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What is a JSNA• Current and future health and wellbeing needs • Short term (three to five years) to inform Local Area Agreements, • longer term future (five to ten years) to inform strategic planning • Commissioning services and interventions to achieve better
health and wellbeing outcomes and reduce inequalities. • Address outcomes described in National Indicator Set for local
authorities and partnerships, and “vital signs” for the NHS
JSNA is:• High Level• About priority setting• Horizon Scanning • An evolving process &
product• A process which must engage
commissioners• Some information to support
commissioning decisions
Not to be confused with….
Health Needs Assessment (HNA) or Equity audit activity
The Director of Public Health's Annual Report
Information which underpins commissioning
Deprivation and inequalitiesWard Rank Income Employment Health Education Housing Crime
Living
Environment
Langworthy 1
Irwell Riverside 2
Broughton 3
Ordsall 4
Little Hulton 5
Barton 6
Winton 7
Walkden North 8
Weaste & Seedley 9
Irlam 10
Swinton North 11
Swinton South 12
Pendlebury 13
Kersal 14
Eccles 15
Cadishead 16
Walkden South 17
Claremont 18
Worsley 19
Boothstown & Ellenbrook 20
Life Expectancy
2
LE Gap LE Gap LE Gap LE Gap
Men 71.6 -3 73.4 -3.1 73.8 -3.1 74.2 -3.1
Women 77.3 -2.4 78.3 -2.6 78.4 -2.7 78.7 -2.8
2003-05Baseline 1995-7 2002-04 2004-06
Employment and worklessness
64.5
67.7
65.1
66.967.9
71.2
67.3
68.5
60
62
64
66
68
70
72
1997/98 1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05
Year
% i
n e
mp
loy
me
nt
Employment Rates in Salford, 1997-2005
Income support Claimants in 2006
Of 13,330 people claiming benefits, over half have being doing so for 5 years or more
Worsley has 135 claimants - Little Hulton 1060.
Nearly 3,000 claimants are aged between 50 and 59 years
Females significantly outweigh males
Young peopleIndicator North West Rank
Emergency hospital admission - males 4Special educational needs (statements) - secondary schools 4Hospital admission for lower respiratory tract infection - males 5Special educational needs (statements) - primary schools 5Hospital admission for asthma - males 6Emergency hospital admission - females 8Hospital admission for lower respiratory tract infection - females 8Child Protection Plan subjects 14Fixed period exclusions - secondary schools 30Authorised absence - secondary schools 32No decayed, missing or filled teeth - 5 year olds 34GCSE achievement 34Hospital admission for alcohol-specific conditions - males 38Income deprivation affecting children 39Lone parents with dependent children 39Absence - primary schools 39No decayed, missing or filled teeth - Year 6 40Conceptions 40Dependent on key benefits 40Unauthorised absence - secondary schools 41Measles incidence 42Obesity - Year 6 females 42Children looked after 42Permanent exclusions - secondary schools 43
Older people
Current & projected prevalence of dementia (estimates)
30-64 65-74 75+ Total % of people 65+ with dementia % of all people with dementia
2007 50 370 1845 2266 6.53 1.05
2021 55 384 2022 2461 6.76 1.14
Social Care needs
2008 2010 2015 2020 2025
Number of older people helped to live at home 4,048 4,035 4,255 4,340 4,560
Number of households receiving intensive home care for people aged 65 and over
763 761 802 818 860
Number of older people receiving community-based services provided or commissioned by the CSSR
6,090 6,072 6,402 6,530 6,860
Total number of older people in residential and nursing care during the year, purchased or provided by the CSSR
1,572 1,567 1,652 1,685 1,770
Number of older people admitted to supported permanent residential and nursing care
98 98 103 105 111
Number of carers aged 65 and over receiving services 487 486 512 522 549
TOTAL 15,066 15,029 15,741 16,020 16,735
SmokingGtr. Manchester Salford
Population 2,531,00 216,400
Smokers >16 540,000 46,170
£ spent by >16’s £629,000,000 £53,779,500
Smokers requiring hospital treatment 30,732 2,628
Hospital bed days due to smoking 92,722 7,928
Cost of hospital admissions due to smoking £37,000,000 £3,163,500
Cost of outpatient follow-up for smokers £4,600,000 £393,300
Deaths due to smoking 6,440 551
Life Years lost 34,000 2,907
Cost of premature deaths £94,000,000 £8,037,000
Working days lost due to smoking-related illness 1,500,000 128,250
Cost to business of smoking related illnesses 105,000,000 £8,977,500
Costs to business of cigarette breaks 364,000,000 £31,122,000
New jobs yielded by 40% reduction in smoking 5,750 492
Additional wages generated by new jobs 107,000,000 £9,148,500
Overall cost of smoking the local economy £630,000,000 £53,865,000
Potential savings yielded by a 1% fall in smoking 344,000,000 £29,412,000
Estimates from Dept. of Health North West Public Health Group Regional Tobacco Policy Team
Cardiovascular disease
Deaths before the age of 65 which are caused by heart disease and stroke
SMR
England & Wales 101
England & Wales 100
North West of England 120
Salford 151
SMRs for Heart Disease and Stroke in under 65s
StrokeStroke Mortality, Salford 2003-2006
England & Wales
North West
SalfordEngland & Wales
North West
SalfordEngland & Wales
North West
Salford
2003 128 148 196 126 141 168 127 144 1782004 115 133 165 115 124 152 115 128 1572005 107 119 146 108 116 140 108 117 1422006 100 115 144 100 113 133 100 114 137
Male Female All
Respiratory diseases
2008 2010 2015 2020 2025
Total population aged 65 and over predicted to have a longstanding health condition caused by bronchitis and emphysema
727 725 774 787 833
Cancer
SMRs for Common cancers in Salford, 2004-2006
Male Females PersonsBladder 41 126 64Breast N/A 84 N/ACervix N/A 213 N/AColon/Rectum 155 88 126Leukaemia 139 74 115Lung 158 214 180Malignant Melanoma 176 20 113Oesophagus (Gullet) 159 136 153Prostate 93 N/A N/AStomach 118 163 132
Alcohol
N.West
No. of hospital admissions
RateNational
RankRate
National Rank
RateNational
RankRate
Alcohol-specific hospital admission, under 18s
165 115.96 329 88.96 286 94.7 297 98.35
Alcohol-specific hospital admission, males
721 661.94 343 809.31 353 915.06 354 536.3
Alcohol-specific hospital admission, females
340 321.88 343 346.57 347 421.73 353 270.13
Salford Manchester Liverpool
N.West
No. of hospital admissions
RateNational
RankRate
National Rank
RateNational
RankRate
Alcohol attributable hospital admission, males
1,652 1,476.44 348 1581.45 353 1708.37 354 1,214.55
Alcohol attributable hospital admission, females
1,045 804.19 348 815.42 350 873.78 354 674.35
Salford Manchester Liverpool
Hospital admissions due to alcohol, Salford with comparators 2005-6
Obesity
Obesity in Salford 2007/08
Salford England Salford England
Obese 14.50% 10.00% 22.45% 23.70%
Overweight 15.00% 25.00% 39.00% 22.50%
Obese and overweight 29.50% 32.50% 61.45% 46.50%
Children Adults
Mental health• In the UK, there are now more mentally ill people drawing
incapacity benefits than there are unemployed people on Jobseeker’s Allowance
• ONS figures suggest that there are currently nearly 21,000 people in Salford being treated for depression
• Anxiety and depression remain a considerable burden to elderly people in whom this aspect of health should be considered as high a priority
Hospital admission and community careAdmissions
Too few Too many
Arthritis of the knee Chronic bronchitis and emphysema
Arthritis of the hip Lung cancer
Skin cancer Bladder cancer
Prostate cancer Heart failure
Mental health conditions
Alcohol
Back pain
Procedures performed
Too few Too many
Knee replacement Gastroscopy
Hip replacement Hysterectomy
Skin lesion removal Tonsillectomy
Prostatectomy Drainage of middle ear
Angiography
Revascularisation
Sigmoidoscopy
Key health priorities:
• Circulatory Disease• Cancer• Respiratory Disease• Mental Health• Alcohol• Obesity
Future Agendas• Wider engagement• Clearer governance• Integration into planning approaches• Access to data which underpins it