Surrey Context Introduction

Introduction

The JSNA is an assessment of the current and future health and social care needs of Surrey residents. In this chapter the contextual background is set for Surrey’s joint strategic needs assessment (JSNA), by exploring an overview of Surrey’s population, followed by an overview of Surrey as a place using geographical and economic indicators. Understanding the age profile, ethnicity, religions, language skills and sexual identity of residents, as well as the wider determinants (such as housing, the economy and environment), in which the population lives is essential to ensure services are meeting their needs.

Community and volunteer organisations across Surrey play a critical role in collection and collation of lived experience and advocacy for voice and understanding people’s lived experiences of health and social care services. Some of this community insight from patients, members of the public and service users can be found on the following partner websites:

• Healthwatch monthly insight reports

• Independent mental health network

• Family Voice

• Surrey minority ethnic forum

• Surrey youth focus

• Active Surrey

• Surrey coalition of disabled people

This chapter is based on the latest available population data at time of publication.

Health and Wellbeing Strategy and Board

The Surrey Health and Well-being Strategy sets the vision in which Surrey wishes to improve the health and wellbeing of residents, reduce health inequalities and ensure that No One is Left Behind. It describes our joined-up efforts to create the best conditions for both physical and mental, health and well-being alongside addressing the wider determinants of health – such as housing, the economy and environment. This includes an emphasis on groups within the population with poorer health outcomes, alongside the refreshed priorities and outcomes that all partners across Surrey recognise and support. The strategy also identifies those priority populations – communities of identity and geography which are often overlooked and currently most at risk of poor health outcomes.

The Health and Wellbeing Board is a statutory Body under the Health and Social Care Act 2012 Act for unitary authorities. The board has representatives from Surrey County Council (who also chair), Surrey Heartlands ICS, Frimley Health and Care ICS, other key public services, and the Voluntary, Community and Social Enterprise sector. In December 2024, the Health and Wellbeing Board merged with Surrey Heartlands Integrated Care Partnership (a statutory requirement of all ICSs under the Health and Care Act 2022), retaining representation from Frimley Health and Care ICS.

Progress against metrics of the Health and Wellbeing Board can be found on the Health and Wellbeing Strategy Index

Understanding health and other boundaries within Surrey

The area covered by Surrey County Council is covered by various administrative and health boundaries. These key geographical boundaries and places are described briefly in this section. The Surrey boundaries GIS map shown below provides an overview of the key health and council boundaries in Surrey and also provides an overview of GP practice locations, pharmacy and key hospital sites in Surrey.

Please select the checkboxes listed under “layers” to display various boundaries and detail available on the map.

County council

Surrey is a county council. In Surrey there is a two-tier system of local government, the county council (upper-tier local authority) and the 11 district and borough councils (lower-tier local authorities). Generally, the county council is responsible for the more strategic functions and services such as education and social care.

Districts and boroughs

Districts and boroughs are the local authorities within Surrey, they provide local services such as environmental health, housing, leisure centres, waste collection and planning applications. There are two districts and 11 boroughs in Surrey. Some functions are shared between county and districts and boroughs. More detail on the responsibilities of each level of council can be found on the council website.

Integrated Care Systems (ICS)

There are 42 ICSs in England which bring health and care organisations together to develop shared plans and joined-up services. They were established in 2022 (and have since been formalised in statutory bodies) and are focused around geographical areas. The ICSs that cover parts of Surrey county can be viewed on the Surrey boundaries map above.

Integrated care boards (ICB)

Each ICS has an integrated care board (ICB), which is a statutory NHS organisation responsible for developing a plan in collaboration with NHS trusts/foundation trusts and other system partners for meeting the health needs of the population, managing the NHS budget and arranging for the provision of health services in the defined area. Further detail is available from NHS England: Integrated care in your area.

Surrey Council works with both NHS Surrey Heartlands Integrated Care Board and NHS Frimley Integrated Care Board.

Integrated care partnerships (ICP)

ICPs are a statutory committee jointly formed between the NHS integrated care board and all upper-tier local authorities that fall within the ICS area. The ICP will bring together a broad alliance of partners concerned with improving the care, health and wellbeing of the population, with membership determined locally. The ICP is responsible for producing an integrated care strategy on how to meet the health and wellbeing needs of the population in the ICS area. Further detail is available from NHS England: What are integrated care systems.

Place-based partnerships

Place-based partnerships operate on a smaller footprint within an ICS. They include multi-agency partnerships involving the NHS, local authorities, the voluntary and community sector (VCSE) and local communities themselves. There are four place-based partnerships within Surrey Heartlands ICS and five within Frimley Health and Care ICS, these are listed in the table below.

All four of the place-based partnerships in Surrey Heartlands ICS (Surrey Heartlands place-based partnerships) sit within Surrey county boundaries. Three of the five place-based partnerships in Frimley Health and Care ICS (Frimley Health and Care communities map) overlap with Surrey county boundaries: Part of Windsor and Maidenhead (which covers Windsor PCN, on the edge of Runnymede and used to cover East Berkshire CCG), all of Surrey Heath (which covers Surrey Heath PCN, Surrey Heath borough council and a part of the West of Guildford borough council) and part of North East Hampshire and Farnham (Farnham PCN on the West of Waverley borough council). The place-based partnerships that cover parts of Surrey county can be viewed on the Surrey boundaries map above.

Table 1: Integrated Care Systems and Place-based Partnerships in Surrey

Further detail can be viewed on Surrey Heartlands place-based partnerships and Frimley Health and Care communities map.

Integrated Neighbourhood Teams (INTs)

Each Place-based partnership in the NHS is further divided into INTs. The approach taken to develop these teams varies; some align with their Primary Care Networks (collections of GP surgeries), and some adopt their own methodology. The purpose of INTs is to facilitate NHS community services, social care and other local providers to work together to deliver more co-ordinated and proactive care on a localised level.

Key Neighbourhoods

Key neighbourhoods are different from INTs. They are 21 of the most deprived areas in Surrey, defined in the Surrey Health and Wellbeing Strategy as a priority due to those residing in them experiencing poor health outcomes. Table 2 outlines these key neighbourhoods.

Summaries about the key neighbourhoods are available on Surrey-i.

Table 2: List of key neighbourhoods and priority wards in Surrey’s health and wellbeing strategy

Source: adapted from the table in https://www.healthysurrey.org.uk/about/strategy/surrey-health-and-well-being-strategy-update-2022 *Overall IMD decile 4 and for IMD supplementary index on Income Deprivation Affecting Children in decile 1 (highest 10% nationally)
** Overall IMD decile 4 and for IMD domain Education, Skills and Training in decile 1 (highest 10% nationally). † Further strategic towns and villages can be found in Table 3

Primary care networks (PCNs)

PCNs are a collection of general practices and other primary care services, such as community pharmacies, situated in the same area. They are technically not a geographical area – as they are responsible for the patients registered into their care, who may or may not live locally. However, with certain assumptions, it is possible to attempt to map PCNs for the purposes of planning. This mapping can be viewed on the Surrey boundaries GIS map. The methodology used to determine this mapping is detailed on the PCN aggregation methodology page of the Surrey population tableau dashboard.

The purpose of PCNs is to bring together local healthcare services to work at scale and provide a wider range of services at neighbourhood level. Further detail on the work of PCNs is available on Surrey Heartlands and Frimley Health and Care websites.

Wards

Wards, or electoral wards, are one of the main administrative areas on which local government is based. Each local authority (district or borough) is divided into a number of wards and between 1 and 3 councillors are elected to represent each ward on the council.

Ward boundaries are regularly reviewed and in 2023 there were 174 wards in Surrey. There were previously 186 (in 2021), 193 (in 2016) 206 (in 2011).

The wards in Surrey county can be viewed on the Surrey boundaries map above.

Middle-layer super output areas (MSOA)

MSOAs are units of geography used in the UK for statistical analysis. They are developed and released by UK Statistics. MSOAs have a minimum population of 5000 and a mean (average) population of 7200.

Lower-layer super output areas (LSOA)

LSOAs are units of geography used in the UK for statistical analysis. They are developed and released by UK Statistics. LSOA have a minimum population of 1000; mean population of 1500. Following the 2021 Census, there are 719 Lower Super Output Areas (LSOA) in Surrey; in 2011 there were 709.

There is a helpful Guide to the Geographies of Surrey | Surrey-i (surreyi.gov.uk) on Surrey-i that explains some of the boundaries further.

Towns and Village Areas

Towns and Villages are a geography created specifically in Surrey and present an opportunity to understand the county from the perspective of places which are recognisable to residents, communities and local partners. They do not represent every town and village in Surrey, just the most recognisable to residents which are likely to have greater economic significance. There are 27 towns and 2 strategic village areas.

Table 3: Surrey Towns and Village Areas

*town areas that also include HWB Strategy Key Neighbourhoods (see table 6)

Towns and village areas aim to improve local co-ordination and delivery of place making enhancements, regeneration of communities, and natural and built environments. Actions taken by key towns will be informed by key strategies aimed at county, ICS and district and borough level. Commonalities of strategies relevant to the geographical area will inform action to address health inequalities, improve equity of opportunity, improve community engagement and empowerment, drive economic growth and promote environmental sustainability.

Figure 1: Map of towns and village areas