Health and Wellbeing Board	20th March 2024
Report of the Director of Public Health

Joint Strategic Needs Assessment – Annal Update

Summary

1. This report provides members of the Health and Wellbeing Board with an update on the Joint Strategic Needs Assessment (JSNA), including work undertaken in the last year by the York Population Health Hub and planned work for the coming year.

Background

2. Health needs assessments (HNA) are a key ‘tool’ within the public health field and specialism, used internationally as a coherent and robust tool to understand the needs and inequalities of populations and to underpin planning and decision-making. Whilst a variety of approaches can be beneficial, most HNAs incorporate elements of epidemiological assessment (e.g. trends in disease prevalence, service activity), comparative assessment (evidence and data from other areas) and stakeholder/patient assessment (e.g. focus groups, surveys).

3. Work on the JSNA is closely aligned to local work on a ‘population health management’ approach to health and care services. Because of this, the JSNA working group now sits as part of the Population Health Hub (PHH). The hub’s purpose is to put the development and delivery of population health management (PHM) programmes and the data which sits within the JSNA at the heart of local decision-making in health, care and other services.

4. Since 2013 it has been a statutory duty through the Health and Wellbeing Board, to produce a Joint Strategic Needs Assessment, which usually consists of:

· an overarching narrative summary on the needs of a population

· deeper pieces of work on specific groups within that community ‘topic-specific’ needs assessments.

5. In York, the PHH steering group oversees the production of the overarching JSNA narrative. We are currently producing a new website to deliver this with greater functionality and accessibility.

Summary of work in 2023

6. End of Life Health Needs Assessment

· Scope: This report takes a closer look at the ‘Ending Life Well’ section of the HWB strategy. The report looks at causes of death, where people died, and use of palliative and hospital care before the death. The report was authored by a GP fellow who was hosted in the public health team during 2023.

· Summary: The report specifically looks at people who died in York in 2023. The report finds that like national trends, deaths in York are rising, with increasingly fewer people dying in hospital and more in care homes.  Palliative care was more common if the cause of death was cancer, and less common if the person lived in a deprived area.

· Impact: The report makes five recommendations for further partnership working, for quality improvement and for integration of care for people who are at the end of life in York.

7. Gypsy Traveller Health Needs Assessment

· Scope: This report described the unmet need within York’s Romany Gypsy and Traveller communities. There is a lack of local quantitative and qualitative data that adequately describes the health needs of this community, including lack of an accurate count the number of people living in York. Recent workshops organised by York Travellers’ Trust have provided some insight into lived experiences, however more work to do.

· Summary: Evidence suggests that these communities experience worse health outcomes, live shorter lives than the rest of the population, and are less likely to receive continuity of healthcare which addresses their needs. The report considers health outcomes such as life expectancy, experiences of access to healthcare and other key services, and wider factors that influence health including discrimination and air pollution.

· Impact: This HNA is directly supporting the priority setting for the Council led Gypsy and Traveller Delivery Group. It has also been included as supporting evidence in Local Plan documentation, and has also supported funding allocation decisions within the Raise York work program.

8. Drug and Alcohol Health Needs Assessment

· Scope: This needs assessment looked at the current and emerging drug and alcohol support and treatment needs of people living in York. The report includes data from national databases, local service providers, and the views of people who access recovery services and their families, as well as people who are eligible for support but not currently accessing the service.

· Summary: The report sets out what we know about drug and alcohol use in York, including the supply of drugs. The report explores what we know about people who are accessing treatment and recovery, as well as the population with unmet need who are presently not accessing support. Hospital admissions, early deaths, crime, and supply of drugs are all given chapters. There is a detailed exploration of the services that were in place, and the experience of clients and their families. Eight recommendations are made which will be picked up through the York Drug and Alcohol Partnership work program.

· Impact: This needs assessment was developed to inform the commissioning of the York community-based alcohol and drug treatment and recovery services. The report has also informed the decision to support the ‘lower my drinking’ campaign and the naloxone distribution program. The needs assessment will also inform the future work of the York Drug and Alcohol Partnership.

9. Population Health Hub

· Cost of Living Pack: The JSNA is also closely linked with the population health hub. The Population Health Hub is joint enterprise with the ICB. Jointly we have produced a number of information packs including the Cost of Living Pack which HWBB received in November.

· Lunch and Learn: The Population Health Hub also host quarterly ‘Lunch and Learn’ sessions with guest speakers invited to share their insights on a broad range of health topics. Recent discussion topics have included Ramadan, Cost of Living, and Social Prescribing. 

Planned work in 2024

10. We intend to launch the new JSNA website in April 2024. The address will remain unchanged (www.healthyork.org). The new site will have far greater functionality and engagement opportunities. Importantly it will be fully accessible to people who use accessible reading technology as well as on mobile and tablet. The new website will also enable us to promote the JSNA resources to a wider audience than we are currently able to do.

11. Special Educational Needs and Disabilities HNA: This HNA brings together information about children and young people with special educational needs and disabilities aged 0-25. It was requested by the SEND board as one tool to review their progress against their strategy and in preparation for future OFSTED/CQC inspections. The report uses local and national statistical information as well as insight collected directly from children and young people, their parents, and professionals working in education, health and social care. This project is near completion and a full draft will be shared with the SEND board for sign off in March or April 2024.  

12. We have committed to completing a further three health needs assessments in 2024 on the following topics.

· All age Autism and ADHD 

· Women’s health 

· Gambling

· We will also begin work on the next pharmaceutical needs assessment. This will be published in 2025 in line with the national three year publishing cycle.

13. Additionally, it is anticipated that further topic specific needs assessments will arise, either through requests from officers within the local authority and/or external organisations, or in response to local requirements for reactive needs assessments.

        Implications

14. There are no specialist implications of this report.

        Recommendations

15. The Health and Wellbeing Board are asked to:

i. note the content of this report and comment on how the JSNA and work of the Population Health Hub can be further disseminated

ii. comment on the use of the JSNA within their own organisations, and suggest how this use could be increased

Reason: To keep the HWBB updated on the work of the Population Health Hub and the JSNA

Contact Details

Author:	Chief Officer Responsible for the report:
Jen Irving Public Health Specialist Practitioner Advanced City of York Council	Chief Officer’s name: Peter Roderick Title: Consultant in Public Health
	Report Approved	√	Date	08.03.2024
Wards Affected:					All	√
For further information please contact the author of the report

Background Papers:

All content relating to the overarching JSNA and the associated health needs assessments can be accessed on the JSNA website at www.healthyork.org

Glossary

CQC – Care Quality Commission

HNA – Health Needs Assessment

ICB – Integrated Care Board

JSNA – Joint Strategic Needs Assessment

OFSTED – Office for Standards in Education, Children's Services and Skills

PHM – Population Health Management

PHH – Population Health Hub

PNA – Pharmaceutical Needs Assessment

SEND – Special educational need and disability