This document summarizes a stakeholder workshop on long term conditions across the lifecourse. The workshop agenda included welcoming attendees, setting the scene on long term conditions, interpreting evidence on LTCs in Cambridgeshire, identifying key findings, and developing next steps. 31.7% of people in Cambridgeshire report at least one long term condition. The workshop aimed to discuss local data on LTCs, gaps in knowledge, priority findings, and how findings could inform local services and commissioning for people with long term conditions.

1. LONG TERM CONDITIONS
ACROSS THE LIFECOURSE
Stakeholder Key Findings Workshop
19th May 2015

2. Welcome

3. Agenda for this morning
9.30 Welcome
9.40 Scene Setting
10.00 Interpreting the Evidence
11.00 Identifying Key Findings
11.15 Refreshments break
11.30 Developing Next Steps
12.30 Closing Remarks
12.45 Finish

4. Scene setting
• The management and care of people with
long term conditions - one of the most
fundamental health and social care challenges

5. LTCs in Cambridgeshire
• 31.7% in Cambridgeshire reported having at least one LTC (GP Survey)
• 90,420 people reported a long-term activity-limiting illness defined as an
illness lasting at least 12 months, with any limitation (2011 Census)
0
10
20
30
40
50
60
70
80
90
100
0-15 16-24 25-34 35-49 50-64 65-74 75-84 85+ All ages
Percentageofpopulation
Age group (years)
Males
Females
Those reporting limiting LTC in Cambridgeshire, 2011 Census

6. Health & Wellbeing Strategy 2012-2017
• Priority 2 - Support older people to be independent,
safe and well:
Promote preventative interventions which reduce
unnecessary hospital admissions for people with LTCs, enable
them to live independently at home or in a community
setting where appropriate and improve their health and
wellbeing outcomes, e.g. through falls prevention, stroke and
cardiac rehabilitation, supporting voluntary agencies and
informal carers.

7. Joint Strategic Needs Assessment (JSNA)
• Commissioners & LA jointly describe health,
care & wellbeing needs & service delivery
• Focus on:
• Outcomes
• Partnership working
• Consultation
• Drives commissioning process

8. • The Local Government and
Public Involvement in
Health Act (2007)
• Health & Social Care Act
2012
• Health & Wellbeing Boards
statutory duty to prepare:
• Joint strategic needs
assessment
• Joint health & wellbeing
strategy
Statutory Background

9. Duties & powers relevant to JSNA & JHWS
LOCAL DEMOCRATIC LEGITMACY – POWERS AND
DUTIES
CCGs Local
Authority
NHS CB Local
Healthwatch
Health and
Wellbeing
Board
Functions of health and wellbeing board
Duty to prepare assessment of needs (JSNA) in relation to
LA area and have regard to guidance from Secretary of
State
X* X* X (to
participate)
X
Duty to prepare JHWSs for meeting needs included in JSNA
in relation to LA area and to have regard to guidance from
Secretary of State
X* X* X (to
participate)
X
Duty to involve third parties in preparation of JSNAs:
 Local Healthwatch
 People living or working in the area
 For County Councils – each relevant DC
X* X* X
Power to consult any persons it thinks appropriate in
preparation of JSNAs
X* X* X
Duty to have regard to the NHS Commissioning Board
mandate in developing the JSNA and JHWS
X* X* X
Duty to publish JSNAs X* X
Impact of duties on other associated functions
Duty to have regard to relevant JSNAs and JHWSs in the
exercise of relevant functions
X [in exercising
any functions]
X [in exercising
any functions]
X [in exercising
any relevant
commissioning
functions

10. Specification &
agreement
• Establish parameters
• Establish process
Data capture
• Identify & bring together relevant data
• Identify best practice
Data review
• Identify relevant data
Analysis
• Appraise
• Jointly agree alignment with strategic agendas
Advocacy &
implementation
• Jointly generate key findings & recommendations
• Jointly promote results/recommendations
Assessing value
• Costs and benefits of JSNA

11. JSNA Impact
• Provide clearer idea of what is needed
• Deliver what people want
• Evidence decisions – enable stakeholders to buy
into change
• Identify best interventions
• Ensure range of interventions available &
accessible
• Inform more effective & economic configuration
of services

13. Starting point: purpose of this work
• Describe patterns of long term conditions (LTCs) across
lifecourse
• Raise awareness of health needs & inequalities
• Understand complexity of LTCs
• Understand impact & interaction of mental health across
LTCs
• Review suitability & accessibility of current services
• Recommendations to improve health, independence &
access to care with a focus on cost-effective solutions
• Engage & empower people with LTCs

14. LTCs across the lifecourse
Primary Prevention JSNA LTC JSNA

15. Scope: LTCs across the lifecourse
• Focus on care management for high risk people with adult-onset LTCs
– integrated management and care for adults with long term conditions,
highlighting opportunities for prevention and avoiding escalation in health and
care needs
– explore the principles of empowerment and self-care, and indicate findings on
potential improvements to enable person-centred and high quality care.
– provide valuable information to the health and social care system, and to
improve health outcomes of the population of people with LTCs across
Cambridgeshire
• Characteristics of those at high risk of poor health outcomes:
– Multiple conditions (multi-morbidity)
– Limitation
– Pain and Mental health conditions (anxiety and depression)
• Cross cutting themes
– Inequalities
– Risk factors across the life course
– Models of care
• Short data supplements
• CVD
• Hypertension
• Diabetes
• Chronic Kidney Disease
• COPD

16. The story so far...
Opportunities and challenges
• Defining the population…
• Multiple conditions
• Emerging evidence (i.e. not a lot there yet)
and more practice focussing on the most
complex 1-2%
• Collaborative working on datasets to generate
useful estimates
• Hearing and collating local views

17. JSNA Process and Engagement
Scoping paper
to HWB
Jan 2015
Stakeholder
Meeting:
SCOPING
November 2014
Scoping
Final report
to HWB
July 2015
Development
Stakeholder
Meeting:
LOCAL VIEWS
April 2015
Stakeholder
Meeting:
KEY FINDINGS
May 2015

18. Aims of today’s workshop
• Increasing awareness and understanding of the evidence
collated so far in this process
• Providing local interpretation of the evidence gathered, and
adding further detail on existing assets and challenges to
improve the accuracy and comprehensiveness of the JSNA
• Gaining a shared view on the gaps in information
• Discussing the priorities among the population needs that
have been identified and exploring how this work can inform
commissioning intentions and approaches
• Recognising the crucial necessity of co-production with local
views at the heart of future work to improve outcomes for
people with LTCs and considering how this can be embedded

19. INTERPRETING THE EVIDENCE
Group Discussions
• What is your reaction to this evidence and
data?
• How would you interpret this evidence?
• What are the gaps in knowledge that need to
be addressed?
• What is this telling us so far?

20. IDENTIFYING KEY FINDINGS
GROUP DISCUSSION
What findings that have been described today
would you consider as ‘key findings’?
5-6 points per group

21. IDENTIFYING KEY FINDINGS
Prioritisation
What findings that have been described today
would you consider as ‘key findings’?
Please vote with your sticky spots on
statements you feel are most important
You can put all your spots on one piece of
information or spread them out

22. DEVELOPING NEXT STEPS
Panel discussion:
What are our current
local assets and how can
these key findings be
taken forward within
them?

23. Keeping in touch
• Contact:
angelique.mavrodaris@cambridgeshire.gov.uk
helen.johnston2@cambridgeshire.gov.uk
Thank you very much
for your attendance &
participation today