The Health and Wellbeing Board and Surrey Heartlands Integrated Care Partnership met to discuss a range of issues, including the reorganisation of NHS Integrated Care Boards (ICBs), the Health and Wellbeing Strategy, intergenerational initiatives, and local government reorganisation. The board retrospectively approved the updated 2025-2026 Better Care Fund Plan.

NHS System Reorganisation

Nicola Airey, Director of Places and Communities (Frimley ICB), and Karen McDowell, Chief Executive, Surrey Heartlands ICS, provided an update on the reconfiguration of ICBs. Due to financial challenges and a requirement to reduce operating costs by 50% by the end of Quarter 3 2025/26, Surrey Heartlands ICB is exploring a collaboration with NHS Sussex. Frimley ICB is considering splitting into three directions, with populations moving to Buckinghamshire, Oxfordshire and Berkshire West ICB (Bob ICB), Hampshire and Isle of Wight ICB, and the new Surrey ICB formation.

Dr Rachel Wardell OBE, Executive Director for Children, Families and Lifelong Learning, raised concerns about the national model ICB blueprint, which suggests that children's safeguarding and special educational needs and disabilities (SEND) services could move to other organisations. Karen McDowell responded that several areas would transition out, but the timescales may vary, and discussions with partners are needed to ensure a safe transfer.

Tim De Meyer, Chief Constable of Surrey Police, asked for clarification on which organisation would be responsible for the health aspects of Education, Health and Care Plans (EHCPs) if SEND responsibilities were transferred. Karen McDowell said that this was a good question, and that it was partly why Dr Rachel Wardell was asking, because in statute, it is the ICB and that's why there are specific board level responsibilities for both safeguarding and for SEND.

Michelle Blunsom MBE, CEO at ESDAS - VCSE, requested simple mechanisms to avoid cliff edges during the transition.

Health and Wellbeing Strategy Highlight Report

The board received a highlights report on the Health and Wellbeing Strategy, covering progress against key priorities.

Priority 1

Mara Roberts-Wood, Managing Director, Reigate and Banstead Borough Council / Chair - Prevention and Wider Determinants of Health Delivery Board, highlighted a new Reablement Referral Guide designed to enhance the inclusivity of the Reablement Service¹, and the launch of an Inclusion Health Smoking Cessation Service provided by the Alliance for Better Care. She noted concerns about sustainable funding for the Changing Futures Programme, which supports vulnerable residents.

Priority 3

Mara Roberts-Wood also noted a specialist social prescribing service for people on probation being piloted in Guildford, and that Surrey Heartlands had agreed to sign the Good Companies End Poverty Pledge². She raised concerns about a 12% reduction in the Household Support Fund allocation for Surrey for 2025-26 and the sustainability of funding for local area co-ordinators.

Unpaid Carers

Samantha Burrows, representing Healthwatch, raised concerns about the extension of the Surrey Carers Strategy and the involvement of unpaid carers in decision-making. She also questioned delays in the Carers Dashboard, intended to monitor progress in carers' support.

Councillor Clare Curran, Cabinet Member for Children, Families and Lifelong Learning, responded that supporting carers is a key priority, and the extension was agreed by the carers partnership in September 2023. She acknowledged the need for more scrutiny and said the dashboard is up and running but needs more promotion.

Dr Sue Tresman, Surrey's Independent Carers Lead, supported the challenge from Healthwatch around the dashboard, stating that a well-developed dashboard had been promised but not delivered.

Household Support Fund

Councillor Mark Nuti, Cabinet Member for Health and Wellbeing, and Public Health, noted that the Household Support Fund would likely be discontinued and the focus would shift to supporting residents with sustainability and resilience. He mentioned a Reducing Gambling Harm project launching in Runnymede.

Councillor Tim Oliver OBE, Leader of Surrey County Council, added that the government would publish a consultation on funding review for local government, which is unlikely to be favourable to Surrey.

Dr Charlotte Canniff, Joint Chief Medical Officer, highlighted that Strelthorne remains the area with the poorest outcomes.

Priority 2

Professor Helen Rostill, Co-Chair of the Mental Health: Prevention Board, reported that the Steps2Work Wellbeing programme, which supports unemployed people, had been awarded a three-year grant in 2024.

Phil, from Public Health, updated the board on the Joint Strategic Needs Assessment (JSNA), noting a new chapter on smoking, vaping and tobacco control, and upcoming chapters on sexual health, physical activity, air quality, transport and unpaid carers. He also highlighted the Health and Wellbeing Strategy Index, which will be updated with new indicators by the end of June, and a new program finder tool.

Intergenerational England

Charlotte Miller, Director of Intergenerational Music Making (IMM), and Emily Abbott, Programme Director of Intergenerational Music Making, presented a proposal to embed intergenerational approaches across Surrey to address health inequalities, social isolation and community fragmentation. They requested support in developing a Surrey-wide intergenerational pledge.

Alistair Burtenshaw, Business - Director & Chief Executive at Watts Gallery Trust, commended the work and asked how to identify the right key performance indicators (KPIs) and integrate this into existing trackers.

Charlotte Canniff supported the intergenerational philosophy and suggested incorporating it into new service development.

Mari Roberts-Wood shared her experience with transformation programs of community centres and asked how to tackle challenging things like housing.

Dr Rachel Wardell praised the presentation and offered support.

Councillor Mark Nuti suggested integrating the concept into community boards and neighbourhood alliances.

The board endorsed the principle of intergenerational approaches and agreed to further work on the details.

Better Care Fund

Jon Lillistone, Director for Integrated Commissioning (SCC), provided an update on the Better Care Fund (BCF), seeking retrospective approval for the updated 2025-2026 BCF Plan. He noted that the submission was approved by the government but with a condition related to the discharge ready date metric.

Councillor Sue Murphy, Chief Executive Officer, Catalyst - VCSE, raised concerns about co-production and ensuring the views of carers and communities are considered.

Dr Charlotte Canniff welcomed the focus on demand and capacity data collection and emphasised the need to build capacity in the system, especially around the home first pathway.

Councillor Clare Curran stressed the financial challenges in adult social care and the need to maximise the use of the BCF and monitor its impact.

The board retrospectively endorsed the 2025-2026 BCF plan and requested a report on the task and finish group's findings.

Refresh of the Health and Wellbeing Board Strategy

Phil, from Public Health, introduced a proposal to refresh the Health and Wellbeing Board Strategy, last updated in 2022.

Dr Charlotte Canniff questioned the timing and use of staff time, given the ongoing reorganisation.

Dr Rachel Wardell agreed, noting that there were clear gaps in the strategy.

Councillor Tim Oliver suggested focusing on tweaking the strategy rather than a full review.

The board agreed to consider how to proceed, focusing on addressing gaps and necessary updates.

Local Government Reorganisation

Councillor Tim Oliver provided an update on local government reorganisation, noting that the government launched a consultation on reorganisation in Surrey, running until 5 August. The consultation will consider two options: creating two unitary authorities or three unitary authorities. The government will provide exceptional financial support for Woking for 2026-27.

Councillor Tim Oliver requested that the board participate in the consultation.

Next Meeting

The next public meeting will be on 10 September 2025, with a virtual meeting in July to explore neighbourhood area committees.