Transcript Slide 1

JOINT STRATEGIC NEEDS
ASSESSMENT FOR
CAMBRIDGESHIRE
Phase 2
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
The Cambridgeshire Approach
• In Cambridgeshire we have produced six JSNAs to date.
These focus on different groups within the population.
While there is some overlap between the different
JSNAs, each looks at their particular population in detail.
• The JSNAs have been led through existing PCT/CCC
joint strategy and commissioning groups.
• More recently a ‘community views’ JSNA has been
produced, bringing together material from several local
and national consultations
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
The combined
JSNA Process
JSNA: Children and
young people
JSNA: Adults of working age
JSNA: Adults with learning
disabilities
JSNA:Older people
JSNA: Adults with mental
health problems
JSNA:
Community
views
JSNA: Adults with physical
disability and sensory
impairment and long term
conditions
Combined Joint Strategic Needs Assessment
Local Area Agreement and other
local outcomes and targets
Commissioning
of services
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
Updating the JSNAs
• The JSNA are being continuously updated as new
demographic and other information becomes available.
• Phase 2 includes, County Council Research Group
population estimates and forecasts as well as the
revised Index of Multiple Deprivation (IMD)
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
Key Demographics
Table 3: Total population : population forecasts, mid 2006 based (CCCRG)
Local Authority
% change
2006 to 2021
Year
Cambridge
East Cambridgeshire
Fenland
Huntingdonshire
South Cambridgeshire
Cambridgeshire
2006
113,690
76,290
89,910
160,830
138,080
578,630
2011
131,910
80,650
91,550
168,170
149,910
622,020
2016
147,470
81,870
94,870
165,510
160,930
650,550
2021
148,920
80,710
99,250
165,690
170,470
664,910
31.0%
5.8%
10.4%
3.0%
23.5%
14.9%
Source: Cambridgeshire County Council Research Group Mid-2006 district level population forecasts by age and gender
By 2021 it is estimated that there will be a further 86,000
people living in Cambridgeshire. The biggest actual
increases and also proportional increases are expected in
South Cambridgeshire and Cambridge City.
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
Index of Multiple Deprivation, 2007
Table 6:Fifth most deprived wards in Cambridgeshire
Table 5: Local Authority, average
of SOA scores
Local Authority
Fenland
Cambridge
East Cambridgeshire
Huntingdonshire
South Cambridgeshire
Cambridgeshire
IMD 2007 score
(average of LSOA
scores)
20.50
13.87
10.84
9.31
6.55
11.49
LA rank
(England)*
139
236
285
311
350
135
NB: *LA rank (England): the rank for 5
district authorities represents the relative
rank within the 354 tier 2 local authorities in
England where rank 1 is the most deprived
authority and rank 354 the least deprived.
The rank for Cambridgeshire represents the
relative rank within the 149 tier 1 local
authorities where rank 1 is the most
deprived authority and rank 149 the least
deprived.
Local Authority
Fenland
Fenland
Fenland
Fenland
Huntingdonshire
Fenland
Fenland
Cambridge
Fenland
Fenland
Fenland
Cambridge
Fenland
Fenland
Fenland
Cambridge
East Cambridgeshire
Cambridge
Fenland
Fenland
Fenland
Fenland
East Cambridgeshire
Fenland
Fenland
Ward
Waterlees
Clarkson
Medworth
Staithe
Huntingdon North
Elm and Christchurch
Parson Drove and Wisbech St Mary
King's Hedges
Hill
Kirkgate
Kingsmoor
Abbey
Roman Bank
Peckover
March East
East Chesterton
Littleport West
Arbury
March North
Lattersey
Birch
March West
Littleport East
Wenneye
Wimblington
IMD 2007 score
41.52
32.83
32.01
31.21
27.00
25.73
25.39
25.10
24.41
24.36
23.01
21.93
21.24
20.42
20.08
20.03
19.47
18.97
17.83
17.24
16.78
16.49
16.48
16.06
15.55
Source: The English Indices of Deprivation 2007, Department for Communities and Local Government
(DCLG)
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
Life Expectancy Cont’d
Life expectancy 2003-2005 by quintiles of IMD score (electoral wards)
Cambridgeshire (CCC) Q1 and Q5 based on IMD scores for wards
Cambs 03- Cambs 03- Cambs 03- Cambs 03- Cambs 03- Cambs
05
05
05
05
05
ave 03-05
Quintiles IMD
County average
Q5
Q4
Q3
Q2
Q1
74.00
75.00
76.00
77.00
78.00
79.00
80.00
81.00
Life expectancy at birth (in years)
82.00
Most of the wards with
significantly higher levels
of deprivation are in
Fenland, but some are in
north east Cambridge,
Huntingdon and East
Cambridgeshire. Those
in the 40% of wards with
the least levels of
deprivation (ie Q4 and
Q5) have statistically
significantly higher life
expectancy than the
county average.
Source: Population data: Research Group of Cambridgeshire County Council population estimates.
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
Children and Young People
Key Findings Summary
• Currently some 139,000 children and young people aged 0-19
live in the county, with Huntingdonshire currently having the
largest such population. On average there are around 7,000
in each single-year age group.
• Forecast growth in the population aged 0-19 in
Cambridgeshire between 2006 and 2021 is 4% (5,300
children). The 0-19 population is forecast to fall by 17% in
Huntingdonshire (6,800 children) and to rise by 40% in
Cambridge City (9,600 children) and 14% in South
Cambridgeshire (4,700 children).
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
Children & Young People
- Lifestyle Issues
In Cambridgeshire as a whole:
• About 8% of children in reception and 16% of children in Year
6 are obese
• About one in ten boys and one in six girls aged 14-15 smokes
regularly
• Nearly a quarter of Year 8 children had had an alcoholic drink
in the last week and a half of Year 10 children
• About one in thirty-five girls aged 15-17 become pregnant
each year, with the highest teenage pregnancy rates in
Fenland and Cambridge City.
• About 6% of young people aged 15-24 in Cambridgeshire
screen positive for Chlamydia (a sexually transmitted
infection)
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
Children ‘in need’ cont.
• Across the county 3.2% of pupils have a statement of
special educational need; a further 5.2% are identified as
having significant educational needs. The majority of
these have moderate or specific learning difficulties,
behaviour, emotional and social difficulties or speech,
language and communication needs.
• In April 2007, there were 365 non-respite children in
care, with the majority aged between 10–15 years.
These children are most at risk of having poor
educational outcomes, at risk of becoming young
offenders and teenage parents, and vulnerable to mental
health problems.
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
Community Views –
Children and Young People
• Children and young people in Cambridgeshire describe
themselves as living quite sedentary lives. They may not
undertake enough physical activity, may have a poor diet and
are often bored. Young people believe that this is because
their leisure options are restricted
• Young people in Cambridgeshire are aware that STIs exist
and that the incorrect use of contraceptives could also lead to
unwanted pregnancies. However, they believe that a more
effective and timelier sexual health education could help
decrease the incidence of diseases and unwanted
pregnancies.
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
Community Views Cont’d–
Children and Young People
• Mental health problems, mainly anxiety and stress, are often a
result of bullying, disagreement and poor communication with
parents or family and because of boredom.
• A poor physical environment at home can also increase
children and young people’s anxiety and stress.
• Smoking, drinking and consumption of substances are mainly
caused by imitation and peer pressure. Anti-social behaviour
is often linked to these activities.
• Minority groups such as Gypsy and Traveller children and
young people describe themselves as being at risk of mental
health problems and a decrease of their general well-being
because of bullying and racism
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
Table 32: Taking forward the findings of individual JSNAs
Children and young people
Many of the needs identified in this assessment are already being
addressed through The Big Plan, and the JAR Action Plan. The next steps
will be to compare the services being provided with the needs identified
and look for gaps in services and for services where there is room for
improvement as part of the update of The Big Plan.
Adults of ‘working age’
Specific work will be undertaken to better understand preventative needs
from the perspective of the population and service providers. This work will
be overseen by a new county-wide Health and Well Being Partnership.
Adults with mental health problems
The JSNA on adults with mental health problems will inform the
development of a Mental Health Promotion Strategy for Cambridgeshire
and the joint commissioning of mental health services.
Adults with learning disabilities
The JSNA will inform the Joint Commissioning Strategy for people with
learning disabilities. The JSNA will be revised in the light of new
developments and guidance; changing needs and priorities and ongoing
consultation.
Adults with physical and sensory
impairment and long term
conditions
The JSNA will be used to inform the Joint Commissioning Strategy for
Physical Disabilities and Sensory Impairment. The JSNA is also informing
the update of the PCT Long Term Conditions Action Plan.
Older people
The data from the JSNA on Older People underpins the PCT Long Term
Conditions Strategy and is informing the multi-agency Older People’s
Strategy which focuses on the broader determinants of health. It will also
inform the Joint Commissioning Strategy for Older People.
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
SWOT analysis – strengths
• The care group approach allowed richness
of data collection for each care group, and
supported the direct use of JSNA in joint
service commissioning strategies.
• The Community Views JSNA brought
together a wide range of consultation
material into one place, in a way which
hadn’t been done before
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
SWOT analysis - weaknesses
• The care group approach made overall coordination of the phase 1 and phase 2
JSNA more challenging, particularly as we
did not have a dedicated JSNA project
manager
• The PH analyst team had to divide their
time between several JSNA strands at
once
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
SWOT analysis - opportunities
• The appointment of a new JSNA coordinator post will enable a structured
programme of updates, stakeholder
engagement and communications for the
JSNA
• This appointment will also enable more
detailed logging of the impact of JSNA on
service planning
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
SWOT analysis - threats
• Council elections may mean that a new
set of communications activities are
required to ensure that members are
aware of and engaged with JSNA
• There is a risk that the JSNA will be well
used internally by public sector
organisations but not owned by local
communities.
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
Gaps in guidance and support
• Timeliness of JSNA guidance in 2007: It
was good when it arrived, but too late to
meet requirements of the Local Area
Agreement process.
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
Data and information analysis –
support from PHO or IC
• Acknowledgement of Local Authority
population estimates/forecasts
• Skills – e.g. predictive modelling and
sensitivity analysis
• There may be some rich data at PHO/IC
level which we are not fully aware of in
PCTs.
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
Possible new pieces of work
• Improving outward facing communication
with the public – web-based materials and
active publicity
• Evaluation of how JSNA has been used in
service planning, its impact on front line
services – and taking the learning from
this.
• (Working with additional data sources e.g. police/housing).
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk
NHS Cambridgeshire (formerly Cambridgeshire PCT)
Web site: www.cambridgeshire.nhs.uk