Frimley ICS’s refreshed ICS strategy is set in the wake of the COVID-19 pandemic. Noting the “fresh urgency” presented by the pandemic to tackle challenges relating to health inequalities and healthy life expectancy, the strategy maintains the six strategic ambitions originally established in 2019, “with new areas of focus and energy against a refreshed set of priorities which better reflect the challenges of 2023 and beyond”.
The strategy sets out the following six strategic ambitions: Starting Well; Living Well; People, Places & Communities; Our People; Leadership and Culture; and Outstanding Use of Resources.
Home to more than 800,000 people “in a broad geography which spans East Berkshire from Bracknell to Slough, North East Hampshire, Farnham and Surrey Heath”, Frimley covers dozens of public sector and VCSE organisations.
The strategy notes the changing health landscape and the need now, more than ever, to draw upon available resources and work together.
“We have brought people together to integrate services and work across organisational boundaries, regardless of the system and organisational architecture which regularly changes around us.”
Frimley’s ICP represents a joint committee between upper tier local authorities and the NHS Frimley ICB. Frimley’s ICP Assembly brings together “clinical and professional leaders of public sector, voluntary sector and charitable organisations which have an interest in improving the health and wellbeing of over 800,000 people who reside in the Frimley ICS geography”.
A meeting of the Frimley ICP Assembly resulted in feedback on the original 2019 strategy, including that:
- The strategy must be inclusive of all partners to provide transparency and collective opportunity system-wide
- The strategy must be driven by an improved understanding of the current landscape and available assets, to promote connection and multiple partner perspectives
- Stronger working with the voluntary sector is essential
- Open and honest conversation is required, about the challenges the ICS faces in terms of economic issues and increased demand on services
Some of the key challenges identified by the strategy include:
- Identifying pockets of deprivation “less visible due to nearby affluence”
- Around 3% of the population living in the most deprived areas of England
- BAME residents 2.6 times more likely to live in deprived areas
- 56,000 residents at risk of fuel poverty
- 98,000 residents whose main spoken language is not English
- 5.8% of the population with a BMI over 35
- 10.6% of the population are smokers
- 28% of the population are in some form of rented accommodation
When considering the association between deprivation and conditions including diabetes, COPD and heart failure, the strategy notes the following:
- Populations identified as Asian/Asian British are at notably higher risk for diabetes, non diabetic hyperglycemia and coronary heart disease (CHD); lower for depression, COPD and atrial fibrillation
- Populations identified as Black/Black British are at notably higher risk for diabetes, hypertension, chronic kidney disease(CKD) and obesity, lower for COPD, depression and atrial fibrillation
Slough is more densely populated, has a younger and more deprived population, as well as a higher proportion of BAME residents, and a higher percentage of multigenerational households.
“Adjusting for age and sex, Slough has significantly higher prevalence of a wide range of conditions and risk factors. There are strong associations between deprivation, ethnicity and prevalence of conditions such as diabetes and hypertension.”
Strategic ambition one: Starting Well
“The purpose of Starting Well is to work towards improving outcomes for children and families. The plan is to work closely with communities across our population by engaging effectively with community groups, voluntary sector organisations and families. Our aim is to better understand the driving factors behind differing health outcomes and particularly barriers to opportunity and healthier choices, and improve equity across Frimley, taking a co-produced, asset-based approach to make a positive impact.”
Areas of focus including pre-conception and early years, and priorities include vulnerable children and families, as well as childhood obesity. The strategy hopes to promote healthy habits in families, including influencing behaviour relating to oral health, diet and smoking in pregnancy.
“We want to build on the existing resources that families and children have available, reducing confusion by having a ‘single front door’ and developing an accessible suite of tools, translated and available for all of our families.”
The strategy celebrates achievements including the development of a Children, Young People and Families innovation fund which has funded 17 projects to date; as well as the Frimley Healthier Together website, which has created a single front door for resources for families and professionals.
The strategy’s focus on healthy behaviours has also seen the development of an ICS-wide “Healthy Weight” group, the delivery of “This Mum Moves” training to tackle gestational diabetes; and the continuing work of the “Smoke-free pregnancy” initiatives which have “resulted in the lowest smoking in pregnancy rates in the South-East”.
Strategic ambition two: Living Well
“The long-term sustainability of our health and social care system depends on people living longer in good health. Our aim is to identify and target the cohorts of people where physical and mental health problems can be prevented or outcomes improved with a focus on deprivation, inequalities and those with most complex needs. Data shows we have stark intra-area health inequalities, with poor, and worsening, health and wellbeing outcomes in our more deprived communities and other groups.”
The strategy places a focus on the use of Population Health Management (PHM) to “embed decision making based on evidence, across the development and monitoring of our programmes”. Priorities include improving the health and wellbeing of the poorest and sickest.
“Individuals need strong stimuli to support their own health improvement and an environment that makes it possible. Places need to engage robustly with their communities about why living well is more challenging and what can be done to improve it. We will need to harness behavioral science and social messaging to support such changes.”
The strategy celebrates achievements in this area including progress in CVD prevention, and in lifestyle interventions through “Healthy Conversations – Making Every Contact Count”, the NHS Digital Weight Management Programme and the Community Asset Based Approaches in Local Authority to support communities. These achievements have led to outcomes including closer collaboration between Health, local government and the voluntary sector; improvements in health literacy and outcomes; and stronger trust and networks within communities.
Strategic ambition three: People, Places and Communities
“In 2019 this ambition started as the Community Deal, inspired by the work in Wigan and elsewhere in the country to focus on a new relationship with local communities. Over the last three years, this work has evolved and taken on a more local direction. In order to better reflect the work being undertaken we propose to change the ambition name to ‘People, Places and Communities’.”
The strategy places a focus on working more closely with communities, promoting inclusive relationships and fostering innovation through place-based initiatives. It also notes the importance of treating people as individuals, ensuring the voice of people “with lived experience” is incorporated into the development and delivery of personalised care.
“The ambition to build new relationships with local people and communities, recognises that real change in the quality of people’s lives cannot be achieved by organisations alone – everyone has a role to play.
Over the last three years the ‘Community Deal’ ambition has focused on the principle of “doing with,” not “doing to” people, encouraging people, families, and communities to take more responsibility for themselves and each other so that everyone can live in healthy and thriving communities.”
The strategy notes achievements in this area including the development of community champions and #OneSlough; the Bracknell Forest Thriving Communities programme; building local capabilities; and the introduction of the Collaborative Practice Programme. Projects supported by funding from NHS Charities Community Partnership Grants also saw outcomes including new links with under-served communities; digitally connecting with families and others to reduce loneliness and isolation; and the establishing of a community Innovation Fund to support local community projects.
Strategic ambition four: Our People
“Workforce challenges in health and care have been talked about for years, but the scale of challenge in the last two years have been unprecedented. Partners across the health and care system are working hard to ensure we have the workforce we need now and in the future. We need to be clear where we best deliver through a system focus- where we are stronger together to resolve some of our most difficult and longstanding workforce challenges.”
The strategy aims to promote the reputation of the ICS as a “great place to live, work, develop and make a positive difference”. It also aims to attract the local population to careers in health and care, and to give people the opportunity to be physically and mentally healthy, and flexible in the work that they do.
The strategy notes achievements in this area, including the “Melting the snowy white peaks” programme to resolve under-representation of BAME nurses in senior roles; a culture where temporary staff are welcomed; and the “People in Partnerships” programme which has seen a leadership programme established aimed at integrated team leaders, teams being supported to have “Culture conversations”, and an integrated team diagnostic.
Strategic ambition five: Leadership and Cultures
“Together with our communities and partners we will build kind and inclusive cultures which harness the rich diversity of experience, knowledge, skills, and capabilities from across our system. We will collaborate with others to co-design, integrate and inspire all our people to make a positive contribution in our neighbourhoods, across our places and throughout Frimley.”
This part of the strategy aims to create opportunities for partners to develop cultures of compassion, cultivating whole system leadership and partnership working, and embedding the universal Freedom To Speak Up principles to ensure people feel empowered to offer suggestions to improve ways of working.
“We will create a thriving environment which values the power and strength of our diversity and ensures our people feel empowered and confident to challenge when things are not right and to offer suggestions to improve ways of working. This will contribute to an inclusive leadership culture which enables equity of access to services, support and opportunities for our communities and staff through life and career.”
Key themes to be addressed through the priority areas of the strategy include ensuring the voluntary community and social enterprise partners can develop leadership skills to make a difference in their communities; continuing to broaden access to leadership programmes supporting underrepresented partners to take part in offers; and continuing to support those benefitting from leadership offers to make a positive and ongoing difference through growing a “community of practice”.
Achievements noted by the strategy include the Frimley Academy’s continued development, and the flagship leadership development programme “2020”, followed by “Wavelength”, as well as several other offers focusing on leadership in the emerging system context. The Frimley EDI Ambitions and the EDI Conference attended by people from across the system, is included as a point of progress. Achievements were also noted from the Academy in delivering 10 offers and reaching over 650 people over the last year.
Strategic outcome six: Outstanding use of resources
“Outstanding use of resources means that the system will collectively aim to deliver the greatest possible value to support the health and wellbeing of the population, with the resources available. Our long term commitment to reducing need and health inequalities will support the long term sustainability of health and care services. We have made digitally-enabled care a priority for this ambition.”
The strategy aims to maximise the impact of the skills and capacities of staff, making decisions based on good intelligence and incorporating digital capabilities. It also notes the importance of shifting resources to maximise benefits and to reduce resource shortfall by improving people’s health and wellbeing outcomes.
“The ICS will ensure joint prioritisation and effective utilisation of all our resources including financial, estates, digital and workforce, recognising these as our as our key strategic assets.”
The strategy notes achievements including “significant innovation” and collaborative working driven by the pandemic, a number of developments in digital and analytics including a “nationally leading population health intelligence platform”, and ongoing investments in key estates programmes such as the Heatherwood Hospital redevelopment and renewal.
Looking to the future
The strategy closes with a “Shared Commitment to Delivering Progress”, which emphasises the role of joint working in ensuring delivery of its aims.
“Our intention is to work with residents, staff, elected representatives and organisations in Q4 of 2022/23 to share this draft strategy and hear further feedback as to how it can be strengthened. We will seek to update the strategy to reflect as much of this feedback as possible, prior to the Integrated Care Partnership being asked to endorse this strategy at its meeting in March 2023.
As we enter 2022/23, we will seek to work with partners in their organisations and Health & Wellbeing Boards to ensure that we have credible plans for delivering improvement against these strategic ambitions as set out in this document. We have already signalled an intention to bring greater clarity to the expected benefits of this work for residents and staff, backed up by a clear understanding of the metrics and indicators which will tell us whether our shared work in this area is delivering tangible progress.”
The strategy also defines future areas for improvement, which have been suggested by partners for subject matter workshops, including:
- Social and private housing, planning and development
- Healthier spaces, leisure and tourism
- Economic development, skills development and training
- Understanding the Social Care provider sector and exploring quality improvement opportunities
- Making best use of collective Public Sector physical assets and anchor institutions
- Digital provision of health and care support to workforce, patients and residents Securing long term sustainability, including environmental improvement opportunities and the broader Green agenda
To read the strategy in full, please click here.
