Sandie Keene: Whole systems approach to assessing the current and future needs of local populations
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Sandie Keene: Whole systems approach to assessing the current and future needs of local populations



Sandie Keene, Director of Leeds Adult Social Services, gives an insight into the demography of Leeds and shares her experiences of establishing a Joint Strategic Needs Assessment (JSNA) for the needs ...

Sandie Keene, Director of Leeds Adult Social Services, gives an insight into the demography of Leeds and shares her experiences of establishing a Joint Strategic Needs Assessment (JSNA) for the needs of the local population.



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Sandie Keene: Whole systems approach to assessing the current and future needs of local populations Sandie Keene: Whole systems approach to assessing the current and future needs of local populations Presentation Transcript

  • LEEDS JSNAA whole system approach to assessthe current and future needs of the local population
  • Lessons from our journey so far…..• Ownership• Integration – into the health and social care system• Community involvement• Analysis – intelligence not information• Qualitative and quantitative• Localism – localities are key
  • This is Leeds – population 787,700 ( at present!) – rising to over 1million by 2033
  • Index of Multiple Deprivation 2010 – 150,00 living in the most deprived SOAs nationally
  • 2001-2009 components of change18.0 Live B irths Deaths16.0 Net migratio n & Other change14.0 To tal change12. M id 2001-02 M id 2002-03 M id 2003-04 M id 2004-05 M id 2005-06 M id 2006-07 M id 2007-08 M id 2008-09
  • Understanding the geography• 33 electoral wards• 8 Parliamentary constituencies (with one extending beyond the Leeds MD boundary)• 3 Management Areas• 10 Area Committees• 108 Middle Super Output Areas• 476 Lower Super Output Areas• 3 Police Divisions• 17 Neighbourhood Policing Teams• 3 ALMOs and 1 TMO• 28 Extended Services Clusters (school based)• 38 Neighbourhood Networks (Adult Social Care)• GP consortia
  • Ownership across all required!
  • A picture of Leeds – 2008/9 JSNAIt gave clear priorities for partners:• Responding effectively to demographic change - Over 75s and children and young people• Responding effectively to specific health and wellbeing challenges - Obesity, alcohol, drugs and smoking• Counteracting widening inequalities between neighbourhoods and key vulnerable groups - Fragmentation across neighbourhoods and communities
  • Key actions from the JSNA 2008/9• Embed the governance and accountability into wider partnership arrangements (through Healthy Leeds, Joint Strategic Commissioning Board)• Closer alignment of planning and commissioning cycles (LCC and PCT)• Process in place – Joint Information Group and Strategic involvement group for a continuous process/review of HNA and HNA template agreed for improved quality• Populate data gaps (e.g. equalities and mental health data in particular) and improve projections and predictive modelling• Locality profiling : Development of 108 neighbourhood profiles at MSOA level
  • Locality profile – example Little LondonNeighbourhood Indexes were developed for each middle level SOA, these are now being revised to include more detailed data
  • Example of Impact – Area Committees• Joint Health Improvement Managers• Locality Partnerships• Prioritisation and Investment• Actions – Alcohol – Multi-Agency Referral Scheme (MARS) – COPD – Smoking Cessation
  • Reducing Infant Mortality rates – a locality approach Mortality under 1 year per 1,000 live births 30.00 rate per 1,000 live births 25.00 2003-2005 20.00 2004-2006 15.00 2005-2007 10.00 2006-2008 5.00 2007-2009 0.00 Chapeltown Beeston Hill Leedssource: NHS Leeds Cluster Information Service Target to Reduce the IM rate in ‘deprived Leeds’ to 7 per 1000 live births by 2013. (Leeds average 5.8; deprived Leeds – 8) Two demonstration sites – Chapeltown and Beeston - multi agency response
  • Impact of housing on healthReport commissioned from Sheffield Hallam and YorkUniversity• Investing in Leeds’ housing stock will enhance the health of residents• Improving the energy efficiency of the Leeds housing stock will reduce fuel poverty• There should be an integrated programme of investment in home safety measures and home adaptations to maintain the independence of older residents• Leeds Council should invest in home security measures as part of an integrated package to improve health by reducing crime and fear of crime
  • Leeds Housing StrategyBuilt on the Leeds JSNA: 3 priorities- Increasing the supply of affordable housing- Improving housing quality- promoting independent livingResearch is now leading to:- an assessment of impact across partners – e.g. police and burglary reduction due to safety in homes- An invest to save model now produced to enable LCC to estimate saving from investments in the housing stock e.g. energy efficiency and saving on health care for chronic conditions
  • Financial Inclusion• Leeds city council led multi-agency financial inclusion steering – 3 priorities with key initiatives = affordable credit, debt/money advice, financial literacy• Engagement with the voluntary sector – working with CAB to establish how voluntary sector information on their clients and areas of need can add value to the JSNA with a focus on debt.
  • Key challenges going forward – Qualitative data• 2009 JSNA acknowledged this as a gap – gathered surveys on City Council portal; established SIG• 2010 – Analysis of common themes – using grounded theory (Nvivo 9 software) – 105 sources gathered• Aim – to develop a comprehensive consultation library of qualitative information, analyse the information and establish themes and recommendations to feed into the refreshed JSNA
  • Emerging themes• Children/Young people• Mental Health• Transport• Older People• Access to Services• Healthy Lifestyles
  • Analysis – intelligence not informationReview of all Health Needs Assessments completed since 2008with the aims of:• To undertake a content review of recently completed needs assessment, against the priorities and data gaps identified by the JSNA• To identify the main themes and priorities arising from needs assessments• To develop a proforma for locally produced needs assessments to lead to quality intelligence
  • Embedding within the commissioning process• In 2009 NHS Leeds was recognised for its work on the JSNA within the WCC process• The JSNA was taken through both Executive within Leeds City Council and Scrutiny Committee – embedded in strategies (e.g the Housing strategy)• Programme of work used the JSNA analysis in their commissioning process – maternity services• However there remains the challenge to embed it through all commissioning in the city to ensure services are delivered in relation to needs – the new Health and Wellbeing Board and Clinical Commissioning groups are an opportunity to revisit this
  • Where are we now?• Refreshing quantitative data set and analysis of qualitative data to feed into shadow Health and Wellbeing Board in September and LCC State of the City report• Two joint workshops held to consider quantitative and qualitative data and add ‘the story behind the data’• Wider workshop planned for all partners in September to consider the 7 quality themes identified by Local Government Improvement and Development to ensure ownership• Shadow Health and Wellbeing Board first meeting to explore their role in relation to the governance of the Leeds JSNA to ensure a whole system approach to assessing need and agreeing priorities for Leeds for now and the future.
  • Future governance