DRAFT East Sussex Health & Wellbeing Board Development Sessions Briefing Note
Session #3: Building blocks of health
1. Background
Two recent Peer Reviews of the Council have noted that our Health and Wellbeing Board (HWB) performs its statutory role very well as a formal committee of the Council, and could be further strengthened to become the vehicle for genuine strategic stewardship of our system, focussed on the health, care and wellbeing needs of the population.
This complements ‘Place’ at upper tier/HWB level being a key point of subsidiarity for collaboration in our Sussex Integrated Care System (ICS) across the NHS Sussex Integrated Care Board (ICB), Local Authorities and the voluntary, community and social enterprise (VCSE) sector – reflecting the size and scale of our Sussex ICS and variation in inequalities, needs and baseline of current delivery.
In light of this, a key East Sussex Health and Wellbeing Board (HWB) objective in the Shared Delivery Plan (SDP) for 2024/25 is as follows:
“We will strengthen the focus and role of the Health and Wellbeing Board and the East Sussex Health and Care Partnership by strategically aligning partnerships and working to support our shared priorities for delivering a joined-up offer for health, care and wellbeing, including prevention, across NHS, local government and VCSE sector services for our population.
To support this a programme of 7 informal development sessions has been arranged, structured around the priority themes in our East Sussex Joint Strategic Needs Assessment (JSNA). Both voting HWB members and non-voting members with speaking rights are invited to the sessions, which are aimed at deepening the shared understanding of our population’s health and care needs and priorities. The current programme runs until February 2026, and overall the sessions are an opportunity to:
· Improve consistency of shared knowledge and understanding about our population
· Generate innovation and ideas
· Inform our in-year plans and co-creation of the Health and Wellbeing Board Strategy refresh in 2 years’ time
This briefing note sets out the summary outcomes and key messages from the third session which took place on 6 February 2025 in Eastbourne on the building blocks of health.
2. Briefing note
2.1 Session 3: The building blocks of health
The JSNA topic for the session was the building blocks of health; a decent home, education and employment alongside good social connections and community, and the work we are doing as a system that contributes to these things. The session explored the following:
• Understanding what is meant by the ‘building blocks’ of health and what this means in and for East Sussex
• The potential impacts of climate change on the building blocks of health, and introducing how a new climate change health impact assessment can help us respond as a system
• How we can enable and strengthen a joined-up approach to the building blocks and climate change through HWB stewardship of our system
The building blocks of health are also sometimes known as the wider or social determinants of health. They are the aspects of life that influence our ability to create the right conditions for a life that is both physically and mentally healthy. Almost every aspect of our lives – our jobs, homes, access to education, whether we experience poverty or racism – impacts on our health and can drive inequalities. These building blocks interact with other things that impact on our health such as individual characteristics and genes, and lifestyle factors such as physical activity, drinking alcohol and smoking.
This means that good health is much more than just having access to good health and care services, although of course this is important. To create a society where everybody thrives, we need all of the right building blocks of health in place; stable jobs, good pay, quality housing and education as well as social connections and a feeling of belonging or community. To explore what this means in East Sussex we looked at four key building blocks, and some of the work we are doing as a system that contributes to them. A summary is set out in the tables below:
|
Housing – what are we focussing on Access to safe, secure housing is a key determinant of health. Across East Sussex there are increasing numbers of people who do not have access to housing or whose housing is temporary. |
|
|
The priorities |
The partnerships |
|
· Homelessness Prevention early identification of people at risk and avoiding temporary accommodation. · Health, Housing and Care Integration including Integrated Community Teams. · Development and Enablement for sustainable housing supply and making best use of existing stock. · Improving housing standards and resident involvement. · Tackling Climate Change including a new retrofit strategy. · Private rented sector improving access and standards across the sector.
|
· Partnership strategy with a long-term vision for the sector. · Refreshed strategic board and themed specialist groups for each priority area. · Co-produced strategy with district and boroughs and cross-sector stakeholders. · New links to the health and care system, including a housing workstream in the shared delivery plan. · Collaboration across the wider network, including East Sussex Homelessness Forum, Skills and Employment and Developers East Sussex |
|
Education – what are we focussing on Education shapes our life opportunities, along with learning and development of skills, education influences our prospects for where we live and work, and for our health. People with the highest levels of education can expect to live around 4 years longer than those with the lowest and are less likely to live in poverty during their working age. In East Sussex, education achievement is variable across the county and exclusion from school is above the England average. |
|
|
The priorities |
The partnerships |
|
Excellence for All 2024 – 2030 vision shared with all partners giving a clear understanding of areas to improve: · Improving absence rates with a focus on SEND persistent absence and severely absent pupils across settings. · Improving attainment through supporting schools to build an inclusive environment to support quality first teaching. · Embedding and supporting school improvement through the Team Around the School and Setting model. · Recommissioning our AP provision. · Development of our school readiness strategy
|
Our partnerships across education are one of our core strengths. · The school led system partnerships are well developed and established and are committed to delivering our priorities in our vision. · Working with the Primary and Secondary boards to ensure a focus on improving attainment and progression for pupils with SEND, and to embed the SEND statement of intent to improve transition arrangements. · Partnerships across all Early Years team, health and community providers to promote school readiness.
|
|
Work, skills and employment – what are we focussing on Access to good-quality jobs is one of the building blocks of a healthy society, from having enough money to meet basic needs, to broader benefits for our physical and mental health and well-being. In East Sussex, there is a greater gender gap in earnings than nationally, but a smaller employment gap between those with and without a long-term health condition. A higher proportion of people with learning disabilities are in paid employment than nationally. |
|
|
The priorities |
The partnerships |
|
· Continue development/showcasing unique ESTAR[1] service which supports those furthest from the workplace · Supporting people back into employment: New Connect to Work programme (funding for 5 years working alongside DWP) · Annual public health report 2021/22 - Work Skills and Health | recommendations · Supporting delivery of the economic strategy · Raising aspirations element of Universal healthcare (Hastings)
|
The Skills East Sussex Partnership includes · Universities · Schools and colleges · Employers · Local training providers including Plumpton College · Libraries · DWP · Housing and Well-being Co-ordinators · In work mentors (SCDA work coaches) · Homelessness Prevention Employment Brokers · Apprentices and work with training · Friends Families and Travellers (for Gypsy Roma and Traveller families)
|
|
Connections and community – what are we focussing on The nature of our social networks (the quality of our relationships, the support we have, whether we feel we belong where we live, whether we feel lonely) can influence our health and wellbeing in a range of ways. A sense of belonging and connectedness means people are less likely to experience poor mental health and more likely to have strong relationships, and is a key factor in preventing long term health conditions from getting worse.
In the 2019 East Sussex Community Survey, around a third of people didn't feel a sense of community belonging, and a similar proportion would have liked to see friends or family more often. Around a quarter reported feeling lonely, but a high proportion felt satisfied with the area where they live. |
|
|
The priorities |
The partnerships |
|
· Establishing a ‘stewardship approach’ to tackling loneliness, including: · training o system-wide knowledge exchange o ‘connecting the connectors’ events o development of a ‘Connection Test’ to influence planning/commissioning · Community and VSCE Development Programme covering infrastructure support for the VCSE, community networks, and learning from Making it Happen · Age Friendly Communities (Rother and Hastings) · TRIBE Volunteering Platform
|
· East Sussex Tackling Loneliness Stewardship Group · Integrated Community Teams (ICT) · Partnership Plus · East Sussex Healthy Ageing Partnership Group · Community Oversight Board · Multi-agency Financial Inclusion Steering Group · East Sussex Migration Partnership
|
The session also explored how climate change impacts on the building blocks of health, and how our new work on a climate change health impact assessment can help us respond as a system. The table below summarises our priorities in this area:
|
Climate change – what are we focussing on Global environment is a key building block of health just as local environment is, and it is a threat to the building blocks. We need to adapt and build resilience to the threats. |
|
|
The priorities |
The partnerships |
|
· To develop and finalise a Climate Change Health Impact Assessment (HIA) - creation of a wider Climate Change System Wide Plan focussed on East Sussex population and place. o To take a ‘whole systems approach’ to explore system wide actions, gaps and opportunities in relation to climate change and the building blocks of health. o To co-develop a set of actions/recommendations for the system via the process and production of a climate change health impact assessment (HIA). · To deliver Climate change action in East Sussex: Climate change action in East Sussex | East Sussex County Council
|
· UKHSA · Environment Agency · Communities Economies and Transport Directorate (ESCC) · District and Borough Councils (Planning, Housing, Environmental Health, Climate Change and Environment Leads) · South Downs National Park Authority · NHS · Association of Directors of Public Health (ADPH) · Water companies · Farmers Union · Food Partnerships · Natural England |
2.2 Outcomes from the session
The session explored what system stewardship means in the context of supporting the building blocks of health and also helping our system respond to the threats of climate change. This key role of the HWB can be described in the following way:
“A Systems Steward is a person, organisation or group that takes responsibility for helping to create a healthy system by building trust and relationships and helping people work better together towards common goals. System Stewardship is not about traditional project delivery nor about ‘directing’ others; instead, it is about helping actors come together to understand the system and weave together their contributions to enable a focus on what people can achieve together that they can’t alone. This role often includes connecting support on the ground but, importantly, has a key focus on creating a healthy system to create the conditions for this practice to thrive in the long term…”
Applying the values of system stewardship to the building blocks of health and climate change in practice means:
• Prioritisation and being clear what is within our gift to influence
• Actively listening and hearing where our communities are to ensure we act in the best way to support health-creation
• Looking at our work on the building blocks through the ‘lens’ of climate change
• Nurturing our whole system of delivery to inform and drive actions, behaviours, perspective
• Keeping climate change ‘front and central’ as a consideration
• HWB role to see the broader context, or ‘in the round’, and hold the ring around the different factors that build health in populations and communities
It was agreed that the HWB has a unique role in positively harnessing the contribution of all partners to improving health, care and wellbeing outcomes for our population, underpinned by a clear shared understanding of the issues and challenges in East Sussex.
It was acknowledged that there is a complex interplay of local, national and international policy that influences the building blocks of health, structural inequalities in society and action on climate change. The diagram below illustrates how our HWB operates within the differing spheres of control, influence and concern:
2.3Next steps
This briefing has been produced for sharing with organisations, partners and stakeholders to facilitate a wider understanding of how our HWB stewardship role is developing to support our joint work, with a particular focus on the building blocks of health. The outcomes of this session will also be shared with our East Sussex Health and Care Partnership to ensure it is aware of the broader work being taken being undertaken by partners including local government, the Department of Work and Pensions, educational institutions and the VCSE.
The key messages from the session discussion will be used to further shape our vision for the collective strategic stewardship and leadership of our joint working in East Sussex through the HWB, so that this can be owned across all partners. Our vision will emphasise the uniqueness of the HWB’s role, and the difference it can make in harnessing the contribution of all partners to improve outcomes for our population, driven by our shared understanding of the issues and challenges in East Sussex.
The next informal HWB development session is scheduled for 19 June 25 and will explore the importance of the life course approach; a good start to life, living well, ageing well and a good end to life.
For more information please contact:
Vicky Smith, Programme Director, East Sussex Health and Care Transformation
East Sussex County Council and NHS Sussex
Contact: vicky.smith@eastsussex.gov.uk