Agenda item - Adults With Multiple Long-Term Conditions - Joint Strategic Needs Assessment

Joint report of Head Public Health Intelligence, consultant in Public Health and Brighton and Hove Clinical Commissioning Group (copy attached)

RESOLVED – That the Board note the findings and recommendations of the needs assessment to improve the prevention of multiple long-term conditions and the care of those with long-term multiple conditions.

6.1       The Board considered a joint report of the Head of Public Health Intelligence, the Consultant in Public Health and Brighton and Hove CCG setting out the Joint Strategic Needs Assessments (JSNAs) in respect of adults with multiple long-term conditions.

6.2       It was explained that JSNAs provided a comprehensive analysis of current and future needs of local people to inform commissioners and providers regarding how they could improve outcomes and reduce inequalities. The Health and Social Care Act 2012 required the function of preparing a JSNa and a Joint Health and Wellbeing Strategy to be discharged by the Health and Wellbeing Board. From April 2013, local authorities and Clinical Commissioning Groups had equal and explicit obligations to prepare these to reflect local’ population health needs.

6.3       An in-depth needs assessment of adults with multiple long-term conditions had been published in February 2019 as part of the JSNA programme. It provided a comprehensive analysis of current and future needs of local people, and provided the underpinning evidence of the need for integration of health and social care and recommendations for commissioning and provision of services. The paper before the Board was intended to provide an overview of the key findings from the needs assessment for it to note summarising progress which had been made so far. There were over 51,000 adults aged 20 years or over living in Brighton and Hove who were recorded as having multiple long-term conditions (two or more) as at March 2017 (22% of adults) and around 8,000 with five or more conditions. These figures were similar to estimates published by Public Health England based on a large scale study in Scotland. There was a significantly higher estimates prevalence than the South East for all age groups under 85 years but because the city’s population was younger our overall estimate was lower that for the South East (23%) as opposed to 21%.

6.4       Councillor Shanks stated that this was a useful document whilst it included a lot of information which members were already aware of or suspected it served to highlight the issues being addressed to ensure that a holistic approach was being adopted. Councillor Shanks enquired regarding the means by which data was shared and how it would be identified for example that an individual had mental health needs as well as physical ones.

6.5       Malcolm Dennett responded on behalf of the CCG stating the that analysis undertaken had shown that this was more significant than had originally been thought and further work was being undertaken with partners and it was anticipated that in consequentially that could lead to some fundamental changes in future. There were two schools of thought on information sharing whilst is was important for partners to be in possession of germane information in some instances there might be safeguarding issues to be addressed. By sharing information appropriately arrangements could be put into place to ensure that those suffering longer term conditions would have arrangements for specialist nursing and medical care in place when they needed them. This would be a “longer” journey but would result in more tailored care.

6.6       The Executive Director, Health and Adult Social Care explained that this work wold also link into and guide the strategy in place to address the “Four Wells” from March 2020 in order to improve health outcomes in the city. The Director of Public Health confirmed that this work had also been reflected in the forward planning process for the “Health and Wellbeing Action Plan” going forward. This work had been well received locally and further afield.

6.7       The Deputy Chair, Councillor Appich, concurred that much of the information which had been drawn out. The key lay in prevention and it was important to ensure that funding was in place to ensure that services were delivered. It was confirmed that the council would continue to lead on well-being and it was anticipated that a report considering the needs of carers who themselves had multiple needs would be available for the Board’s September meeting.

6.8       Councillor Bagaeen considered it unfortunate that homelessness and the multiple health issues that could give rise to would be considered by the Housing and New Homes Committee in future. Those who were homeless often had complex health and mental health conditions. Ms Banjoko, CCG, explained that there was awareness of these issues and measures were being put into place to effectively address the needs of this group.

6.9       The Chief Executive confirmed that stakeholder meetings occurred regularly to ensure that effective support mechanisms were in place for this group and that they were dealt with sensitively and were not criminalised.

6.10    RESOLVED – That the Board note the findings and recommendations of the needs assessment to improve the prevention of multiple long-term conditions and the care of those with long-term multiple conditions.