Our priorities
Our vision for East Surrey is a healthy, happy, and equitable place, where people are supported to be independent, live well and stay well.
We believe in the power of partnership where organisations work together to create positive health outcomes for local communities. We place great importance in engaging with residents, hearing what they have to say and listening to their experiences, and this helps develop our priorities and improve our services.
Our five key priorities for the people of East Surrey
What does this mean for local residents?
Our six key priorities for the people of East Surrey are:
- Making sure that access to our Urgent and Emergency Care services – such as in an emergency – is simpler and working to get patients discharged quicker after a hospital stay
- Enabling residents with Long Term Conditions to live as fulfilled a life as possible
- Working together to improve care for older people – Ageing Well
- Helping people to stay well by working together to prevent illnesses and creating conditions to enable everyone in East Surrey to improve their own health and wellbeing – Prevention and Communities
- Making sure that people can access to mental health services if they need to – Primary and Community Mental Health
- Bringing together Children and Young People's Services from across the Place to facilitate more joined-up, holistic experiences for children, young people and families.
Ageing well
Delivering an Ageing Well service to the pre-frail and frail population of East Surrey will provide a positive impact on health care systems and for people as they age.
There are an estimated 3,323 people in East Surrey who are frail with a further 14,836 who are pre-frail. We’re working together across East Surrey Place to improve care for older people, sharing best practice and expertise between partners about what is working well. This means that care for people as they get older is proactive and helps prevent deterioration, and enables them to live at home for as long as possible.
Our partners are working together to anticipate and react to the needs of older people, listening to what they - and those who care for them – want, and ensuring we have the right workforce with the right training to support our innovations.
Anticipatory Care Hubs
How healthcare professionals in East Surrey are working together to keep older people well at home and reduce unplanned hospital admissions.
Children and Young People’s services
We’re bringing Children and Young People’s services together from across the Place to facilitate more joined-up, holistic experiences for children, young people and their families accessing services in East Surrey.
We have created an East Surrey Network to improve communication and awareness between service providers from health and Surrey County Council. We anticipate that these partnerships will lead to a more integrated pathway of care for young people and support providers to manage system pressures.
Our programme plan is in development, currently we are reviewing data and intelligence to understand the current service capacity and determine the key areas of need. We plan to engage directly with young people and families to understand their perception of the local services and accessibility. This insight will be fundamental in shaping our programme plan.
Long Term Conditions
We endeavour to enable our residents to live well with Long Term Conditions. We seek to provide support for people in our area to make and maintain healthy lifestyle choices, managing both their mental and physical wellbeing.
Focusing primarily on diabetes, cardiovascular disease and respiratory conditions, we are aiming for robust screening and early diagnosis, and therefore better prevention of the negative impact these conditions can have. We are working to establish improved access to a variety of services and tools to help people in the self-management of their condition. Through better self-management we will see better quality outcomes for all.
Some of the current work underway includes:
- A Breathlessness Clinic pilot to aid the diagnosis of asthma and Chronic Obstructive Pulmonary Disease (COPD)
- Improving the pulmonary rehabilitation service for lung disease patients
- Continuing to roll out the Blood Pressure@Home service – which around 1,700 patients have already used
- An atrial fibrillation screening project aimed at residents from South Asian, Black African and Black Caribbean backgrounds who tend to have a higher risk of developing diabetes and cardiovascular disease.
Prevention and Communities
We’ve brought together health, social care, housing, police, voluntary and community, and district and borough partners to co-create conditions to enable everyone in East Surrey to improve their own health and wellbeing.
We aim to promote well-being and intervene at the earliest possible stage to radically turn the tide in healthcare away from reactive services that focus on ill-health, and towards health creation – for example by reducing social isolation, improving physical activity levels, promoting inter-generational activities and utilising green social prescribing initiatives. The programme is guided by population health data, wider determinants of health data and community engagement to determine local needs.
Prevention and Communities: one year on, 2022/23
The local system is under growing pressure. East Surrey Place is working with district and boroughs, local partner organisations, general practices, voluntary sector organisations, communities, and residents to find ways to transform and make the system sustainable for the future.
The Prevention and Communities priority is a key part of the answer, by shifting the investment more into prevention given that a huge burden of ill health is avoidable (Hewitt review report). This can only be done through a system wide approach which focuses on a radical upgrade on prevention working in collaboration with partner organisations, moving away for operating with siloed budgets and recognising the role of the community and residents into system change.
The focus of this report is to review key health creation and preventative initiatives that have supported local outcomes. In addition, this review provides robust evidence of effectiveness at a local level followed with some economic modelling examples via the Growing Health Together programme and examples across the country.
Prevention and Communities in East Surrey One Year On Report 2022-23 [pdf] 1MB
Prevention and Communities in East Surrey One Year On Report 2022-23 plain text [docx] 2MB
Growing Health Together
How the Growing Health Together programme is bringing together health, social care, housing, police, voluntary and community, and district and borough partners to co-create conditions to enable everyone in East Surrey to improve their own health and wellbeing.
Primary and Community Adult Mental Health
We’re making sure that people across East Surrey can access mental health services if they need to.
We are doing this by focusing on improving access, navigation and sign posting for people with mental illness, improving wellbeing support, providing early intervention and identifying people who are at risk of developing mental illness, with our collective resources.
We are providing increased specialist support – such as the GP integrated mental health service roll out across our GP practices – and have also been chosen for two community pilot projects: a mental health prevention crisis pilot in partnership with the Richmond Fellowship and a rough sleeping pilot with Surrey County Council’s Public Health team.
Urgent and Emergency Care
Integrated Urgent and Emergency Care services is a complicated system with directives often given from the national and regional Urgent and Emergency Care teams. As a result, it can be a complex system for patients and health and social care professionals to navigate seamlessly across multiple care pathways.
All of our partners across East Surrey Place are working together to deliver a better service to patients – for example we are now enabling patients to pre-book slots at Caterham Dene hospital via NHS 111 to reduce pressure on East Surrey Hospital’s Emergency Department, and providing additional specialist capacity through a new health and care recovery team that supports people for a time limited period to recover at home post-discharge.