Improving Children’s Health and Wellbeing in the West Midlands

Feedback from survey

Present

To what extent did the JSNA really affect the priorities of the Health and Wellbeing Strategy?

• Mixed response• Where JSNA did affect the priorities– Clarity of link – Order of development– Having consistency of Officer involvement

• Challenges– Speed of development – Work in progress

How to improve the development of JSNA/ Health and Wellbeing strategy

• Wider consultation• Linking key health risks to key Marmot themes• Contract Monitoring to align service/team

impact to strategic priorities• Dynamic relationship between JSNA and

Outcomes frameworks

Best features of JSNAs

Data• Identifying the level of need in the population and Priority Neighborhood profiles• Level of Detail from overview to comprehensive data depending on their

individual requirements.• Comprehensive coverage of topics

Presentation• Dynamic website, • The way the information is presented in layers on website- Overview to allowing

visitors to a greater level of detail, maps, data, etc, depending on their individual requirements.

Process• Collaborative process, • Senior manager buy in

Possible additional priorities for the H&WB Strategy

• Qualitative indicators for child health• Increase scope to incorporate deprivation in a

wider context.• Focus on life course

• Some respondents requested a decrease in the number of priorities

How will the H&WB Strategy really direct the services commissioned?

• By governance through the HWBB • Focusing on the priorities • Having teeth and being part of the DNA of the LA• Encouraging joint commissioning• Assigning a Board member as "champion" for each of the

outcome areas.• Agreeing the monitoring process• Informing Public Health Priorities

Challenges• Public Health Priorities smaller list• Interface between professional and public/patient

Improving the Health and wellbeing strategy

• Having a Strategy• Wide spread consultation and engagement in

the Strategies development• Communicating Strategy to stakeholders/ Staff• Refreshing Strategy once Board members

established / board matures• More detail

Best aspects of Health and Wellbeing Strategies

• Clear Governance Structures in place• Identify work areas for priority• Consultation with key stakeholders• Links to other Strategies, Plans and priorities.• Evidenced based targeted on clear and validated

data• Short, easy to read, comprehensive• Whole system approach

Improving existing Governance arrangements

• Awaiting the Governance Structures for CCGs. • Alignment of local structures/governance• Ensuring all stakeholders are fully represented• Improved communication between Boards

Managing relationships across the complex system

• Health and Wellbeing Board critical role• Being Active rather than passive• Focus collaboration on specific themes/ Services• Ensuring strong collaborative relationships exist at all levels of

structure.– Regular contact, – Mutual trust and respect,– Transparency, – Genuine desire to work differently – Commitment to new arrangements.

• Strong links in place based on existing working relationships– relationship building between key individuals where these don’t exist

Strengths of current joint commissioning

• Health Visiting services working in Children's Centres– Family and Child Centred – Sharing skills and expertise

• Joint commissioning posts– Enables all perspectives to be afforded equal importance

• School nursing service– Regular meetings with commissioners from health & LA

Strengths of current joint commissioning (Cont)

• Multi Agency Panels– Multi-agency group – Single Focus. All three agencies fully committed.– Budget Holders– joint decision

Examples• Joint Solutions Panel

– Pooled Budget to support children with complex needs – Focus on sourcing better, cheaper, more local solutions to meet needs.

• Children and Young Person's Substance Misuse Group.– Comprehensive needs assessment process.

• Women and Children's joint commissioning group – Includes council's and NHS Provider services

Future Priority areas For joint commissioning

• Social support in pregnancy and early years• Children's integration with adult

commissioning• CAMHS, • School nursing, • Health Visiting• 0-19 Healthy Child Programme

Examples of joint delivery that are working well

• JSNA• Triaging arrangement involving children's

social care, health and police.• Obesity• Targeted Youth Support Panel• Sexual Health Services• CAF

Areas for further integration of delivery

• Priorities within HWB strategy• Having an holistic approach to an individuals health and wellbeing.• 5-19 healthy child programme• Front line and preventative services

• Specific areas– School nursing, – Health visiting– CAMHS – Early years -Children’s centres, – Schools and colleges,– Youth services

Sharing best practice: Warwickshire County Council JSNA Website

Sharing best practice: Dudley’s Joint local protocol between adult drug and alcohol

treatment services and local safeguarding and family services. :

Link

http://safeguardingchildren.dudley.gov.uk/information-for-professionals/safeguarding-children-procedures/children-in-special-circumstances/?assetdet549=106104

Sharing best practice: • CAMHS

West Midlands– Warwickshire and Coventry Tier 2 Targeted Services for Mental

Health (TAMHS),– Wolverhampton Tier 3+– Worcestershire Service redesign

National• SE Scotland redesigned Tier 4 across 3 NHS Board areas (Lothian, Fife,

Borders)• Tendering of Tier 2, 3 and 4 services

Sharing best practice: Public Health (0-5)

– Family Nurse Partnership Programme (FNP)– Costs of the FNP are typically around £3200 per supported family per year

based on supporting a caseload of 100 families.– Stoke, Staffordshire, Telford & Wrekin, Walsall, Birmingham, and Dudley.

YP Substance misuse• National Treatment Agency Guidance and Best Practice

– http://www.nta.nhs.uk/young-people.aspx• London CAMHS Substance Misuse Specialist Service –(3 Las)• Stoke

– Outcomes Based Commissioning• Worcestershire

– payment by results– recovery based– outcome focused contract.

Sharing best practice: • Disabled Children’s Services and complex health needs

– Personalisation– http://

www.opm.co.uk/wp-content/uploads/2012/10/MIP-word-doc-of-pdf-final-Oct-2012.pdf

• Teenage pregnancy (and sexual health)– http://www.respectyourself.info/

Joint commissioning of sexual health services• Solihull and Birmingham (4PCTS)• London Sexual Health Programme

– http://www.londonsexualhealth.org/about-us.html• Yorkshire and Humber

– http://www.yorksandhumber.nhs.uk/what_we_do/improving_the_health_of_the_population/sexual_health/

•

Links to JSNABirmingham City Council http://bhwbb.net/wp-content/uploads/2012/09/New-One-JSNA-SUMM

ARY-2012-final.pdfCoventry City Council http://www.coventrypartnership.com/upload/documents/news/PIE%2

0GROUP/JSNA%202012.pdfDudley MBC http://www.dudleylsp.org/jsna/

Herefordshire Council http://www.herefordshire.gov.uk/factsandfigures/docs/Research/JSNA_2011_Key_points_and_Recommendations_(V1.2).pdf

Sandwell MBC

Shropshire Council http://shropshire.gov.uk/jsna.nsf/viewAttachments/JSHW-8WLCEF/$file/Shropshire_JSNA_SummaryDocument_2012.pdf

Solihull MBC http://www.solihull.gov.uk/akssolihull/images/att14595.pdf

Staffordshire Ccunty Councilhttp://www.staffordshire.gov.uk/health/PublicHealth/Staffordshire-Needs-Assessment-2012.pdf

Stoke-on Trent City Councilhttp://www2002.stoke.gov.uk/planning_uploads/Joint%20Strategic%20Needs%20Assessment%202011.pdf

Telford and Wrekin Council

http://www.telford.gov.uk/downloads/file/4286/discussion_1-priorities_and_new_ways_of_working_to_improve_the_health_and_wellbeing_in_telford_and_wrekin

Walsall Councilhttp://cms.walsall.gov.uk/observatoryindex/wpo-needs_assessments/wpo-jsna.htm

Warwickshire County Council http://jsna.warwickshire.gov.uk/

Wolverhampton City Councilhttp://www.wton-partnership.org.uk/UserFiles/File/JSNA%202009%20Update.pdf

Worcestershire County Council http://www.worcestershire.gov.uk/cms/pdf/JSNA-Summary-2012.pdf