Redbridge Joint Strategic Needs Analysis – an update
by Ross Diamond, Chief Officer, RedbridgeCVS
Background
In 2006, the Department of Health White Paper “Our Health, Our Care, Our Say”, set out a new direction for improving the health and well being of the population in order to:
• achieve better prevention and early intervention for improved health, independence and well-being;
• provide more choice and a stronger voice for individuals and communities;
• tackle inequalities and improve access to services; and
• offer more support for people with long-term needs.
The White Paper also identified the need for Local Councils and Primary Care Trusts (PCTs) to undertake regular strategic needs assessments of the health and well being status of their populations. This is part of a commitment by the government to “transform health and social care services, putting people in control and at the centre of services”. It aims to ensure that every locality has a universal, single community based support system focussed on the health and well-being of the local population binding together local government, primary care, community based health provision, public health social care and the wider issues of housing, employment, benefits advice and education.
The process of analysing local needs is called the “Joint Strategic Needs Assessment” – or JSNA – and RedbridgeCVS has been working to ensure that the views of the local voluntary and community sector can be heard by those managing the process locally.
The Redbridge JSNA
The JSNA aims to identify the current and future health, well-being and social care needs of the local population. At the end of last year, Dr Datta, Redbridge PCT’s Director of Public Health, together with representatives of the Director of Housing and Community Services and the Director of Children’s Services established the process for JSNA in Redbridge. It was agreed that the Redbridge JSNA would contribute towards the setting of the Local Area Agreement (LAA) targets. Because – as is often the case – the government’s timescales didn’t quite fit with the calendar in the real work, this required working to a tight timescale to establish an overview of health and well being in Redbridge.
RedbridgeCVS sought the views of the voluntary and community sector back in December and January – and a number of groups responded to our requests for input. We are still keen to hear from any local group that is aware of ‘unmet needs’ in the community that local health and social care services might support – and will be pleased to pass on your comments to the JSNA team whenever you wish to pass these on to us.
A Working Group was established in November 2007 to oversee the work locally, and it has also established two sub-groups. One covers Community and Service Users (and its attended by RedbridgeCVS) and one covers Quantitative Information (and is attended by the Redbridge Disability Association).
The Quantitative Information Group has collated a wide range of data with the aim of describing health and well being among the Redbridge population in comparison to the rest of London and England.
The Community and Service Users sub group has carried out an audit of existing patient and service user engagement work to find out what local people have said about their well-being, the services they use, and what changes to service provision have occurred as a result of this engagement.
To gather information regarding community views regarding health and well being in Redbridge a number of activities were undertaken:
• An audit of user involvement activities within the PCT, London Borough of Redbridge and partner organisations was undertaken to identify what local people had already said about health and well being and services in Redbridge.
• The University of East London was commissioned to conduct the Healthy Redbridge Project to work with local communities in areas of high deprivation in Redbridge to enable local residents to identify how their well being could be improved and work with service providers to develop plans for addressing issues identified. This project is focusing on healthy eating, physical activity and mental well being. The completion date for this work is September.
• An article was published in Redbridge Life and the “Community” newsletter, requesting feedback on emerging priorities.
• A leaflet identifying emerging priorities and requesting feedback was delivered to 600 organisations (including all the groups on the RedbridgeCVS database), libraries, GP practices and Children’s Resource Centres. Two presentations have also been held at the RedbridgeCVS monthly Network meetings.
The findings of JSNA in Redbridge This work has resulted in a wealth of information regarding health and well-being in Redbridge. This includes a better understanding of the demographic changes affecting the borough – such as the predicted rise in young children and older people.
For example, the number of children between 5 and 9 years is projected to rise by 5% between 2006 and 2011 and then by a further 13% by 2016. The number of children aged between 10 and 14 is not expected to change and the number of young people aged 15 to 19 years is projected to fall by a total of 5% between 2006 and 2016. The number of people over the age of 64 years is projected to grow by 2.2% from 2006 to 2011 and by a further 6.8% by 2016. This increase is particularly apparent in the 65 to 69 years age group which is expected to risk by 11% between 2006 and 2011 and by a further 13% by 2016. They have also mapped the expected changes in the ethnic make-up of the borough.
Redbridge population in general experiences similar or better health and wellbeing than the average for London or England. One indicator of this is that life expectancy within Redbridge is higher than that for London and England. Another indicator of future health is educational achievement in which Redbridge achieves well. Additionally, among residents of Redbridge there is a lower level of alcohol misuse, smoking, drug misuse, teenage conceptions and accidental injury in comparison to London or England.
However, there are factors in which the Redbridge population compares less favourably these include obesity and physical activity.
What is all this information for?
Now that the PCT and Council have a better idea of current and future needs, they will use this knowledge to help them to commission appropriate services and support. Further development of the joint commissioning relationship will help to ensure that services work well together, and that resources are used in a more efficient and effective way.
In order to make good commissioning decisions for populations and individuals locally, there is a need to develop the health and social care workforce of those that commission and provide services. If your voluntary and community group currently provides (or would like to provide) services that meet the health and social care needs of local people, please contact me at RedbridgeCVS to see how you might be part of this process. Discussions across a wide range of partner agencies are underway to begin to identify skill and capacity gaps and explore ways of addressing them both in terms of front line staff and management and leadership.
The JSNA is part of the government drive to help prevent illness, instead of just focusing on treating people when they have become sick. As part of this process locally a diagram to help clarify the health and well being pathway was developed.
Conclusions
A number of conclusions have already been drawn by the JSNA process in Redbridge – including the following, which are of particular relevance to the voluntary and community sector.
• In general the health and well being of people living in Redbridge is good in comparison to London and England. However some groups within the Redbridge population are vulnerable to poor health and well being and have worse health outcomes than the rest of the population.
• There is an overarching need for a focus on prevention and early intervention in the development of poor health and well being within the population as a whole. In order to improve the health of the Redbridge population in the long term it is increasingly important to focus on ensuring good health in all age groups of the population including the preconception and antenatal stages.
• There are estimated to be increasing numbers of older people and children being born with multiple physical and learning disabilities and people surviving serious accidents and trauma living within Redbridge,. Due to this there is an increasing number of people with chronic health conditions and loss of mobility within our local population. Work must focus on establishing healthy lifestyles, preventing chronic disease and maintaining independence. Preventative work must take a universal approach working across the Redbridge population in addition to targeted work with groups vulnerable to poor health and well being.
• There is need to focus on improving health and well being among vulnerable groups identified below. This should occur via early interventions including health screening and preventative services.
i. Those experiencing poor quality housing and homelessness
ii. children in care and leaving care
iii. people with mental health needs
iv. people with disability including learning disability and others with complex care needs
v. refugees and asylum seekers
• The well being of the population living in Redbridge can only be improved via the continued coordinated action between statutory, voluntary and private sector organisations and local communities.
• A Community Development focus in Redbridge is essential to ensure local communities have a sustained ownership of health and well being.
• It will be vital to explore opportunities and reconfigure existing services to provide more effective and flexible support to meet a range of community health and well being needs.
• It will be vital to move towards outcome based commissioning for all services which include health and well being targets, particularly those included in the Local Area Agreement.
• It will be vital to work with partners across the statutory, voluntary and community sectors to support the development of a workforce that can meet the challenges of the personalisation agenda embedding quality, safety and dignity and respect.
For more information – including copies of the latest JSNA findings and information about how to get involved or share your views of local services and needs – please contact Ross Diamond on 020 8553 1004 or email ross@redbridgecvs.net
Alternatively visit JSNA
