Agenda item

This paper provides the Health and Wellbeing Board with an update on the implementation and delivery of one of the ten big goals within the Local Joint Health and Wellbeing Strategy 2022-2032. It also includes information on performance monitoring.

The Director of Public Health introduced the report, highlighting the report’s findings that loneliness has a significant impact on people.

The Head of Communities and the Local Area Coordinator presented the report, beginning with a video entitled “Glynn’s story” which articulated how the local authority and organisations such as Move Mates could progress people forwards, through social interaction, exercise and increasing service users’ confidence.

The case study explained how long-standing, trusted relationships could be built through a Local Area Coordinator facilitating introductions to Housing Managers, Childrens and Adults Social Care and social prescribers. The Head of Communities explained that 50% of ward funding went into community projects to address this, including 140 trained Community health champions. He also discussed partnerships with York Cares, York CVS and The Cares Family national model which created intergenerational social clubs at the Spurriergate Centre and Community Furniture Store.

He discussed other cases in which the Local Area Coordinator supported service users to improve their situation; he explained that the Move Mates charity had recently been awarded the king's award for voluntary service and had created 112 active pairings in the past year between a move Mate walking buddy volunteer and somebody struggling with loneliness, isolation, physical health or mental health challenges.

He noted that the report addressed gaps in provision and discussed an event held at Guildhall to identify loneliness as well as issues of transport – specifically accessing York city centre.

The chair thanked the speakers, noting that this service was invaluable, and that the case study presented in “Glynn’s Story” showed that a service user could go on to support others.

The board noted that Annex 5 of the report stated that 25.7% (year on year since 2019) of adults felt lonely, asking by what metric loneliness was being measured, and also how the presenters viewed their relationship with ward councillors.  

The Head of Communities answered that figures regarding loneliness indicator were captured annually but the last information received went back to 2019 so there was an issue concerning the methodology around how we're that metric was being captured. He added that how Local Area Coordinators measured service users’ loneliness affected the type of relationships they had with them, due to the dynamic involving strengthening a circle of support. He said that the relationship between local councillors and Local Area Coordinators was seen as integral to the relationship being fostered at Place based level.

The Director of Public Health added that the metric around loneliness originally derived from an Active Lives survey carried out in 2019, and the Office of National Statistics had intended to ask the same question every year to build a loneliness index and then they didn’t ask that question. As a consequence the ongoing data was erroneous and officers had pushed back to Public Health England to ask whether further information would be available. Further information had been added to the index, but this only covered those who received social care or were themselves carers. He conceded the gap in the current data, and highlighted that the Campaign Against Loneliness website had identitifed specific risk factors, particularly impacting young people, women and those with mental health concerns. He noted that this discussion had raised further risk factors such as lower neighbourhood belonging and low social trust, providing further items which could be picked up in the next couple of years to ensure work going forwards not only reflected the brilliant practice evidenced in this presentation but also moved the work into sections of the population where it could have the greatest impact.

The Local Area Coordinator said that they encouraged people to come and see them at community centres which increased service user’s confidence and many became involved at community centres as a result.

The board acknowledged that Local Area Coordinators had experienced a difficult time during lockdown because of its effect on people’s mental and physical health, and asked whether this remained the case or had things moved on? The Local Area Coordinator said that while many people still felt a long-term impact, in general things were now moving forward. Some people who were rehoused during the pandemic had been unable to make local contact at the time, and as a result these people have only now been seeking assistance.

The board asked whether there was now a Local Area Coordinator for each ward covering the whole city? The Head of Communities answered that there was not currently coverage for every ward in the city; while the team had grown in accordance with resources provided, 12 of the 21 wards were presently covered, with dispersal reflecting need and demand.

The board asked how they saw their service connecting to prevention and further downstream/specialist services?

The Director of Public Health answered that Local Area Coordinators represented a marked difference in removing the social care burden from primary care practitioners through their work.

He stated that they played a major role in prevention, which provided an invaluable scaffolding for primary care, though he conceded it would be important to challenge that Local Area Coordinators, Social Prescribers and Health Trainers were meeting the most appropriate service users to effect change when looking at the next stage of work around prevention.

The board asked, how do we know Local Area Coordinators were targeting the “right” people with regard to the limited resources available, ie. The people with the greatest capacity to benefit?

The Head of Communities answered that the reasons why people were introduced to the team had always been the same in terms of mental health, loneliness and housing but poverty and the cost of living have especially rocketed over the last three or four years. He stated that they worked with population health management data to build relationships and make referrals to social care/public health. He said they worked with the right people but needed to ensure the right referrals come through, since they are only as good as their referrals.

The board suggested that not everyone who is lonely is receiving or in need of services, and perhaps the loneliness people don’t need services or intervention and just require help to connect. The board asked how those people, not on our radar, could be reached?

The Head of Communities answered that the best form of introduction is from people themselves or the community, often as a result of someone having worked with a Local Area Coordinator (or Social Prescriber) previously.

The board asked whether we were using these roles to understand where there are problems a Local Area Coordinator cannot resolve, where another service should be stepping in? How do we prioritise funding the part of the system that will solve the problem rather than holding a service user with someone who cannot help them?

The Local Area Coordinator said that part of the model was to identify problems and draw attention to these problems from appropriate services, feeding things back to bring about improvement.

The Director of Public Health stated that an action point to take away would be the system change behind social isolation, taking into consideration upstream factors including socialisation, isolation and loneliness and additionally considering younger age cohorts.