Report to: East Sussex Health and Wellbeing Board
Date of meeting: 13 December 2022
By: Director of Public Health
Title: East Sussex Joint Strategic Needs Assessment (JSNA) Update
Purposes: To present to the Health and Wellbeing Board an update on the Joint Strategic Needs Assessment for East Sussex and share plans for its refresh.
RECOMMENDATIONS
The Board is recommended to approve the JSNA refresh plans for 2023 and beyond.
1. Background
1.1 The Joint Strategic Needs Assessment (JSNA) programme was established in 2007 and reports on the health and wellbeing needs of the people of East Sussex. It brings together detailed information on local health and wellbeing needs to inform decisions about how we design, commission and deliver services to improve and protect health and reduce health inequalities. The JSNA is an on-going, iterative process, led by Public Health within the County Council.
1.2 Statutory guidance for Joint Strategic Needs Assessments states that the responsibility for overseeing JSNAs lies with the Health and Wellbeing Board and this has been reiterated in more recent guidance on health and wellbeing boards published in November 2022. In East Sussex this process has been led by Public Health on behalf of the Health and Wellbeing Board.
1.3 Since January 2012, all JSNA work and resources have been placed on the East Sussex JSNA website so that it provides a central resource of local and national information relevant to East Sussex.
1.4 Resources include local needs assessments, local briefings on specific topics, direct links to national tools containing local data, Director of Public Health (DPH) Annual Reports and signposts to other useful resources such as East Sussex in Figures (ESiF).
2. JSNA developments since the last report to HWB
2.1 COVID-19 and the local response has meant that we have had to re-prioritise some aspects of work within the Public Health team which has had some impact on the JSNA in 2022. JSNA updates have included:
· End of Life briefing, Dec 2021
· LGBTQ+ Needs Assessment, Dec 2021
· Health Inequalities briefing, Mar 2022
· Population projections briefing, May 2022
· COVID Overview, May 2022
· DPH annual report – Work, Skills and Health, July 2022
· State of the County Demographic Overview, Aug 2022
· Pharmaceutical Needs Assessment, Oct 2022
2.2 The plan had been to move the current content to a new interim site, which passes accessibility requirements, but this has been delayed. The transfer should complete in the next few weeks.
3. JSNA refresh project
3.1 As agreed in last year’s report, the JSNA content needs to evolve and develop to meet the needs and challenges in East Sussex. There have been significant changes both from a population perspective, in part because of the pandemic, but also as a result of an evolving health and care system in East Sussex which includes the establishment of an Integrated Care Board at a Sussex level. The JSNA website also needs to develop alongside other resources, such as East Sussex in Figures, to make it easier for users to find the resources they need on population needs in East Sussex.
3.2 During the summer of 2022 a working group was formed to propose the next steps for the JSNA refresh. The group considered JSNAs from other local authority areas including those that were identified as good practice by the former Public Health England.
3.3 Whilst the JSNA is in statutory guidance (Health and Social Care Act 2012), there is no set format for their production with local areas free to manage and design JSNAs that fit their local requirements. The group were keen to move from a collection of useful resources to a JSNA that also answered some key questions and provided some key priorities to improve the health and wellbeing of people in East Sussex. The group also reviewed the different topics that were included in other JSNAs, and it quickly became clear that a new framework for the East Sussex JSNA was required to bring more structure to the JSNA resources. A Project Initiation Document (PID) was developed for a two phased project.
Phase 1 - Planning, to be completed by the end of December 2022
• Develop a shared understanding of the role of the JSNA in East Sussex.
• Develop a framework for the East Sussex JSNA content
• Agree who participates in the governance, prioritisation, development, and work programme of the JSNA.
• Develop a work programme and agree milestones for phase 2.
Phase 2 – Building, for 2023 and beyond
• To begin the JSNA work programme agreed in phase 1.
4. Phase 1 progress
4.0 The PID for the JSNA refresh has been shared and discussed at many meetings across East Sussex County Council (ESCC) and the wider system partnership which has enabled us to update and improve the proposed approach. Engagement has included all Department Management Teams within ESCC as well as the East Sussex Population Health Prevention and Health Inequalities Steering Group (Aug 2022) and the East Sussex Health and Social Care System Partnership Board (Oct 2022).
4.1 Shared understanding of the JSNA
4.1.1 The working group have drafted a mission statement for the JSNA as follows
Our Joint Strategic Needs Assessment (JSNA) identifies the current and future health and wellbeing needs and strengths of local communities. These resources help to inform decisions and plans to improve local people’s health and wellbeing and reduce health inequalities in East Sussex.
4.2 Integration with East Sussex in Figures (ESiF)
4.2.1 We are working with the Performance, Research and Intelligence team at ESCC on the replacement for East Sussex in Figures, which is necessary as it does not currently pass accessibility requirements and updates are no longer supported by the provider. The Head of Performance, Research and Intelligence sits on the JSNA refresh working group and the Head of Public Health Intelligence sits on the ESiF/JSNA replacement working group to ensure consistency in the approach.
4.3 JSNA Framework
4.3.1 Appendix 1 contains the framework that we have shared and evolved during our phase 1 engagement work.
4.3.2 At the top of the framework will be an overall summary describing the key identified priorities in the JSNA. These will be developed from the resources within the rest of the framework. Within the overview section will be some accessible summaries of key issues across the life course which will focus on data for East Sussex.
4.3.3 The middle section of the framework will look at three big questions for East Sussex around how we improve healthy life expectancy, reduce health and wellbeing inequalities and understand need and demand now and in the future. These will explore local data and evidence in more detail and provide recommendations for action.
4.3.4 The lower section of the framework will explore the determinants of health and wellbeing looking at the local data, evidence and services relevant for each topic. Some will be briefings and/or links to other useful resources and some will require a more detailed comprehensive needs assessment. There are limited resources to undertake a needs assessment, so the choice of topics will need to be prioritised.
4.4 Types of resources required
4.4.1 The types of resources within the framework will include strategic summaries, briefings, evidence reviews, accessible infographic summaries, area profiles and signposting to external resources such as tools, profiles and reports.
4.4.2 As well as resources within the framework, there will be clear links to relevant data, profiles and summaries as part of the integration with ESiF. These will include work on describing key demographic outputs from the 2021 Census, Indices of Deprivation, population projections and resources relating to equalities groups to help inform Equality Impact Assessments.
4.5 Joint approach
4.5.1 Key to a successful JSNA is the joint approach from across the health and care system. The framework includes key collaborators for the JSNA, who will be involved in the design and production of the resources. This may involve the creation of task and finish groups to work on resources, or utilising/signposting to other resources to save duplication of effort.
4.6 Governance
4.6.1 The working group are proposing a governance structure that includes both internal ESCC and cross partnership oversight.
Figure: Governance structure for the JSNA refresh
5. Workplan for phase 2 during 2023/24
5.0 The refresh will not be a quick piece of work so we will start on the following resources during 2023/24.
1. Complete the transfer of current JSNA resources to interim JSNA site whilst ESiF replacement is developed
2. Publish accessible overviews of key issues across the life course
3. Publish strategic summaries for each of the Big Three JSNA questions
4. Publish the key priorities from the JSNA based on work to date
5. Continue integration with ESiF replacement developing area profiles and local data to be explored by users
5.1 Proposed process for developing and agreeing an annual workplan
5.1.1 It is crucial that the JSNA workplan is developed to ensure that it meets the requirements of the Health and Wellbeing Board and supports the wider health and care system in East Sussex. This means that outputs need to be prioritised for development with commitment from key collaborators to support the design and development of those outputs.
5.1.2 The working group proposes that in the summer of 2023 the Population Health, Prevention & Health Inequalities Steering Group discuss the key resources that will be required 2024/25. These will then be taken to the East Sussex Health and Social Care System Partnership Board in the autumn to prioritise outputs for the workplan. This workplan will then be presented to the Health and Wellbeing Board in December 2023 for endorsement.
6. Conclusion and Reason for Recommendation
6.1 The Health and Wellbeing Board is recommended to:
1. Endorse the approach and governance for the JSNA refresh programme.
2. Agree to the workplan for 2023/24 and the proposal for developing and agreeing future annual workplans.
DARRELL GALE
Director of Public Health
Contact officer: Graham Evans, Head of Public Health Intelligence
Tel No. 01273 336038; Graham.Evans@eastsussex.gov.uk
