Although a formal committee of Brighton & Hove City Council, the Health & Wellbeing Board has a remit which includes matters relating to the Clinical Commissioning Group (CCG), the Local Safeguarding Board for Children and Adults and Healthwatch.
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Title:
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Annual Joint Strategic Needs Assessment (JSNA) programme update
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Date of Meeting:
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12/07/2022 |
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Report of:
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Alistair Hill, Director of Public Health |
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Contact:
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Caroline Vass, Public Health Consultant
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Tel: 07717 303300
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Email:
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Wards Affected:
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All |
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FOR GENERAL RELEASE
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Executive Summary
Since April 2013, local authorities and CCGs have had equal and explicit obligations to prepare a Joint Strategic Needs Assessment (JSNA) which provides a comprehensive analysis of the current and future needs of local people and is used to inform commissioning of services that will improve outcomes and reduce inequalities.
This duty is discharged by the Health & Wellbeing Board and up to the onset of the Covid-19 pandemic in 2020 has been overseen by the City Needs Assessment Steering Group.
The Director of Public Health submits an annual update on the JSNA programme to the Health and Wellbeing Board.
This year, the annual JSNA programme update comprises:
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Glossary of Terms JSNA – Joint Strategic Needs Assessment JHWS – Joint Health and Wellbeing Strategy PNA - Pharmaceutical Needs Assessment |
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1. Decisions, recommendations, and any options
1.1 That the Board note the annual JSNA programme update.
1.2 That the Board agree the next steps of the steering group to review and develop the JSNA structure and proposed three year programme of in-depth needs assessments for 2023/24 to 2025/26.
2. Relevant information
2.1 Needs assessments provide a comprehensive analysis of the current and future needs of local people to inform commissioners and providers how they can improve outcomes and reduce inequalities. They also ensure that health strategies, including the Joint Health & Wellbeing Strategy, are based on high quality evidence. In addition, they are a valuable resource for community and voluntary sector organisations (for example in making external funding bids).
2.2 Evidence for the needs assessments usually includes local demographic and service data; evidence from the public, patients, carers, service users and professionals; national research; and best practice. These elements are brought together to identify need, current services, service gaps and under-provision, unmet need, inequalities, and overprovision of services.
2.3 Brighton and Hove City Council is an integral part of the development of the Sussex integrated care system (ICS), working to a Population Health Management strategy informed by the needs and health outcomes at Place.
2.4 The focus on Place, defined by the 3 geographies of the Sussex local authorities is informed by the detail of health outcomes and population needs at Place level, reflected in the JSNA.
2.5 Historically, the JSNA is delivered as a city-wide partnership led by the Public Health team. The programme is overseen by the City Needs Assessment Steering Group, which includes representatives from the council’s Public Health, Adult Social Care, Families Children and Learning, Housing, Policy, and Communities Equality & Third Sector teams; the CCG; HealthWatch; Community Works; Sussex Police; and the two universities.
2.6 The steering group has not met since the start of the Covid-19 pandemic in 2020.
2.7 This paper advises on the decision to re-convene the steering group, and to develop its remit to include not only the programme of needs assessments required over the next three years but also to undertake a review of the JSNA structure itself.
2.8 The current JSNA structure is well developed and has served the purpose of local partners well. However, with the developing needs of the Integrated care system and the reinvigorated focus on Place based delivery, the structure should be reviewed to ensure it meets the future needs of the city.
2.9 The JSNA programme has three elements:
· Resources and outputs: Including the JSNA executive summary, data snapshots, survey briefings and Annual Reports of the Director of Public Health.
· A rolling programme of in-depth needs assessments on a specific theme or population group, approved by the Health and Wellbeing Board. Due to the resource requirements and partnership working involved this is usually two assessments.
· Community Insight, an online resource providing a wide range of data mapped at small area level across the city as well as up to date reports for these areas.
All resources described above are accessible via the Local Intelligence website (http://www.bhconnected.org.uk/content/local-intelligence) the strategic partnership data and information resource for those living and working in Brighton & Hove.
3 JSNA Programme Update
3.1 Update on JSNA executive summary
3.2 An executive summary of the Brighton & Hove population and its needs continues to be updated quarterly. A link to the most recent May 2022 JSNA executive summary is in the supporting documents section of this paper and is also attached as an appendix.
3.3 The executive summary provides a snapshot of the key health and wellbeing issues for the city, across the life course, set into wider determinants of health and the four ‘wells’ (Starting, Living, Ageing and Dying Well) from the Joint Health and Wellbeing Strategy.
3.4 The summary is also available in an interactive online version and users can click on the icons to link to trend data, where available.
3.5 The format will be reviewed again as part of the JSNA structure review to ensure it meets current requirements and builds in more automation where possible.
3.6 Update of JSNA in-depth needs assessments and topic-based summaries
3.7 There is a statutory requirement to complete a Pharmaceutical Needs Assessment (PNA) by October 2022. This is part of the JSNA programme. The PNA has been drafted and is currently out for consultation. A separate paper is scheduled for review at the Health and Wellbeing Board meeting of 12 July 2022 and in a special meeting in September convened for the purpose of receiving the PNA. A link to the PNA is supplied in the supporting documents section of this paper
3.8 A Mental Health all ages in depth JSNA is underway. This has been developed in two phases. Phase one is a rapid review using currently available data and information and will provide an overview of the picture of mental health and services locally. Phase two will comprise an in-depth needs assessment of specific areas that are identified from phase one as benefitting from greater insight.
3.9 In addition to these in-depth needs assessments, the Public Health team, with support from partners, has produced a number of summary topic-based JSNAs (these are different to a full JSNA as they do not include primary data collection or new qualitative research). These have been produced over the last year for:
· Population (December 2021)
· Physical activity – children and adults (April 2022)
· Life expectancy (August 2021)
· Primary care network profiles (February 2022)
Links to these can be found in the supporting documents section of this report.
4 Next steps
4.1 Discussions are currently underway with East and West Sussex public health teams to explore how best to coordinate JSNA development at Place and system level. It is noted that the JSNA programme needs to focus on the priorities of Place.
4.2 In order to develop and progress the JSNA programme, we propose to reconvene the City Needs Assessment Steering Group in early autumn 2022 to:
· review the JSNA structure and programme and make recommendations to develop the JSNA structure to better respond to current needs
· consider the requirement for in-depth needs assessments
· recommend a three year programme of needs assessments for 2023 - 2026
4.3 The City Needs Assessment Steering Group will bring a three year programme of in-depth needs assessments for approval by the Board in March 2023.
4.4 The prioritisation criteria for in-depth needs assessment includes:
· Is it a priority for Brighton and Hove City Council and the NHS?
· Is this helpful for the community/voluntary sector?
· Is it timely to do an assessment now?
· How much current intelligence is there?
· What is the prevalence of the condition and the impact?
5. Important considerations and implications
5.1 Legal:
The Health and Social Care Act 2012 (s196) requires the function of preparing a JSNA to be discharged by the Health and Wellbeing Board. Specifically, from April 2013, local authorities and Clinical Commissioning Groups have equal and explicit obligations to prepare a Joint Strategic Needs Assessment (JSNA) which provides a comprehensive analysis of current and future needs of local people to inform commissioning of services that will improve outcomes and reduce inequalities. The Health and Care Act 2022 replaces CCG’s with Integrated Care Boards. S26 of the 2022 Act inserts new provisions into the 2012 Act requiring the formation of an integrated care partnership [comprising the Local Authority and Integrated Care Board] and for that partnership to develop and review its own integrated care strategy in light of local needs assessments, including the JSNA.
Lawyer consulted: Sandra O’Brien Date: 17 June 2022
5.2 Finance:
The resources required to support the production of the JSNA are funded by public health ring-fenced grant and the budget allocation for 2022/23 is £0.055m. The JSNA provides the needs assessment for the city. Future commissioning plans and delivery plans will need to reflect on these needs. Any subsequent reports and plans will need to individually assess their financial implications, the impact on the needs of the city and the intended outcomes.
Finance Officer consulted: Sophie Warburton Date: 16/06/2022
5.3 Equalities:
Needs assessments consider specific needs of groups with protected characteristics. The JSNA is a key data source to inform action to improve outcomes in all groups and meet the public sector equality duty (including Equality Impact Assessments).
5.4 Sustainability:
No implications: Sustainability related issues are important determinants of health & wellbeing and these are integrated in the summary. The JSNA will support commissioners to consider sustainability issues.
5.5 Health, social care, children’s services and public health:
The JSNA summary sets out the key health and wellbeing and inequalities issues for the city and so supports commissioners across the city in considering these issues in policy, commissioning & delivering services.
Supporting documents and information
Appendices:
Appendix 1: JSNA Executive Summary May 2022
Supporting Documents:
Brighton & Hove Joint Strategic Needs Assessment executive summary May 2022 is available at: B&H JSNA exec summary: June 2022 - Infogram
The Pharmaceutical Needs Assessment (PNA) is available for consultation at: Brighton & Hove draft Pharmaceutical Needs Assessment (PNA) consultation - Brighton & Hove City Council - Citizen Space (brighton-hove.gov.uk)
Topic-based summaries can be found here:
Population (December 2021) Brighton & Hove Population JSNA 2021 - Infogram
Physical activity (April 2022) Physical activity JSNA tableau April 2022 Final.pdf (bhconnected.org.uk)
Life expectancy (August 2021) Life expectancy JSNA summary 2021 - Infogram
Primary care network profiles (February 2022) REPORTS | BH Connected