Joint Strategic Needs Assessment

Turning the Tide 29th Sept 2009

Workshop C

Mike Link & Ed Cassidy

Workshop Format

• Short presentation - JSNA re-cap and examples

• Discussion - what does JSNA tell us about Coastal areas?– in general– for social care in particular

• Are we making the most of JSNA?

• Key messages

Strategic Needs Assessment means:

Demography

Joint Strategic Needs

Assessment

Desired health and well being outcomes in

3 – 5 years time for population

Social & environmental

Current health of population

Current provision

Patient voice

Public demands

Service Reviews

Contracting & procurement

Market development

Investment decisions

Capital Plans

INPUTS

Decisions made by:

LA/LSP

PCT

SCS, LAA, Budget

planning

Prospectus & metrics

Inequalities- Outcomes- Access

Budgets

Effectiveness

OUTPUTS

JSNA not a single product – but an ongoing process

• On going process of examining needs, services and projecting forward.

• Looking at each service in detail.• Breaking down what we know into smaller

areas.• Includes the important aspect of “voice” -

what people want or expect to change with time

Assessment must reflect:

• Need for data to inform short, medium and longer term – can get easily bogged down in performance targets and immediate delivery.

• Changing nature of public services – less direct provision more promoting/fostering market.

• Choice – people able to exercise choice and be supported to achieve good outcomes.

0

1

2

3

4

5

6

WESTSUSSEX

MEDWAY EASTERNAND

COASTALKENT

BRIGHTONAND HOVE

CITY

HASTINGSAND ROTHER

WEST KENT EASTSUSSEX

DOWNS ANDWEALD

SURREY

Lif

e e

xp

ec

tan

cy

ga

p (

ye

ars

)

Gap in life expectancy between the SHA bottom quintile and the rest of the SHA, by PCT. 2003-2005, with 95% confidence limits.

Inequalities - one of the main priorities in the JSNA – huge challenge for coastal areas

Index of Deprivation 2007 Overall Deprivation West Sussex Lower Super Output Areas (LSOAs)

Deprivation Deciles(National Rankings)

Most Deprived 10%

20%

30%

40%

50%

60%

70%

80%

90%

Least Deprived 10%

Coastal areas contain most deprived areas in West Sussex

Thinking ahead – health and social care have to expand horizon of what we need to influence and change.

Wider Determinants e.g Pupils obtaining5+ A*-C Grades - ADUR

41.7

39.2

34.3 38

.0

34.8

34.7

34.6

35.0 37

.7

37.6

50.7

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

1997/98 1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08

Adur West Sussex England

2004/05 2005/06 2006/07 2007/08

35.0 37.7 37.6 50.7

21.3 23.2 25.9 31.0

•Need to break into cycle of deprivation in many neighbourhoods – education vital for longer term health and social care

•Links to teenage pregnancy, obesity levels, smoking, some long-term conditions.

= in top 25% of LAs= in middle 50% of LAs= in bottom 25% of LAs

NI 8 (from Active People 2)

- adult participation in sport and active

recreation %

ADUR 19.9%

ARUN 19.4%

CHICHESTER 27.1%

CRAWLEY 19.6%

HORSHAM 24.1%

MID SUSSEX 25.3%

WORTHING 19.4%

West Sussex 22.1%

ENGLAND n/a

Wider Determinants – Mid Life Physical Activity Rates

•Very important for later life health is health of “mid lifers”

•Physical activity rates in coastal WSx poor

•Important for mental and emotional health not just physical.

•Raising activity rates will have pay-off for health and social outcomes (and budgets).

•Need to push for some key client groups to access leisure (adults with learning disabilities, people with long-term conditions, older people)

Citizens EveryoneHousing, employment, safety, lifestyle……

Individuals, groups, communities

Organisations -

statutory, voluntary, community

Prevention policies

Frail/vulnerable

Acute Care

Health, social care, housing

Service users, patients, carers

Knowledge – to keep/move people down the pyramid

CHOICE / CONTROL

COST/RESOURCE INTENSIVE

SPECIALIST INTERVENTION

SUSTAINABILITY

•Information required for all levels of support for health and well being - populations, specific groups or communities and services.

Some basic stuff- who is receiving a service, - who isn’t receiving a service - and who may need support in the future.

e.g plotting where adults with a learning disability currently attend day centres, how far they travel and what facilities / activities they access.

5,1403,950

8,8708,110

12,060

14,010

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

2006

2011

2016

2021

2026

Num

be

r

Males Females Total

Dementia: prevalence assumptions applied to West Sussex Population Projections

Source : Personal Social Services Research Unit (PSSRU) at the London School of Economics and the Institute of Psychiatry at King’s College, London, for the Alzheimer’s Society, 2007.

Estimates of 10% increase by 2021, 16% by 2026

Planning for the Future – e.g Numbers of People with Dementia

Shorter Term use of JSNABeing able to target specific work – e.g. Tackling Fuel Poverty

SOLID WALLS – the map below shows the percentage of total dwelling in each ward estimated to have solid walls

OFF GAS – the map below shows the percentage of total dwelling in each ward not on mainline gas.

% Solid Walls(Estimated of total households)

66 to 6732 to 6618 to 324 to 180 to 4

% Off Gas(Estimated of total households)

12 to 139 to 128 to 93 to 81 to 3

Challenges

• Gaps in knowledge – e.g. Housing, homelessness, young people, time lags in data

• Well being for mental and emotional health. • Treating families as a unit – not just treating

individuals – relation between cared for and carer.

• No longer provider of many services – need to ensure market is developed for people’s needs

• How to keep track of outcomes on self directed support.

• Prevention – ageing population means we need to be as healthy and as independent as possible.

• Jointly planning and delivering services with health.