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Agenda item

Joint Strategic Needs Assessment and the District Needs Assessment (Lesley Wyman)

Purpose: To present a snapshot of the JSNA, which includes any changes the Board needs to be aware of.

Minutes:

The Board considered a report (Agenda Item 11) concerning the process of merging the Joint Strategic Needs Assessment (JSNA) with the District Profile and to share some of the latest data on JSNA chapters.

The JSNA used data and evidence about the current health and wellbeing of residents in West Berkshire and highlighted the health needs of the whole district. Councils and Clinical Commissioning Groups (CCGs) had an equal and joint duty to prepare JSNAs as part of the NHS reforms outlined in the Health and Social Care Act 2012. In West Berkshire this process was overseen by the Health and Wellbeing Board. The JSNA was the key source of information which was used by the Health and Wellbeing Board to agree the priorities within the Health and Wellbeing Strategy.

The structure of the JSNA took a life course approach and focused on the demographics of the West Berkshire population and information about different groups of people throughout their life. The main sections including demography were starting well, which was about giving children a healthy start in life and laying the groundwork for good health and wellbeing throughout life; developing well, which focused on children and young people aged between 5 and 19 years, detailing what affects their health; living well, which looked at general health and wellbeing of adults, including lifestyles and health protection; ageing well, providing information about the health of people aged 65 and over and finally a section on the wider determinants of health and vulnerable groups.

Information and data about many of the wider determinants of health were available for West Berkshire in the form of a District Profile. This had been produced locally for a number of years and had provided a wealth of facts and figures that could also be used to guide commissioning of services within the district. There were considerable overlaps between the JSNA and the District Profile resulting in the decision to bring together these two key documents into a District Needs Assessment (DNA).

A strict version control process would  be employed whereby each section of the DNA would be allocated to a designated data provider who would be responsible for the updating of information/data when it became available. The Research, Consultation and Performance team within West Berkshire Council would oversee this process, with  updates being released on a quarterly basis and version control documentation logging the changes made and the version reference number.

A solution would be explored for presenting the key findings as part of a high level summary (e.g. info graphics). This would be accessible for a wider audience and would enable them to get an effective overview of the District, the needs of communities and gaps in services.

Cathy Winfield advised that it would be of benefit to CCGs to receive headline data in September as they began to prepare their budgets for the following financial year in the autumn. Lesley Wyman agreed that data could be provided to all partners in September.

Rachael Wardell posited that a key issue was that it was difficult to make visible the positive impact of public health programmes. For example, the quality of the delivery within schools of these programmes was clear however those Not in Employment, Education, or Training (NEET) were difficult to engage. The district had an advantaged population on the whole however, there was a need to ‘close the gap’ between the advantaged population and the less advantaged.

Lise Llewellyn commented that a disadvantage of the JSNA was that the data presented a negative slant on the population, whereas the DNA might be more positive.

Councillor Lynne Doherty questioned the timeliness of the data available, for example some figures cited that they referred to 2012/13 and others 2013/14. She asked that a note be included with data to advise whether it was the most current data available.

Lesley Wyman referred to the Public Health outcomes framework which did have a ‘time-lag’. She advised that an advantage of the DNA would be that updated information would be immediately published. Information on what action was being taken by health partners to rectify concerning data trends could also be included.

Rachael Wardell commented that in the current financial climate there needed to be clear evidence of the ways in which public money effected outcomes. However the positive impact of some services might not be known until the funding and the programme was withdrawn.

Cathy Winfield drew attention to the information in the report that the rate of young people who smoked was increasing. She also noted the information on cancer trends, which indicated that West Berkshire was an outlier. Lesley Wyman added that the under 75 mortality rate was consistent and being monitored. Dr Lise Llewellyn commented that Public Health Berkshire had produced a cancer profile which was specific to each CCG area.

Councillor Graham Jones drew attention to the statistic on page 70 of the agenda which reported that two thirds of West Berkshire residents were overweight or obese. He identified a link between this figure and the information that 10% of NHS spending was for diabetes related illnesses. Councillor Jones was alarmed that such a proportion of the resource was targeted at treating this area of illness rather than preventative measures. Lesley Wyman agreed that obesity was the biggest challenge in public health and the Health and Wellbeing Board’s next hot focus session would be on the topic.

Rachael Wardell stated that she would like to see a clearer distinction between obesity and being overweight, arguing that West Berkshire’s rates of obesity were better than the national average. It was felt that focussing on those who were overweight might be counterproductive. Dr Lise Llewellyn agreed that the overall health of those who were overweight and active was better than those who were of a normal weight and inactive, however people with obesity would find it very hard to be active. Councillor Roger Croft remarked that if using Body Mass Index as an indicator, most rugby players (who were very active) would be considered to be technically obese.

Councillor Jones summarised that there was an increase in health issues associated with lifestyle issues.

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