feel isolated are supported
• Environments and communities in which people live, work and learn build good mental health

Who is leading this?

Priority sponsors:

• Professor Helen Rostill, Deputy Chief Executive and Director of Therapies, Surrey and Borders Partnership ​
• Kate Barker - Joint Strategic Commissioning Convener
• Liz Williams - Joint Strategic Commissioning Convener

Programme Manager: ​

Jason Lever, Policy and Programme Manager, Surrey County Council​

For more information on the performance of individual programmes and projects within this priority such as progress against key milestones please contact the relevant programme manager via ​
healthandwellbeing@surreycc.gov.uk

What will be different for people in Surrey?

The Community Vision for Surrey describes what residents and partners think Surrey should look like by 2030: By 2030 we want Surrey to be a uniquely special place where everyone has a great start to life, people live healthy and fulfilling lives, are enabled to achieve their full potential and contribute to their community, and no one is left behind.

In light of the Community Vision and the vital role, communities and staff/organisations in the health and care system play in its delivery, the Strategy sets out Surrey's priorities for improving health and wellbeing across the priority populations for the next 10 years. It identifies specific groups of people who experience poorer health outcomes and who may therefore need more support. It also outlines how we need to collaborate so we can drive these improvements, with communities leading the way.

Priority Two of the Health and Wellbeing Strategy focuses on enabling our citizens to lead emotionally healthier lives. This priority area is focused on prevention, removing barriers, and supporting people to become proactive in improving their emotional health and wellbeing.
Priority Two aims to impact in the following ways:

• Ensuring the right early help and resources are available to support mental health across life stages
• Support during pregnancy and for young families
• Recognising and addressing the impact of isolation
• Building good mental health in the range of spaces and places including schools/workplaces.

How has collaborative working between HWB board organisations added value and contributed to the achievement of outcomes?

The Mental Health: Prevention Oversight and Delivery Board (MHPODB) first met in October, to meet the joint ambition across Surrey to have coordinated oversight of delivery within Priority 2 of the HWB Strategy and the early intervention and prevention work stream of the Mental Health Improvement Plan. It aims to support the system to move forward on the most important priorities in mental health within prevention and early intervention. The MHPODB will seek to align efforts, reduce any duplication and ensure a common set of collaborative programmes can be prioritised. The MHPODB is reviewing primary prevention evidence in mental health and co-producing the programmes of work with the system Co-Production and Insights Group (CPIG). It is planned for the Work Plan framework to be taken to the Mental Health Delivery System Board and to bring the refreshed programme as part of the updated summary implementation plan to the HWB Board in March 2023.

Engagement on the draft Surrey Suicide Prevention Strategy 2022-2025 with partners, community groups and the public ended on 24 November. The number of suspected suicides in the county continues to be monitored (79 during 1 January – 30 September 2022, higher than in 2021, but lower than 2020).

Work in North East Hampshire and Farnham has taken place to understand levels of awareness amongst Frimley's health, VCSE, social care and district borough colleagues of available services to support people's mental health and wellbeing. The aim is to increase self-referrals and access to these preventative offers across sectors and agencies.

Data, insights and challenges - proactive mental health crisis prevention programme

Conversations with system stakeholders and people with lived experience had revealed a gap in mental health provision for adults living in Surrey Heartlands who are experiencing mental health challenges, though are not yet meeting eligibility thresholds for more active intervention. This cohort of citizens can 'bounce' between services within the system.

This is a digital and data programme centred on using a range of data sources to identify need. In the first phase (April – June this year), the Proactive Mental Health Crisis Prevention Delivery Group explored potential gaps in provision of mental health support. In the second phase (July – September), the Delivery Group has been working with members of staff from 15 organisations, as well as 18 people with lived experience, to co-produce a new approach to identify people in this cohort, understand their holistic needs, and identify the support they need to prevent further deterioration.

The current phase (October – December) of the project focuses on planning how to pilot the new approach. This will involve identification of a service and a high-impact area to conduct the pilot, development of a data-sharing tool and user-feedback sessions on digital mental health tools, which can enable people to manage their mental health needs in the short-term.

The work is being supported by the Surrey Heartlands Health Technology Accelerator based at the University of Surrey.

What has been achieved this quarter under refreshed priority 2 outcomes?

Adults, children and young people at risk of and with depression, anxiety and other mental health issues access the right early help and resources

• Youth Mental Health First Aid training is freely available to all schools in Surrey. All 256 training places were taken up in 2022. There are over 1000 places now commissioned for 2023. Over 700 people attended trauma-informed care training.
• Six new Mental Health & Well Being Practitioners were recruited to Surrey in September through the new Additional Reimbursement Roles Scheme (ARRS). The training and first year salary are fully funded by Health Education England under their Recruit to Train programme. It is now planned in January to recruit around a further 10 posts in this way.
• Frimley South's VCSE Surrey partner, Catalyst, has been successful in recruiting new Lived Experience Practitioners to work with their Mental Health Integrated Community Services in Surrey Heath and Farnham.
  * To deliver the Men's Mental Wellbeing and Suicide Prevention Project, Mentell have been commissioned to provide online peer support groups. A Men's Emotional and Mental Wellbeing post for Surrey is now being recruited to.
• The first stage of a review mapping all voluntary services around dementia has been completed. This is followed by identifying how they are resourced and where there are gaps in services. Publishing the information on the Surrey Dementia Roadmap, Dementia Connect website and Healthy Surrey has begun.
• Working with Healthy Surrey and Active Surrey, a campaign is being developed with consistent public health messages around how to prevent dementia. The focus is on "what is good for the heart is also good for the brain".

The emotional well-being of parents and caregivers, babies and children is supported

• A Draft Best Start for Surrey Strategy 2022-27 has been published. There was a major workshop to engage with stakeholders on 1 November. The strategy will focus on where we need to work collaboratively to improve outcomes for pregnant people, babies, children, and families in the earliest years (pregnancy to five). The draft strategy was due for sign off at the Best Start Transformation Board on 29 November and a year 1 implementation plan is being developed.
• Extensive consultation has been taking place on the refresh of the Emotional Wellbeing and Mental Health (EWMH) Strategy for Surrey's children and young people. There were surveys with stakeholders, children and young people (see emotional health and wellbeing (EHWB) questionnaire - right), and parents/carers on how we can better prevent EWMH arising and improve support and services. A 'Defining the Future' workshop was held on 8 December to draw out insights and propose recommendations.

Isolation is prevented and those that feel isolated are supported

• Hope Community Project involves Community Connections Services consulting with their clients about what hope means for them and then developing arts and cultural based activities. One example is Catalyst running 11 hope based Historic or Nature Walks in Surrey and a social trip for residents from two different faith groups.
• A Future NHS Green Health Collaboration Platform was launched on 3 November at an event designed to build a strong, skilled and connected network of Green Health and Wellbeing professionals across Surrey. First Step (Green) volunteering sessions are now being booked by community groups. A Dose of Nature trained the first cohort of volunteers in Guildford.
• The Forest Bathing Institute has been commissioned to run a 6 week course of 'Forest Bathing +' in partnership with Catalyst.
• End Stigma Surrey (formerly Time to Change) held an 18 October event with 70 attendees, 95% of whom felt it had given them 'total' or 'good' understanding of stigma and discrimination. Talks included Mental Health Champions with lived experience and a powerful interactive drama session about stigma in the workplace.

Environments and communities in which people live, work and learn build good mental health

• The Public Mental Health Team is undertaking engagement to understand how communities living in key neighbourhoods would like the Wheel of Wellbeing to be delivered to build community capacity for emotional and mental wellbeing. They are working to engage community leaders (in Stanwell in the first instance) to support with building businesses cases that include evidence based, co-produced and community lead initiatives to build community resilience. This support will also help them to be able to apply to the Mental Health Improvement Fund. which has now been launched.
• The Workplace Wellbeing Standards pilot in SCC's Adult Social Care is expanding to include Public Health.

In the spotlight - children and young people EHWB questionnaire

Following the 2022 launch of the Surrey Health Related Behaviour Questionnaire, a total of 8197 pupils took part from 39 primary schools and 11 secondary schools, with two special schools contributing information.

In primary schools, 22% of pupils worried about more than 5 issues 'quite a lot' or 'a lot', which compared with 15% the last time. 84% of primary school pupils said they worried about at least one issue 'quite a lot' or 'a lot' (81%, 2019), with crime (39%), Standard Assessment Tests (SATs) (42%) and family problems (32%) being the key worries for these children.

Overall, secondary school students feel they are less likely to identify a trusted adult and report less happiness with life. There has been a drop in the percentage of secondary school pupils who know an adult they trust who they can talk to (67% this year compared with 73% in 2019). Of secondary pupils who responded that they worry 'quite a lot' or 'a lot', 27% of boys and 40% of girls said they worry about the mental health of someone in their family.

Just over half (52%) of secondary school pupils report being at least 'quite happy' with their life, down from 58% in 2019.
The full questionnaire reports provide detailed insights on issues of self-esteem, bullying, eating, physical activity, and alcohol, smoking and drugs in the family. Each school which completed the survey will get an individual report to make the positive changes relevant for their setting and in conjunction with the Healthy Schools approach. Wider system partners will also have these insights to inform future delivery models and health needs for school age populations.

For more information, please contact: adam.letts@surreycc.gov.uk and you can read the full reports on Surrey-i.

Priority 3 - supporting people to reach their potential

Impact summary

Outcomes by 2030

• People's basic needs are met (food security, poverty, housing strategy etc)
• Children, young people and adults are empowered in their communities
• People access training and employment opportunities within a sustainable economy
• People are safe and feel safe (community safety incl. domestic abuse; safeguarding)
• The benefits of healthy environments for people are valued and maximised (incl. through transport /land use planning)

Who is leading this?

Priority sponsor:
Mari Roberts-Wood, Managing Director, Reigate and Banstead Borough Council

Programme Manager:
Olusegun Awolaran, Policy and Programme Manager, Surrey County Council

For more information on the performance of individual programmes and projects within this priority such as progress against key milestones please contact the relevant programme manager via healthandwellbeing@surreycc.gov.uk

What will be different for people in Surrey?

The Community Vision for Surrey describes what residents and partners think Surrey should look like by 2030: By 2030 we want Surrey to be a uniquely special place where everyone has a great start to life, people live healthy and fulfilling lives, are enabled to achieve their full potential and contribute to their community, and no one is left behind.

In light of the Community Vision and the vital role communities and staff/organisations in the health and care system play in its delivery, the Strategy sets out Surrey's priorities for improving health and wellbeing across the priority populations for the next 10 years. It identifies specific groups of people who experience poorer health outcomes and who may therefore need more support and outlines how we need to collaborate so we can drive these improvements, with communities leading the way.

Priority 3 of the Health and Wellbeing Strategy focuses on enabling our citizens to lead healthier lives. This priority area is focused on primary prevention and addressing the wider determinants of health. Priority 3 cuts across five outcomes and action focuses around:

• Ensuring that everybody has enough income to live on and lives in good and appropriate housing
• Building social capital in communities
• Improving access to training and jobs
• Preventing crime and supporting the victims of crime including domestic abuse -supporting and empowering survivors
• Improving environmental factors that have an impact on people's health and well-being.

How had collaborative working between HWB board organisations added value and contributed to the achievement of outcomes?

On 10 November, the inaugural Surrey Skills Summit took place at Sandown Park Racecourse. The packed event with over 200 attendees saw local business leaders, colleges, universities, skills providers, and health system and local government officials take the next step in collaborating to create a more inclusive and dynamic skills system in Surrey.

This event was also the backdrop for the launch of the Surrey Skills Plan developed by Surrey County Council's One Surrey Growth Board. Partners, including many of those on the Health and Wellbeing Board, will play a critical role in owning the ongoing delivery of the Plan to help create the right conditions to support all our residents. The Plan's objectives are:

1. Supporting Business: Help businesses prosper by making the skills system more responsive – both to immediate needs and those presented in the medium-to-long term.
2. Supporting People: Support inclusive access for Surrey's residents to improved careers education, information and guidance, linked to clear learning, work and training pathways.
3. Enabling Collaboration: Deliver a step change in the skills system through enhanced and purposeful collaboration between and across businesses, anchor institutions and skills providers.
4. Future Proofing: As part of a thematic focus on skills of the future, strengthen the pipeline of priority skills to meet employer demand, recognising the needs of both small and medium-sized enterprises (SME) and larger businesses.

The plan sets out the three-year roadmap to address short and medium-long term needs within the skills landscape. For more information contact Jack Kennedy at jack.kennedy@surreycc.gov.uk.

Data, insights and challenges - the unexpected costs of healthcare / cost of living

With worries about the increases in the cost of living, we are hearing more about costs of healthcare that are unexpected and cannot be planned for: for example, extra cost of parking at the hospital while waiting for medication at the pharmacy, petrol and parking costs for daily visits to sick baby who is in intensive care, urgent need for barrier cream after operation:
"I am still physically very unwell (diarrhoea 15 times yesterday) …. I was told by my consultant my medication…would be ready, this was not the case, so I was told to go home and collect the next day… I received a call today after being home 3 days to say my lansoprazole was there, no they did not have my barrier cream (vital going to the loo so frequently as my bottom is bleeding) and no sick note (in order to try to claim Statutory Sick Pay) I am in desperate need of the cream so had to buy this and am currently buying pull up pants, so far spent £40."

In our engagement we are hearing about the worries that people have regarding the cost of living, the cost of food and heating:
"I decided to make an appointment with Citizens Advice Bureau (CAB), I'm seeing them tomorrow. It's a big thing for me to go to them, but I am so worried, food, the cost of living is weighing on my mind. I don't know how I'll cope with the winter coming, we rely on the community fridge". Resident

"I'm already worried about the heating costs this winter. I won't be turning the heating on as they are electric storage ones. I struggled this summer with the bills, so how am I going to cope this winter?" Resident

"We are seeing an increase in first time Foodbank users at the moment, we have CAB here and people can make appointments to see them for help with a range of issues, from benefits to housing to managing bills" Foodbank Manager

What has been achieved this quarter under refreshed priority 3 outcomes?

People's basic needs are met

• Warm hubs went live across Surrey on 1 November 2022, and they serve as a physical space run by a community group or council, where people having trouble in heating their homes can warm up, get energy advice & debt support, enjoy a bit of human interaction and potentially in some settings also benefit from additional services (e.g., food, clothes, fuel vouchers). A total of 78 Warm Hubs are live so far and they will be opened through to March 2023, with over £280,000 committed in spend so far and over £50,000 of this directly issued to community-based hubs. A map of all locations including opening times is available on www.surrey.gov.uk/warmhubs. These locations include 18 of the 21 Health & Well-Being Strategy (HWBS) Key Neighbourhoods. The locations are accessible and available for people to go into and keep warm, access a range of resources and facilities including somewhere to sit, power devices and so on – and therefore conducive to people needing to work or study. Other support services offered at the Warm hubs will include recruiting and training additional volunteers, connecting energy advisers from partner organisations to host sessions on how to save energy at home, and provide advice to other financial support available in paying and reducing energy bills. Prevention officers will also provide advice on fire and carbon monoxide safety and book home safe and well visits (including fitting of carbon monoxide detectors) where appropriate. General enquiries can be directed to: warmhubs@surreycc.gov.uk

Children, young people and adults are empowered in their communities

• There are now four Local Area Coordinators in post (through Surrey County Council) working alongside local communities in Maybury/Sheerwater (Woking), Horley (Central/West) (Reigate & Banstead), Hurst Green (Tandridge), and most recently the Old Dean and St Michael's, Camberley (Surrey Heath).
• A bid has been approved by the Surrey Heartlands Workforce Innovation Fund to enable the expansion of Local Area Coordination in three further areas of the county.
• SCC Community Link Officers roles now exist in all district and boroughs, initially focusing on Health and Wellbeing Strategy Key Neighbourhoods. They are helping to run and join up local engagement, learning and action alongside all partners; recent examples of positive partnership community events in Hurst Green, Englefield Green and Merstham have underlined the value of creative and thoughtful approaches to community listening that can help to Make it Happen. You can find out more about Community Link Officers by contacting Jane Last at janel@surreycc.gov.uk

People access training and employment opportunities within a sustainable economy
(see above – Surrey Skills Plan)
People are safe and feel safe

• Police and Crime Commissioner Lisa Townsend has awarded £20,000 to charity The Skill Mill to increase employment opportunities for young people aged between sixteen and eighteen. Employing only ex-offenders, they actively reducing reoffending whilst increasing engagement, participation, employability and educational levels of young people.
• The Office of the Police and Crime Commissioner (OPCC) has also provided funding for £2,000 to Spelthorne Mental Health Charity, in a joint project with His Majesty (HM) Probation service. The project helps 'People on Probation' get access to online learning courses and employability courses such as CV writing skills.
• Surrey Gold Standard Coercive and Controlling Behaviour Framework has been launched by OPCC. Based upon 'Safe & Together' ™ principles and critical components, these help everyone work better together, reach consensus and achieve better outcomes for survivors. The approach advocates the action child and adult survivors need from all services there to protect them - done 'with' them, not 'to' them.
• 'Canal Watch' (Woking) -improving safety for women/girls on this Surrey towpath - has won the prestigious Tilley Award.

The benefits of healthy environments for people are valued and maximised

• Work continues apace on Surrey's 'Liveable Neighbourhoods' which seek to create safer and healthier environments in which people are connected to local places and the dominance of vehicles compared to other road user groups is rebalanced. Three early internal engagement workshops have taken place in October and November 2022 to aid formulation of the Liveable Neighbourhoods programme and identify/propose zones across Surrey. Internal stakeholder engagement and briefing sessions have also taken place to update colleagues on the work programme and opportunities for collaboration. The next steps will involve sense-checking Liveable Neighbourhood zone proposals and testing against local officer knowledge before identifying early Liveable Neighbourhood proposals to benefit from one or more of the design packages.

In the spotlight - cost of living

The effects of the current cost of living are already starting to be seen locally. Over 500 new clients registered with Surrey Citizens Advice between April – June 2022, with increased demand coming predominantly from those identifying as having a disability or long-term health condition, or as female. Demand for food support is also increasing, with some foodbanks across Surrey stating they have seen a 300% increase in demand on their services over the past two years.

In response to the evolving situation, Surrey County Council is putting in place a governance framework to underpin work across the county which includes working with partners. The aim is to enable a coordinated, creative and dynamic approach that supports vulnerable residents and furthers the objective that no one in Surrey is left behind, without requiring a large additional financial commitment. To date, the following interventions have been delivered by SCC:

Communications:

• Advice and guidance, incl. our Customer Services welfare support line
• Leaflet through the letterbox of every household in Surrey
• Online health and welfare support hub

Practical support:

• Network of 'Warm Hubs' across Surrey, with a hub currently in 18 of the 21 HWBS Key Neighbourhoods
• Digital energy advice tool (being launched in December)
• Support for staff including access to low-cost loans / sharing cupboards

Funding to voluntary and community groups to reach vulnerable communities, for example:

• Surrey Crisis Fund, which provides support for immediate needs
• Community Foundation for Surrey, to create a 'Winter Poverty Fund'
• Fareshare, to develop county wide food distribution initiative

Close partnership working will be key to the success of the county's response to the cost of living, and we are interested to hear from anyone who would like to get involved. For more information, please contact Rhiannon Ford at Rhiannon. Ford@surreycc.gov.uk.

Work on the Health & Well-Being Board (HWBB) Whole System Approach to poverty prevention will begin in the New Year, with the HWB Team at SCC now having the capacity to lead. For more information, contact Olusegun Awolaran at Olusegun. Awolaran@surreycc.gov.uk.

Communications

Winter wellness

We raised awareness and encouraged uptake of COVID-19 and Flu vaccinations for residents and staff. We targeted specific
groups with bespoke messaging, including carers, parents and people who are pregnant. We provided residents with health and wellbeing advice through our directory of support, distributed to every household in Surrey, along with libraries, community groups and food banks. We included information about which service to contact if you're unwell (to ease system pressures), we highlighted mental wellbeing support and vaccination information and advice about fuel poverty and warm hubs.

Human Papilloma Virus (HPV)

We ran a campaign to highlight the importance of HPV vaccinations for boys. We used digital advertising and social media, along with articles in Surrey Matters and our internal newsletters. We used the social media app snapchat to reach our teen audience. We also used specific messaging to encourage parents to sign the consent forms sent out by schools.

Know your numbers

In 'Know Your Numbers!' week, we ran a campaign to highlight the importance of checking your blood pressure and where
you can get your blood pressure checked for free across Surrey. Mark Nuti, Cabinet Member for Adults and Health, helped promote blood pressure checks by attending one of a series of SCC staff events at Woodhatch. SCC also offered wider health checks to staff with a really positive uptake and plan to run more in future.

Mental Health Awareness Week

During this week we raised awareness of the mental health support across Surrey, with a particular focus on
recognising the stress caused by the current financial uncertainty. We signposted people to Mental Wellbeing – Healthy Surrey and our 'wheel of wellbeing' self-help tool to build resilience.

Stoptober

We raised awareness of the national 'Stoptober' campaign highlighting the stop smoking service delivered by our providers OneYouSurrey. We encouraged residents to take up the 28-day challenge. We know if smokers stop for 28 days, they are five times more likely to quit for good.

White Ribbon / domestic abuse

Our campaign, developed with the Surrey Against Domestic Abuse Alliance, was launched with White Ribbon Day
on 25 November and includes 3 videos about Isolation, Monitoring and Financial control highlighting coercive and controlling behaviour. These videos will be used across social media and internal comms, with an outdoor advertising campaign following in the new year. The advertising campaign and social media are being targeted in areas of higher incidence of domestic abuse across the county. This campaign aligns with the development of the first Surrey multiagency Violence Against Women and Girls Strategy.

Living well in later life

With an engaging video as its centrepiece, we raised awareness of the Living Well in Later Life strategy, which has been shaped from the views of hundreds of residents, carers, staff and care providers. The 2030 plan sets out the ways the county council and its partners including across health and care will work together to make Surrey the best place it can be for older people. It's centred around enabling people to be active and independent in their communities and increasing choice for those who do need care. The video outlines what the strategy means for residents and invites them, as well as partners and staff, to continue to give their views and input during the lifespan of the strategy and shape how it's put into practice.

Safeguarding Adults Week 2022

We highlighted that safeguarding is everyone's business during Safeguarding Adults Week in November.
Everyone has the right to live safely, free from abuse and neglect, but people who have care and support needs may find it more difficult to protect themselves. The week aimed to raise awareness of the forms abuse or neglect can take, the potential signs it's happening and the actions we should take in response. Alongside partners including the Surrey Safeguarding Adults Board, we drew attention to key themes in adult safeguarding.

Home equipment finder

This new online catalogue aims to help residents access equipment and technology to suit their needs, helping them
stay well at home and less likely to be admitted to hospital. We're raising awareness of the resource which residents can search to explore practical solutions to fit their needs, from grab rails to help overcome physical barriers, to smart technology to help make daily life easier.

Joint Strategic Needs Assessment: progress as of November 2022

For further information please contact the Public Health Intelligence Team phintelligence@surreycc.gov.uk
Chapter published in last Quarter: 0

Chapters published

Surrey Context

We have now published our Surrey Context JSNA chapter – which provides an overview of the people and place of Surrey through a health inequalities lens.

Priority 1 - Oral and dental health

In line with Integrated Care Systems (ICSs) taking increased commissioning responsibilities for dental services, we prioritised the refresh of our Joint Strategic Needs Assessment (JSNA) chapter regarding Oral and Dental Heath in Surrey.

Planned JSNA chapters to be published by April 2023 / development started:

• Priority 1
  • Screening services - to be published
  • Substance use - to be published
• Priority 2
  • Mental health of adults - to be published
  • Mental Health of children and young people - to be published
• Priority 3
  • Economy and employment - development started
  • Housing and housing-related support - development started
• Priority Populations
  • People with learning disabilities - to be published
  • Children and young people with additional needs - to be published
• Other
  • Responding to recent international developments, the JSNA will be adding a 'rapid needs assessment' to those done during the pandemic, exploring Migrant Health. This will be delivered in several phases with the focus of phase one being on asylum seekers and refugees which will reference the Afghan and Ukrainian support schemes that are currently in place. - To be published

NB Once completed, sign off of chapters is subject to Chapter working group approval.