jsna 29th sept (mike link & ed cassidy)
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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.
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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.
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