Healthy Surrey:

Healthy Surrey

Surrey Health and Well-Being Strategy - update 2022

Foreword

I am delighted to present this refresh of our ten-year Health and Well-being Strategy for Surrey. The original Strategy was the product of unprecedented collaboration between the NHS, Surrey County Council, district and borough councils and our wider partners, including the voluntary and community sector and the police. In the wake of COVID-19, the exacerbation of existing inequalities in our vibrant county and numerous transformation programmes in our hard-working system, we needed to review our progress and reaffirm a focus on reducing health inequalities as well as improving community safety so no-one is left behind.

Through this Strategy refresh, we're reasserting our joined-up efforts to create the best conditions for physical and mental health and well-being. This includes addressing the wider determinants of health - such as housing, the economy, the environment. We remain focused on prevention.

We have arrived at a set of refreshed priorities and outcomes that all partners across Surrey recognise and support. We remain committed to making a real change for the next generation by focusing on these and on those groups within the population who need more support. This Strategy acknowledges the importance of building trust and a deeper understanding of communities if we are to make a difference.

Our Strategy has an increased focus on working together with communities which will be crucial to our success. Making the most of our strengthened system partnerships that have worked together so effectively during the pandemic will help us deliver outcomes in the key neighbourhoods and communities that experience the poorest health.

- Tim Oliver, Chair of the Surrey Health and Well-Being Board and Leader of Surrey County Council

Background

1.2 million people live in the county of Surrey, interacting with and having their needs addressed by:

  • Over 700 local neighbourhoods
  • 11 District & Borough Councils
  • 6 healthcare trusts
  • 25 Primary Care Networks
  • Over a hundred GP practices
  • Over 5,000 Voluntary, Community, Faith, Social Enterprise organisations
  • Around 400 schools and academies
  • Two Integrated Care Systems
  • Numerous higher and further education establishments
  • Thousands of local businesses
  • Hundreds of community healthcare providers
  • Surrey Police and the Office of the Police and Crime Commissioner
  • Surrey Fire and Rescue
  • Surrey County Council

The community vision for Surrey describes what residents and partners think Surrey should look like by 2030 (a review is currently underway):

Underpinning this vision is a set of ambitions for people and for our place.

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.

Our ambitions for people are:

  • Children and young people are safe and feel safe and confident.
  • Everyone benefits from education, skills and employment opportunities that help them succeed in life.
  • Everyone lives healthy, active and fulfilling lives, and makes good choices about their well-being.
  • Everyone gets the health and social care support and information they need at the right time and place.
  • Communities are welcoming and supportive, especially of those most in need, and people feel able to contribute to community life.

We want our county's economy to be strong, vibrant and successful and Surrey to be a great place to live, work and learn. A place that capitalises on its location and natural assets, and where communities feel supported and people are able to support each other.

Our ambitions for our place are:

  • Residents live in clean, safe and green communities, where people and organisations embrace their environmental responsibilities.
  • Journeys across the county are easier, more predictable and safer.
  • Everyone has a place they can call home, with appropriate housing for all.
  • Businesses in Surrey thrive.
  • Well connected communities, with effective infrastructure, that grow sustainably.

Surrey residents helped shape the original Health and Well-being Strategy. It was informed by views gathered through data, bench-marking, formal surveys and feedback provided on a draft version of the Strategy, and partners made a commitment to continue to work with residents as the Strategy was implemented to find the best ways to achieve our outcomes. We recognise that the county of Surrey sits across the Surrey Heartlands and Frimley Integrated Care Systems (ICSs). These, along with other local partnerships and communities themselves, will continue to be the key partners in the delivery of the Strategy.

This refreshed Health and Well-Being Strategy sets out Surrey's priorities and captures our revised outcomes. It identifies specific groups of people who experience health inequalities that have been exacerbated during the COVID-19 pandemic and outlines how we need to collaborate so we can better meet their needs.

The Strategy's new focus is on a commitment to working in creative partnerships with communities to achieve our aim - to reduce health inequalities so no-one is left behind. It is not intended to include all the services or projects that impact on people's health and well-being and therefore doesn't cover the range of specific, organisational or local plans, although these will all need to be aligned to this overarching work.

Priority populations

Surrey will focus on delivering these outcomes within our priority populations - communities of identity and geography which are often overlooked and currently most at risk of experiencing poor health outcomes, as identified by the COVID Community Impact Assessment and Rapid Needs Assessments.

People who experience the poorest health outcomes:

  • Carers and young carers
  • Looked after children and adults with care experience
  • Children with additional needs and disabilities
  • Adults with learning disabilities and/or autism
  • People with long term health conditions, disabilities or sensory impairments
  • Older people 80+ and those in care homes
  • People who are racially minoritised
  • Gypsy, Roma, Traveller
  • Young people out of work
  • People experiencing domestic abuse
  • People with serious mental illness
  • People with drug and alcohol problems
  • People experiencing homelessness

Note: These populations also include those who identify as being from a diverse background that includes one of these populations. Projects and programmes should identify the specific populations within those above that they are working with in their plans/logic models.

People living in geographic areas which experience the poorest health outcomes in Surrey

We acknowledge an individual's needs may result in them identifying across several of these groups of identity and geography.

Acknowledging that there are pockets of deprivation countywide, the following electoral wards have been identified as the 'Key Neighbourhoods' for initial focus within the refreshed Strategy, based on the 2019 Index of Multiple Deprivation's rankings for the Lower Super Output Areas in Surrey that these wards encompass:

Please note: the top 5 are the initial priority areas.

Lower Super Output Area
(ranked on Index of Multiple Deprivation (IMD) score)
IMD Decile
(lower is more deprived)
Electoral Ward/Key NeighbourhoodsDistrict / BoroughPrimary Care NetworkHealth Areas
Surrey Heartlands/ (SH) Frimley
1. Reigate / Banstead 008A2Hooley, Merstham and NetherneReigate and BansteadHorleyEast Surrey (SH)
2. Woking 004F
Note: Lower layer super output areas (LSOA) boundary change; now within 004G
2CanalsideWokingWise 3North west (NW) Surrey (SH)
3. Guildford 012D2WestboroughGuildfordGRiPCGuildford and Waverley (SH)
4. Guildford 007C2

Bellfields and Slyfield

Note: Ward name change only, previously known as Stoke

GuildfordGRiPCGuildford and Waverley (SH)
5. Spelthorne 001B3Stanwell NorthSpelthorneSpelthorne, Staines Ashford Sunbury Shepperton and Egham (SASSE) 3NW Surrey (SH)
6. Mole Valley 011D3

Dorking South

Note: Ward boundary change, LSOA in ward previously known as Holmwoods

Mole ValleyDorkingSurrey Downs (SH)
7. Reigate / Banstead 005A3Tattenham Corner & PrestonReigate & BansteadBanstead HealthcareSurrey Downs (SH)
8. Epsom and Ewell 007A3CourtEpsom & EwellEpsomSurrey Downs (SH)
9. Spelthorne 002C3Ashford North and Stanwell SouthSpelthorneSASSE 3NW Surrey (SH)
10. Woking 005B3Goldsworth ParkWoking

Wise 3

NW Surrey (SH)
11. Runnymede 002F3Englefield Green WestRunnymede

Windsor

Windsor and Maidenhead (Frimley)
12. Elmbridge 004B3Walton SouthElmbridge

Walton

NW Surrey (SH)
13. Reigate and Banstead 018D3Horley Central & SouthReigate and Banstead

Care Collaborative

East Surrey (SH)
14. Waverley 002E3

Farnham Heath End

Note: Ward boundary change, LSOA in ward previously known as Farnham Upper Hale

Waverley

Farnham

North East Hampshire and Farnham (Frimley)
- Spelthorne 001C 3Stanwell North
(already included above)
Spelthorne

SASSE 3

NW Surrey (SH)
15. Waverley 010A3Godalming Central and OckfordWaverley

East Waverley

Guildford & Waverley (SH)
16. Runnymede 006D3Chertsey St. Ann'sRunnymede

Chertsey Health Centre
Ottershaw Surgery
Crouch Oak Family Practice (Coco)

NW Surrey (SH)
17. Reigate and Banstead 010E3Redhill West & Wray
Common
Reigate and Banstead

Care Collaborative

East Surrey (SH)
18. Guildford 010C3Ash WharfGuildford

Surrey Heath

Surrey Heath (Frimley)
19. Elmbridge 008A4*Walton NorthElmbridge

Walton

NW Surrey (SH)
20. Elmbridge 017D4**Cobham and DownsideElmbridge

Leatherhead

Surrey Downs (SH)
21. Surrey Heath 004C4**Old DeanSurrey Heath

Surrey Heath

Surrey Heath (Frimley)
  • * Overall IMD decile 4 and in decile 1 (highest 10% nationally) for IMD supplementary index on Income Deprivation Affecting Children
  • ** Overall IMD decile 4 and in decile 1 (highest 10% nationally) for IMD domain Education, Skills and Training.
  • Note: As the Index of Multiple Deprivation uses LSOAs as its base level of geography and has not been updated since the HWB Strategy Key Neighbourhoods were approved by the HWB Board, any revisions do not affect the list or ranking of the Key Neighbourhoods.

Principles for working with communities

Through the process of refreshing the Strategy, the Health and Well-Being Board recognised the need for and committed to starting more collaborative and creative work with those communities in the geographic areas of deprivation with the poorest health outcomes. This commitment was based on the strong evidence that in order to achieve lasting change in communities, improve community safety and reduce health inequalities, it is essential that communities themselves participate and lead. Organisations need to be open to new types of collaboration where power sits more firmly with the communities we serve.

The Health and Well-Being Board has adopted the following principles (the Four Cs) for working with communities to guide this commitment across the system:

  • Community capacity building: 'Building trust and relationships'
  • Co-designing: 'Deciding together'
  • Co-producing: 'Delivering together'
  • Community-led action: 'Communities leading, with support when they need it'

Priorities and outcomes

Surrey will remain focused on three interconnected priorities - supporting people to lead physically healthy lives / to have good mental health and emotional wellbeing, and creating the contexts in which individuals and communities can reach their potential, with a clearer intent on addressing the wider determinants of health. These priorities adopt both a primary prevention (stopping ill health in the first instance) and secondary/tertiary prevention (making sure things don't get any worse) approach, and focus on providing the right physical, psychological, social and economic contexts for communities that experience the poorest health outcomes to begin to thrive. The Strategy will continue to evolve, reflecting the latest data, evidence and insights, including the Joint Strategic Needs Assessment as it is continually updated.

Supporting people to lead healthy lives by preventing physical ill health and promoting physical well-being

This includes ensuring people are eating healthily and are active, addressing individual lifestyle factors including addiction, with specialist support where these addictions are compounded with several other disadvantages ('multiple disadvantage'), such as mental health/behavioural issues, homelessness or risk of homelessness, contact with the criminal justice system and/or domestic abuse. Ensuring access to diagnostics and immunisations to prevent disease and support is available to live well independently for as long as possible is also key.

Supporting people's mental health and emotional well-being by preventing mental ill health and promoting emotional well-being

Enabling the emotional well-being of our citizens by focusing on preventing poor mental health and supporting those with mental health needs so people have access to early, appropriate support to prevent further escalation of need, including parents and care givers. This priority is also about creating communities and social environments that tackle isolation and build good mental health.

Supporting people to reach their potential by addressing the wider determinants of health

Enabling our citizens to articulate their aspirations and reach their potential by helping them to develop the skills needed to succeed in life and flourish in a safe community. This is not only about making sure people's basic needs are met but also about skills development, training and employment, involvement in life-long learning and in their own communities and considering the impact of community safety and the built/natural environment on health.

Each of the priorities are now further defined through the outcomes described below.

Priority 1 outcomes

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

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
  • 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

Priority 3 outcomes

  • 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 including domestic abuse, safeguarding)
  • The benefits of healthy environments for people are valued and maximised (including through transport/land use planning)

System capabilities

Our outcomes give us a clear vision of what we want to achieve for our citizens in Surrey. It's also clear we need to work together in a different way and develop new capabilities if we are to deliver these outcomes. Breaking down barriers that might be preventing collaboration across the different parts of the Surrey system will be critical for success and to driving real system change.

Set out below are the refreshed system capabilities we are committed to developing and embedding, with examples of the types of action we need to take against each.

Empowered and thriving communities

Creating a new relationship with communities, building trust and relationships, co-designing and coproducing solutions to our challenges and aspiring to community-led interventions and influence.

Clear governance

Establishing governance groups to oversee delivery of the Strategy, mapping governance groups to identify opportunities to streamline, and redefining the remit and membership of the Health and Well-being Board.

Estate management

Working closely with health and other public sector partners to develop clear frameworks for delivery, innovation and economies of scale for property requirements and maximise opportunities that support communities, place ambitions and operational needs.

Workforce recovery and development

Supporting our workforce during COVID-19, developing a single system-wide Surrey workforce strategy, creating a health and care 'workforce passport', and developing a Surrey public sector skills academy.

Programme management

Utilising programme guidance on the scope of what is included in the Strategy and establishing a partnership programme management network of senior responsible officers to ensure a clear view of delivery of the Strategy, providing regular progress reports, identifying barriers and escalating risks for resolution.

Equality, diversity and inclusion including digital

Ensuring we protect those with protected characteristics, improving information, advice and communications, undertaking a digital maturity assessment across Surrey and developing a digital inclusion strategy for Surrey.

Data, insights and evidence

Establishing evidence, monitoring and providing the data/metrics to track delivery of the Strategy, and identifying and filling gaps in the evidence at a system and more local level using lived experience.

Integrated care

Identifying where securing additional freedoms, flexibilities or greater local influence and decision making, alongside effective partnership working, will support the delivery of integrated care.

Measuring and tracking success

As a system, we will measure the long-term impact of the Health and Well-Being Strategy on reducing health inequalities in Surrey using the Health and Well-Being Strategy Index. The purpose of the Index is to measure progress against the Strategy's priorities and outcomes, particularly for our priority populations (including the key neighbourhoods) where the data is available.

The Index combines appropriate physical/mental health and wider determinants indicators into baskets at different geographic levels. These allow us to see improvements that come from working together in partnership. The Index is calculated on an annual basis but not all data is from the same year; the most recent data available is used for each indicator.

Alongside the Index are overarching indicators around life expectancy/ healthy life expectancy and indicators currently available for some of the priority populations only at a Surrey-wide level currently.

Further information

The Surrey Health and Well-Being Board is responsible for producing and overseeing delivery of this Strategy.

Highlight reports, based on our implementation plans, document progress against outcomes are available every quarter.

For any other questions about the Surrey Health and Well-Being Strategy, please email us at healthandwellbeing@surreycc.gov.uk.a

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