Ealing Local Strategic Partnership
Report for Executive Board: 26th July 2010

Title:JSNA Update

Report from: LBE Policy and Performance
Author: Ann Griffiths and Dami Awobajo / Item number
3
Background:
Ealing Council and PCT have a statutory duty to produce a Joint Strategic Needs Assessment (JSNA), considering the health and wellbeing needs of the local population over the next 3-5 years and beyond. This is expected to be updated periodically and to be used to inform effective health and wellbeing strategies, commissioning and delivery in the borough.
The production of the JSNA in Ealing is currently managed through a project group consisting key stakeholders across the PCT and Council. The 2010 JSNA is well underway, with data collection complete, analysis underway, and drafting of a JSNA document in progress. This is being developed closely alongside the Children and Young people’s Plan, Adults Commissioning Strategy, and other key strategies to be considered over the coming year, with a view to ensuring that information is used to best possible practical effect.
This brief report provides an update on progress of the JSNA in Ealing and will be accompanied by a presentation outlining key findings and messages from the JSNA to date.
Purpose of Report:
This report is intended to:
  • provide an update to LSP Executive partners on the progress of the 2010 JSNA in Ealing, to raise awareness of the JSNA and its potential
  • seek feedback as to partners’ views on the JSNA’s potential use and practical development
  • seek input from partners as to useful sources of information and analysis available currently, or which we may wish to include in the future
Recommendations:
That LSP Executive:
  • consider the update on the JSNA and provide feedback as to areas for development
  • consider and identify opportunities for partners to contribute to the JSNA’s development and use of its findings
  • provide information which may be useful to inform the JSNA
  • agree to consider a further report on the JSNA in the autumn meeting of LSP Executive, where reflections on lessons learned and proposals for future development of the JSNA will be provided, taking into account any developments in national policy by this time.
Report Body:
Background to the JSNA
The Local Government and Public Involvement in Health Act 2007 introduced a statutory duty on local authorities and PCTs to produce a Joint Strategic Needs Assessment (JSNA), considering the health and wellbeing needs of the local population over the next 3-5 years and beyond.
At present, this requirement still stands and there have been no indications at this stage as to how this might change as the forthcoming changes to public health are implemented.
The JSNA is intended to provide a robust source of information to enable evidence-based decision-making, service planning, commissioning and provision. Its ultimate objective is to provide health and social care services that genuinely meet local needs, tackle inequalities and effectively promote health, well-being and social inclusion.
Regardless of future changes in health there will continue to be a value in having some form of coherent, joint needs assessment of the factors and concerns affecting our communities with regards to health and wellbeing, which informs effective health and social care strategies, commissioning, and service delivery.
The production of the JSNA in Ealing is currently managed through a project group consisting key stakeholders across the PCT and Council, with representatives from other organisations participating as appropriate. This group meets fortnightly to consider progress and agree next steps. The project also reports regularly to the HIP and periodically to other partnerships, overseeing the broad progress of the project.
All partners are responsible for ensuring that key information and tasks are carried out as required across their organisations in order to inform an effective JSNA process that genuinely informs key commissioning strategies for Ealing, including the Sustainable Communities Strategy, the Children and Young Person’s Plan, the Health and Well-being Strategy, the Integrated Adults’ Commissioning Strategy, and the NHS Strategic Plan.
2010 update of the JSNA
There is an expectation at the JSNA will be refreshed as often as necessary, and at a minimum, every three years. Since the publication of Ealing’s previous JSNAs, new data has become available, the emphasis on increasingly good evidence is increasing, and the development of new strategies and plans is increasingly emphasising the importance of robust evidence to inform future commissioning.
In response to these needs, Ealing Council has worked with its partners to run a project to deliver the JSNA since late in 2009, focussing on a genuinely joint process to collect, analyse and use wide ranging evidence to inform priority setting, service commissioning, and service delivery. The project was refocused in early 2010, aiming to ensure that all work on the JSNA added value, and delivered a genuinely action-focussed approach to ensuring that information on health and social care needs informs future strategic commissioning and planning as effectively and efficiently as possible, across organisations.
Progress to date
The project group’s priority focus in the first half of 2010 has been to collect and analyse data, develop initial drafts of a JSNA document, instigate technological developments to enable a future online JSNA, and to engage in ongoing discussions with commissioners to ensure future products meet the needs of services and local people.
The initial data collection stage of the work for this year’s JSNA is now complete. Analysis is largely complete, with partners continuing detailed analysis on some areas of high priority, identified through colleagues working on aligned strategies, such as the CYPP.
Initial drafts of the JSNA document are now underway, with project group discussions over the coming months intended to focus these drafts, ensure that information is provided in a way that meets local needs, and continue to inform active work to improve health outcomes in the borough.
Overall progress to date has included:
  • Sign off of revised project plan, PID, and process diagram for the 2010 JSNA project set out in detail how the project is intended to go forward this year to deliver improved outcomes.
  • Initial and ongoing meetings between project team and commissioners to identify key milestones and priority areas for working together.
  • Survey sent out to end users to collect information on user needs and priority JSNA content – responses used to update project plan. (Information on responses and strategies that JSNA will inform provided as an appendix)
  • Priority commissioning timetables informing our initial focus over the coming months are confirmed as follows:
  • Adults Integrated Commissioning strategy: analysis to inform drafting of strategy in July/August, consultation during Sept/Oct and redrafting Nov/Dec, for final sign off Jan – Mar 2011.
  • CYPP – undertake needs assessment and consultation required May - Oct, for final drafting Oct-Dec and consultation from Jan 2011, sign off April 2011
  • Children’s Services JSNA workshop, led by the DCSF, to identify needs and data gaps; CYPP priority setting day on 25 February 2010.
  • Progress on technical solution for the final JSNA repository – ‘business objects’ developed to provide an interactive tool that can be loaded up onto external website for access to all, alongside reports and needs analyses.
  • In the meantime, a ‘Communities of Practice’ webpage has been set up to host interim data sets and analysis.
  • Core and previously identified additional data sets collected and uploaded to interim data repository
  • Analysis underway and discussions ongoing with regards to prioritisation, support and development. All analysis to date available on Communities of Practice website.
  • Gaps and areas for further development in future data collection, analytical focus and planning being identified – for example, children with complex needs. Input of existing data, analysis and developments into first drafts of strategies and plans.
  • Full Equalities Impact Assessment drafted and signed off by project group. VCS Equalities Reference Group considered in early June 2010 and gave positive feedback (EIA available for more information as required)
  • Stakeholders asked to consider their existing and planned consultation and engagement in order to consider how engagement on JSNA can be included and developed – engagement underway to ensure that drafts of JSNA are consulted on and final documents developed in line with partners’, services’, and residents’ needs.
Attached appendices show the outline of the JSNA document as proposed to date, and show an outline narrative of the key messages flowing from this year’s JSNA.

Next Steps

Throughout the past month the project group has focussed on collating all existing data and analysis and considering gaps, quality assurance, and further development required. More recently a draft JSNA documents has begun to be drafted (data collection, analysis and drafting of document led by Dami Awobajo), for discussion by the project group over the coming month to September 2010, and for publication in the latter parts of 2010.
Next steps for the project group are to:
  • reconfirm (after discussion as required) the final layout and content of the analysis for the JSNA, to meet all users’ needs, including the format in which we would like the JSNA to be presented and uploaded on the web
  • agree the narrative of the JSNA and the priority analysis and information to be included
  • continue to work closely with commissioners to ensure the information collected informs development of key strategies and commissioning plans in development
  • continue development of the web-based solution for providing the public face of the JSNA – anticipated at present to be possible by the end of the year, which will enable people to access a range of data online and to manipulate this to meet specific issue or area-based needs
  • continue engagement with partners and the public, considering the information from project members on recent and planned consultation and communications, and participating in consultation
In the longer term, discussions and future planning will ensure that plans are in place to sustain the development and updating of the JSNA over coming years, that public and service users are increasingly involved in the development of future JSNAs, and that the website hosting the JSNA becomes increasingly developed and well used to inform evidence-based planning for the future.
APPENDIX 1: Strategies and plans to be informed by the JSNA
Key questions: How much of this will we be providing anyway?
What can we do to collect the data that is not currently captured and make plans for this to occur on a rolling basis in the future?

STRATEGIES

/

TIMESCALES

/

INFO REQUIRED

Work and Skills plans, Local Economic Assessments – informing commissioning, bids, projects /
Summer 2010
/ Child poverty, edu. outcomes, benefit claimants, employment, destinations post-16 – specifically more info on families in poverty, including those in private accommodation; language and skills levels of those in poverty.
Ealing Hospital Trust Commissioning Plans / February 2011 (annual) / Commissioning intentions Ealing and West London.
PCT strategic plan (annual) / December 2010 (annual) / JSNA completed to DH guidance.
Particular emphasis on improving quality of info relating to Children.
Health inequalities, and analysis according to equalities strands, service use.
Future projections of key health conditions.
Info to help target initiatives.
e.g. Maternity services – info on low birth weight and extent and type of related complications; extent of maternal obesity in pregnancy; incidence and distribution of anaemia and vit D deficiency; post-natal depression incidences.
PCT commissioning strategy: PD/SI, HSC grants, investments / Autumn 2011 / Health needs analysis, disability population and distribution by ward, gender, demand for PD and other services, number of people with acquired brain injuries
Tobacco Control Strategy /
Summer 2010
/ Tobacco use analysis, interventions to control and reduce
CYPP
(also Commissioning strategy for LAC, care leavers, SEN; Parenting Strategy; CAMHS strategy) / Jan 2011 signoff, drafting May-Oct 2010 / Child health
Prevalence rates, e.g. of mental ill-health and disability – complex health needs
Housing Strategies / Ongoing / Children in temporary accommodation, overcrowding, special needs housing. Links between overcrowding and poor health prevalence. Domestic violence rates and locations.
Adults Integrated Commissioning strategy / April 2011 sign off, drafting begins June 2010 / Demographic info about clients, e.g. disabilities, mental health, older people.
Existing commissioning activity, service use, service demand, unmet need and service spend. Health, employment, carer prevalence and projection info. Third sector activity info. Information about customer preferences.
Crime Prevention strategies / Ongoing / Risk factors for young people and adults. Links between poor health / wellbeing, poverty and crime.

APPENDIX 2: Proposed Sections of Ealing JSNA

SECTION 1 – Background to JSNA

Executive Summary

SECTION 2 – Population characteristics and change

Population characteristics

Young People

Older People

Specific Health Needs associated with ageing

Births

Ethnicity

Religion

Migrant Populations

Housing

Fuel Poverty

Employment

Disability

SECTION 3 - How do we compare with similar local authorities

Life Expectancy

All Cause Mortality

Circulatory Disease

All cancers

COPD

Stroke

CHD

SECTION 4 – Socio-economic Factors

Socio-economic factors within Ealing

Index of Multiple Deprivation

Overall Index of Multiple Deprivation 2007

Income Deprivation - IMD 2007

Income Deprivation Affecting Older People – IMD 2007

Income Deprivation Affecting Children – IMD 2007

Employment Deprivation - IMD 2007

Health and Disability Deprivation - IMD 2007

Education Skills and Training Deprivation - IMD 2007

Barriers to Housing and Services - IMD 2007

Crime - IMD 2007

Living Environment - IMD 2007

Air Quality

Community Health Profiles

SECTION 5 – Life Expectancy

Life Expectancy

Healthy Life Expectancy

Disability Free Life Expectancy

Conditions with Most Impact on Life Expectancy

All Age All Cause Mortality

Main Causes of Death

SECTION 6 – Burden of Disease

Circulatory Disease

CHD

Cancers

Chronic Obstructive Pulmonary Disease

TB

Stroke

Mental Health and Suicides

Infant Mortality

Risk taking behaviours

Alcohol related harm

Deaths attributable to smoking

Drug Misuse

Sexual Health

Healthy weight/Obesity/Diabetes

Immunisation

SECTION 7 – Children and Young People

Infant Mortality

Low birth weights

Smoking during pregnancy

Breastfeeding

Under 15 mortality

Emergency admissions for under 19

Child Dental health

Obesity

Substance misuse

Teenage conceptions & Sexual health

Health schools

LAC

Road safety

Serious injury admissions

Education KS1 & KS4

Youth offending

Exclusions

Racism and bullying

NEET

Income Deprivation Affecting Children – IMD 2007