East Sussex Health & Wellbeing Board Development Sessions Briefing Note

Session #4: The importance of the life course

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 in our Sussex Integrated Care System (ICS) for collaboration across the local NHS, Local Authorities and the voluntary, community and social enterprise (VCSE) sector – and reflecting the variation in inequalities, needs and context for delivery in Sussex.

Strengthening the focus and role of our HWB and our East Sussex Health and Care Partnership was a key objective in year 2 (24/25) of the Shared Delivery Plan (SDP). To support this a programme of 7 informal development sessions was 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 26, 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

 

To continue the strong progress already made our year 3 (25/26) SDP plans have been updated as follows:  

We will continue to strengthen the strategic stewardship role and vision of the Health and Wellbeing Board (HWB) through completing our programme of development sessions aimed at growing a deeper shared understanding of our population health and care needs and strengths, and understanding how well we are working together as a system to improve outcomes.

 

 

 

Building on the work on system stewardship in 24/25, we will ensure our East Sussex Health

and Care Partnership is operating effectively across our system at Place, with accountability to the HWB for our strategic planning and operational collaboration in our local communities.

 

This briefing note sets out the summary outcomes and key messages from the fourth development session, which took place on 19 June 25 in Eastbourne on the importance of the life course. Building on our previous discussions about system stewardship, the aim of the session was to provide some time to grow shared understanding of the following:

2. Briefing note

2.1 The importance of the life course                                    

The JSNA topic for the session was the importance of the life course; a good start to life, living well, ageing well and a good end to life. The session explored the following:

•     Understanding what is meant by the ‘life course’ and how as an approach it can help us better direct and target resources to support prevention and improve population health

•     The full range of partnership work that contributes to this across the whole life course and some of the key related population statistics that demonstrate how East Sussex is doing currently  

•     A deeper dive into the collaborative work that supports a good start to life for our children and young people.

 

A life course approach considers the critical stages, transitions, and settings where large differences can be made in promoting or restoring health and wellbeing. It values the health and wellbeing of both current and future generations. It recognises that:

 

•      There are a wide range of protective and risk factors that interplay in health and wellbeing over the life span

•      Maintaining good functional ability is the main outcome of the life course approach to health

•      Functional ability can be enhanced throughout life by a supportive environment

•      By altering policies, environments, and societal norms, inequalities affecting the life course trajectory can be reduced, which could benefit the whole population across the lifespan, as well as future generations

 

Deep dive into a good start to life

In earlier sessions members of the HWB had expressed an interest in hearing more about our partnership work to enable a good start to life, noting how getting this right can have positive impacts across the whole of life including prevention of ill-health and improved healthy life expectancy in later years. This included Family Hubs, school readiness - noting that education is one of the key building blocks or determinants of health (please see the briefing for session 3) - and the results of the recent East Sussex My Health, My School survey. A summary of key points about each is captured below.

 

 

 

 

Family hubs in East Sussex provide help and support for children aged 0 -19/25 and their families, with the aim of promoting the best start for life and best outcomes for babies and young children. Through the Government-sponsored and recently extended Family Hubs and Start for Life programme, a partnership between East Sussex County Council, East Sussex Healthcare NHS Trust and local VCSE partners such as Amaze and strong connections with Early Help support and services for babies and children with Special Educational Needs and Disabilities (SEND) and their families, Family Hubs provide: • a one stop shop for local families with children aged 0-19 (up to 25 with SEND) to receive support in their community • support and activities to ALL families, recognising that parenting is sometimes hard • a focus on strengthening connections with families by being a visible and trusted source of information within communities Eleven Family Hubs are open in Sidley, East Hastings, Hastings Town, Robsack, St Leonards, Hailsham, Shinewater, Devonshire, Lewes, Peacehaven and Uckfield. In addition, there are four Youth Hubs – existing sites in Hollington and Eastbourne and new build Youth Hubs in Heathfield and Peacehaven, funded by the Youth Investment programme Family hubs

 

The 2024 national School readiness survey: School Readiness Survey | Kindred² (January 25) is used to guide the priorities and focus to help young children be ready for school and be in a good position to make the most of their potential. The key headlines show that too many children are behind before they start Reception and that readiness for school is worsening. Added to this there are differing perceptions between parents and teachers about whose responsibility it is to help children be ready for school and to what level. To help remedy this in East Sussex through a partnership approach we have started to drive forward improvements with the following actions: • Bringing together professionals from health, education, schools and settings to develop a school readiness strategy for East Sussex. • Conducting a research review, analysed national approaches and looked to other local authority strategies to ensure we are using best practice. • Developing a single shared understanding of what school readiness means – focussing on children being ready for reception, schools being ready for children, and parents having the information they need to support their children. • As part of our strategy, we are looking at how we can promote the use of the National ‘Starting Reception’ resources so that schools, settings and parents have shared expectations. School readiness

My Health My School Survey The ‘My Health My School’ survey is a student perception survey for children and young people in years 3-13. It is completed anonymously online, and participation by schools, children and young people is voluntary. The survey asks ‘age-tailored’ questions across ten themes including healthy eating, social, emotional and mental health, physical activity and sport and gambling, drugs alcohol and tobacco use. The survey was first conducted in East Sussex during the 2020-2021 academic year and is now in its fourth year, receiving the largest number of responses to date at 16,441. The latest survey results for 2023/24 have just been published and can be found here. It is a rich source of information about the self-reported views and behaviours of children and young people aged between 7 and 18 in East Sussex. Some of the key high-level findings were shared at the session and the next steps include: • Schools reviewing their results, and getting support from the School Health Service to make changes • Sharing the East Sussex findings more widely and using this to inform interventions, plans and strategies • Conducting further data deep dives, for example looking at protected characteristics and other detailed questions • Exploring options for hearing feedback from children and young people on the survey results The County Council’s Public Health Team can help with questions about the analysis, requests for further data analysis and are open to any other ideas for using this valuable survey data.

 

2.2 Our challenges and risks in 25/26

The HWB also had a collective discussion to explore the wider context of change and some of the challenges and risks influencing our work as health and care system partners in 25/26. In summary this includes:

·         Increasing demand and complexity of need in our population causing pressure on Local Government budgets across social care, temporary accommodation and homelessness and special educational needs and disabilities (SEND)

·         A national drive in the NHS to reduce waiting lists and waiting times in Accident & Emergency (A&E) departments, and achieve financial balance in 25/26, alongside broader issues about healthcare services being seen to be overfunded in Sussex and low levels of public satisfaction with the NHS

·         As part a broader move nationally to stabilise NHS finances and reduce duplication, all Integrated Care Boards (ICBs) in England have been asked to reduce their operating costs to reduce by 50% by December 25/26

·         Reducing funding streams being experienced in the VCSE sector, alongside unfunded National Insurance (NI) and National Minimum Wage (NMW) increases

·         Similar unfunded increases and phasing out of the Health and Care Worker visa route for overseas recruitment causing additional pressure in the independent care sector

·         A broad range of national policy development and change including the 10 Year Health Plan and NHS provider reform; major children’s social care reforms and 39 new policies for children’s social care and education outlined in the Children’s Wellbeing and Schools Bill and significant SEND reforms expected this year; the Casey Commission on adult social care and a ‘national care service’; housing developments,  and; Devolution and Local Government Reorganisation (LGR)

 

The discussion covered the following themes:

 

·         Many of the changes will happen over multiple years and timeframes. The need to hold onto a strong partnership focus based on Place and neighbourhoods is essential for understanding the differing strengths, needs and support requirements of local areas.

·         Related to this, local tailoring alongside partnership and integrated working are often key to efficiency and the best use of collective resources when finances are so constrained. At the same time there is likely to be less capacity to do this and therefore more drive to centralise and standardise approaches, and the right balance needs to be struck across both.

·         Although developments are happening at pace with ICB proposals needing to be implemented to support operating cost reductions by December 25, there should be scope to explore possible opportunities for commissioning care and health services at a Place /neighbourhood level which could better enable a more holistic view with prevention at its heart.

·         In the context of devolution and local government reorganisation, with its understanding of community-based strengths and needs, and wider view of housing, public health, employment and education to focus on whole life and prevention, the role of our HWB will become increasingly important in supporting this approach across our health and care system.

·         The HWB having a key role in concentrating and anchoring our work as the East Sussex Health and Care Partnership in relation to the needs of our population, and ensuring the specific opportunities, resources and context unique to East Sussex are being used to best effect, to help us best manage our risks and challenges for the benefit of our population.

·         This includes fostering a positive environment for shared learning, including the mistakes and challenges encountered, and encouraging our organisations to continue being open and working in partnership even in challenging times.

 

2.3Next steps

This briefing has been produced for sharing with organisations, partners and stakeholders to facilitate a wider understanding of how our HWB’s role is developing to support our joint work. In this case we have looked at the importance of the life course and our partnership work to support and enable the best start in life children and young people in East Sussex. Helpful connections were made about further possible opportunities to collaborate and make better use of our existing capacity to enable more access to services and support in our communities.

The session also discussed some of the risks and challenges to partnership working and collaboration arising from the broader policy environment across health, care and wider public services in 25/26. The expectations we have of ourselves as partners working for the common good of the East Sussex population, and our HWB’s role in stewarding our system and helping us to hold ourselves mutually to account for this will be key.

As we await the publication of the 10 Year Health Plan (at the time of writing this is due in the first week of July 25) and the evolution of new ICB model proposals and plans, on behalf of the HWB our East Sussex Health and Care Partnership has identified the following areas and next steps to help us begin to navigate the immediate challenges ahead:

·         Shared priorities – being clear that we can’t do everything we want to do, so we need to ensure our capacity to deliver change is aligned around the critical priorities that will make a difference. This includes adapting to take advantage of immediate opportunities as well as delivering change to care models over the medium term.

·         Governance – streamlining structures and meetings to concentrate capacity on delivering our shared critical priorities, and ensure a strong focus on Place where it can have the best effect by ensuring clarity on local challenges and population health outcomes

·         Integrated Community Teams (ICTS) – mobilising neighbourhood multi-disciplinary teams to deal with more issues as quickly as possible, with less hand-offs and referrals and putting our health and care system on a more sustainable footing through freeing up and better using our available capacity

·         Prevention – building this in across our whole system and across all sectors using ICTs as the ‘footprint in common’

·         Data, digital and technology – improving cross-sector information sharing, sharing our learning about potential tech solutions

·         Risk sharing – reaching a common understanding of what this means and where it could have the best impact

 

The next informal HWB development session is scheduled for 4 September 25 and will look at the JSNA theme of inequalities in East Sussex.

 

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