Archived decisions

HAMPSHIRE COUNTY COUNCIL

Decision Report :

EXECUTIVE SUMMARY

1) Summary of Decision Area:

1.1. Since 1 April 2008, local authorities and PCTs have been under a statutory duty to produce a Joint Strategic Needs Assessment (JSNA) of the population's health and social care needs. The JSNA will inform the Local Area Agreement and Sustainable Community Strategy and provides a valuable evidence base for use by all county council services. It will also be an important tool to assist with more effective partnership working between Hampshire County Council and Hampshire PCT, to tackle inequalities and improve outcomes across the county.

1.2. It is the responsibility of the Director of Adult Services, the Director of Children's Services and the Director of Public Health to jointly produce the JSNA.

1.3. This report presents to the Cabinet Hampshire's JSNA, and asks for Cabinet's approval of the document.

2) Issues Covered in Report:

2.1. This report sets out the context for the JSNA, the purpose of the document, and outlines the key emerging themes for the people of Hampshire. The Executive Summary of the JSNA is attached as an Appendix to this report.

3) Recommendations:

It is recommended that:

3.1. Cabinet approve the Hampshire County Council/Hampshire PCT Joint Strategic Needs Assessment.

MAIN REPORT

1) Purpose of the Report:

1.1. This report presents to the Cabinet Hampshire's Joint Strategic Needs Assessment (JSNA), and asks the Cabinet to approve this document.

1.2. The JSNA brings together a wide range of data to tell the story of health and wellbeing needs in Hampshire. It begins to give a much greater understanding of the inequalities and the health and social care needs that exist within Hampshire's population, so that priority setting and strategic decision making can be undertaken with a much more robust evidence base in future.

1.3. It will also be an invaluable tool to assist with the development of more personalised services across the County, in line with the Government's Transformation Agenda for Social Care and the NHS World Class Commissioning Programme.

For reasons of practicality, the Executive Summary rather than the full JSNA (172 pages with additional appendices) is attached to this report. The Executive Summary identifies the key themes emerging from the data. The full JSNA can be obtained from the Director of Public Health.

2) Contextual Information:

2.1. The Local Government and Public Involvement in Health Act (2007) places a duty on upper tier local authorities and primary care trusts (PCTs) to undertake a Joint Strategic Needs Assessment (JSNA). This is a new process which follows national guidance issued in December 2007, in which the JSNA is described as `a systematic method for reviewing the health and well-being needs of a population'.

2.2. The responsibility for the development of the JSNA lies with the Director of Adult Services, the Director of Children's Services and the Director of Public Health.

2.3. The Department of Health stipulates a core data set of information that must be included in the JSNA, and this requirement has been followed. The latest version of the core dataset was published in August 2008. Wherever possible, data have been analysed at district authority level or below.

2.4. In compiling the JSNA, care has been taken to ensure that there is synergy between its emerging themes and the Sustainable Community Strategy, the LAA, the refresh of the Children and Young People's Plan, the PCT strategy `Healthy Horizons' and joint commissioning and wellbeing strategies.

2.5. Officers from Hampshire County Council's Adult Services Department and Children's Services have been collaborating with Public Health colleagues at Hampshire PCT to bring together the data for the JSNA, and this in itself has been an effective catalyst for strengthening partnership working across the two organisations.

2.6. Consultation with stakeholders has taken place during the development of the JSNA and further consultation is planned through the Third Sector. Opportunities to present the emerging findings to the Children & Young People Select Committee, the Safe and Healthy People Select Committee and the Health Overview and Scrutiny Committee have been put in place and further arrangements will be made for an all-member briefing session in early 2009.

3) Key Issues:

3.1. The key emerging themes arising from the JSNA are:

a) The changing population profile of Hampshire

b) Health and health inequalities

c) Deprivation

d) Lifestyle and modifiable risk-taking behaviours

e) Social care need

f) Children and inequalities

3.2. The attached Executive Summary outlines the key headlines for each of the above emerging themes.

3.3. The collation of the data in the JSNA has revealed a marked variation in terms of health and social care indicators, as well as variations in the key determinants of future health and well-being such as deprivation, children living in poverty and educational achievement. For example, life expectancy for men in particular varies quite markedly across the county, with Hart having the highest life male expectancy at 80.7 years and Gosport having the lowest at 77.2. There are also striking differences in educational attainment across the county. For example, the proportion of pupils attaining five or more GCSE grades A*-C is 74.4% in Winchester but only 46.1% in Gosport. The data also show some trends which are surprising, for example, the highest estimated prevalence of hazardous drinking is in Hart (the least deprived district area in the whole of England), and eight out of 11 of Hampshire's districts have estimated hazardous drinking levels higher than the England average.

3.4. Identifying unmet need is, however, as important as identifying need. The potential for unmet need is harder to quantify, but analysis of the JSNA data, along with information on patient and public voice and experience, and social marketing data, will all contribute to a much clearer understanding of future needs of the population.

4) Outline of Options:

4.1. Production of the JSNA following a core dataset is a statutory requirement, therefore an outline of the options is not applicable.

5) Option Analysis / Comparison:

5.1. Not applicable.

6) Conclusions:

6.1. The JSNA brings together for the first time data and intelligence on both the social care and health needs of Hampshire residents. It also starts to explore the use of social marketing techniques, such as the Mosaic tool, to further understand the characteristics of the people of Hampshire, which when linked to the health and social care data will help provide much richer intelligence to inform commissioning and service development in the future. For example, Mosaic can help identify likely parts of the county where older homeowners may be struggling on low incomes, but have significant equity in their homes (in other words, asset-rich but income poor).

6.2. The JSNA highlights a number of key themes, including the predicted increase in the number of older people in Hampshire; and variations between district authorities in indicators relating to health inequalities. Havant and Gosport are consistently shown to be the most disadvantaged district areas in Hampshire.

6.3. The JSNA's findings highlight key challenges facing both the people in Hampshire and the agencies providing health and social care services. However, there is a real opportunity for these agencies to work closely together on models of care that will meet these needs.

6.4. The next steps in the process are wider consultation with the voluntary sector, with county council members, and other partners, to engage people in the findings of the JSNA and to look at emerging priorities and actions to deliver improvement where needed. Stakeholder views will be incorporated into a draft Health & Wellbeing Strategy which will go out to consultation in Spring 2009, under the leadership of the Health & Wellbeing Partnership Board, co-chaired by Councillor Felicity Hindson, Executive Member for Adult Social Care, and Professor Jonathan Montgomery, Chair of Hampshire PCT.

7) Recommendations:

7.1. That Cabinet approve the Hampshire County Council/Hampshire PCT Joint Strategic Needs Assessment.

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