Joint Strategic Needs Assessment programme update 2024

Kate Gilchrist, Head of Public Health Intelligence

Louise Knight, Senior Public Health Intelligence Specialist

Since April 2013, local authorities and NHS Clinical Commissioning Groups (now Integrated Care Boards) have had equal and explicit statutory obligations to prepare a Joint Strategic Needs Assessment (JSNA). 

The JSNA provides a comprehensive analysis of the current and future needs of local people and is used to inform commissioning of services that will improve health outcomes and reduce inequalities. Their outputs are used to help to determine what actions the Council, the local NHS and other partners need to take to meet health and social care needs, and to address the wider determinants that impact on health and wellbeing. The JSNA informed the development and delivery of our Joint Health and Wellbeing Strategy.

This duty is discharged by the Health & Wellbeing Board and overseen by the City Needs Assessment Steering Group.

In July 2023 the Board agreed a three-year programme of needs assessments and action plan to further develop the JSNA.This paper updates on the progress in the first year of the programme, and provides and updated programme for years two and three for the Board to approve.

Glossary of terms

• JSNA products refers to the products held on the JSNA website, including in-depth and summary needs assessments, data profiles and summaries reports and briefings, and the Local Insight data mapping platform
• JSNA stakeholders refer to users including, the Community and Voluntary Sector, NHS Sussex, the local authority, the public, and other partners

1.1 

That the Board notes the progress in the first year of the three-year JSNA programme.

1.2

That the Board approves the updated proposed programme of needs assessments for years two and three of the programme (July 2024 to July 2026) (Appendix 2).

2.1 

The current JSNA comprises a suite of products and resources held on the Brighton & Hove City Council website Joint Strategic Needs Assessment (JSNA) including:

• a programme of in-depth needs assessments on a specific theme or population group, approved by the Health and Wellbeing Board. Due to the resource requirements and partnership working involved, there is usually one in-depth needs assessments per year
• summary needs assessments which take the form of a range of products including the JSNA executive summary data summaries, briefings, data profiles, and signposting
• local Insight, an online resource providing a wide range of data mapped at small area level across the city as well as up to date area reports
• additional resources – for example survey briefings and evidence reviews

2.2 

In-depth needs assessments provide a comprehensive analysis for a specific topic of the current and future needs of local people to inform commissioners and providers how they can improve health outcomes and reduce inequalities. They also ensure that health strategies are based on high quality evidence and are a valuable resource for community and voluntary sector organisations. 

2.3 

Evidence for the needs assessments usually includes:

• local demographic and service data
• evidence from the public, patients, carers, service users and professionals
• national research
• best practice

These elements are brought together to identify:

• need
• current services
• service gaps and under-provision
• unmet need
• inequalities
• over-provision of services

2.4 

The JSNA informs key Brighton & Hove and Sussex health and wellbeing strategies including the Brighton & Hove Joint Health and Wellbeing Strategy, and the Sussex Health and Care Partnership strategy Improving Lives Together. 

2.5

The JSNA is delivered by a partnership led by the Brighton & Hove City Council Public Health Intelligence Team. The programme is overseen by the City Needs Assessment Steering Group which includes representatives from the council’s Public Health, Adult Social Care, Families, Children and Learning, Housing, Sustainability, Policy, and Communities Equality & Third Sector teams; NHS Sussex; University Hospitals Sussex Foundation Trust; Healthwatch; Community Works; Sussex Police; and the two universities. 

2.6

In 2022 to 2023 a JSNA review was completed, reflecting the changing needs with integrated working arrangements including the Sussex Health and Care Partnership and new Place structures (Brighton & Hove) to ensure that the JSNA continues to meet the needs of the city and stakeholders. The Board approved the action plan for development of the JSNA and a three year programme of needs assessments in July 2023.

JSNA action plan

2.7

From this review, the 10 key areas for of the action plan for the JSNA programme are:

• Joint Strategic Needs Assessment (JSNA) governance
• working with East and West Sussex
• engagement, involvement and co-production
• JSNA production
• JSNA framework and products
• website and JSNA webpages
• accessibility of the JSNA website and products
• promotion, communication and maximising use of the JSNA
• explore potential for additional resources to produce the JSNA
• JSNA needs assessments prioritisation process

2.8

There has been good progress made with JSNA action plan in the last year. 

This includes:

• governance - The City Needs Assessment Steering Group membership and terms of reference have been strengthened
• JSNA framework and website - new website and framework implemented (further design improvements planned)
• production - incorporating stakeholders feedback into product types, templates and guidance strengthened, for examples strengthened guidance on inclusion of intersectionality and sustainability and wider determinants of health
• products and accessibility - good progress, Local Insight update, new product types - signposting, key summaries for example healthy places, evidence reviews and accessible versions
• across Sussex collaboration - good working relationships established, to be further strengthened in years 2 and 3

2.9

One of the key areas for focus in the next year is the promotion, communication and maximising use of the JSNA. 

We know that JSNA resources are well used, with:

• 2,492 views of infogram products
• 2,656 visits to the Local Insight data and mapping platform
• JSNA webpages – 360 views to 17 June, awaiting updated figures to end Sept
• between 1 April 2024 and end September, but that we need to do more to promote the evidence available

JSNA programme delivery July 2023 to July 2024

2.10

The following products have been published in year 1 of the programme:

• JSNA Executive summary update
• Healthy Places summary (one of the three new key summaries for the JSNA, see appendix 2)
• equalities data profiles (12 demographic data profiles for key population groups)
• population briefing
• child poverty briefing
• drugs and alcohol needs assessment
• signposting documents for chronic respiratory disease and hypertension
• updated mapping and data platform Local Insight
• Health Counts survey 2024 took place, with over 16,500 respondents

2.11 

The following are in progress:

• Special Educational Needs and Disabilities (SEND), neurodiversity and learning disabilities (children and young people aged 0 to 25) in depth needs assessment - scoped and initiated stage 1
• sexual health JSNA, to be published by March 2025
• healthy child programme summary, to be published by March 2025
• Gypsy, Roma and Travellers needs assessment (commissioned qualitative research)
• Health Counts summary, to be published by January 2025, area profiles by March 2025
• Pharmaceutical Needs Assessment (PNA) for October 2025 has commenced – this is a statutory duty of the Board
• sensory impairment JSNA summary, to be published by March 2025

JSNA programme for July 2024 to July 2025 and July 2025 to July 2026

2.12

The programme for July 2024 to July 2026 is given in Appendix 1. This has been agreed by the City Needs Assessment Steering Group. The Board is asked to approve this revised programme.

JSNA programme links with the Brighton and Hove Shared Delivery Plan objectives

2.13 

The JSNA directly informs the Brighton and Hove Shared Delivery Plan objectives. In-depth needs assessments on Adults with multiple compound needs (2020), Adults with multiple long-term conditions (2018), and Mental health (2022), and a summary on Cancer (2022) all inform the current programme. 

Year 1 of the 3-year JSNA programme: Special Educational Needs and Disabilities, neurodiversity and learning disabilities in-depth needs assessment (ongoing), Hypertension and Chronic Respiratory Disease signposted evidence 2024; Drugs and Alcohol needs assessment (2024), Core20 most deprived and local area evidence (e.g. area profiles for Integrated Community Teams 2023 and Local Insight local data mapping tool update 2024), Core20plus5 and Inclusion Groups (e.g. carers and migrant groups equalities data profiles 2024, ongoing Gypsy, Roma and Travellers needs assessment). 

Years 2 and 3: summaries on local evidence from the Health Counts survey (2023) on inequalities across population groups and areas; scoping and delivering on topics and populations groups to inform the Shared Delivery Plan objectives (e.g. care leavers/care experienced, globally displaced communities and sex workers).

3.1 

Legal: The Health and Social Care Act 2012 (s196) requires the function of preparing a JSNA to be discharged by the Health and Wellbeing Board. Specifically, from April 2013, local authorities and Clinical Commissioning Groups (now Integrated Care Boards) have equal and explicit obligations to prepare a Joint Strategic Needs Assessment (JSNA) which provides a comprehensive analysis of current and future needs of local people to inform commissioning of services that will improve outcomes and reduce inequalities. 

Lawyer consulted: Sandra O’Brien 

Date: 14 October 2024

3.2

Finance: The resources required to support the production of the JSNA are funded by public health. The majority of the function is provided by the Council’s Public Health team together with some externally funded provision. The Council’s TBM net budget for external provision only is £0.025M in 24-25 and is expected to remain the same for 25 to 26 and 26 to 27. The Public Health grant allocation has not been confirmed beyond the financial year 2024 to 2025 which may impact on the availability of funding for both staffing and the external provision, though it is anticipated that financial resources will be available to enable the commissioning of the services detailed above from financial year 2025/26 and beyond. Any re-provision or changes will need to be managed within this existing budget. 

Finance Officer consulted: Katy Humpries 

Date: 10 October 2024

3.3 

Equalities

Needs assessments systematically consider specific needs of groups with protected characteristics. The JSNA is a key evidence source to inform action to improve outcomes in all groups and meet the public sector equality duty (including Equality Impact Assessments).

3.4 

Sustainability

No implications: Sustainability related issues are important determinants of health and wellbeing and these are integrated in the summary. The JSNA will support commissioners to consider sustainability issues.

3.5 

Health, social care, children’s services and public health

The JSNA summary sets out the key health and wellbeing and inequalities issues for the city and so supports commissioners across the city in considering these issues in policy, commissioning and delivering services.

Supporting documents and information

Appendix 1: JSNA programme outline for Years 2 and 3 (July 2024 to July 2026)

Appendix 2: Healthy Places JSNA summary

Proposed JSNA programme of in-depth needs assessments - Year 2, July 2024 to July 2025

1.

Topic

Pharmaceutical Needs Assessment.

Type

Statutory requirement. Commissioned out with some elements to be delivered in-house.

Stage by July 2025

Initiate (Publish by October 2025).

2.

Topic

Stage 2: Special Educational Needs and Disabilities (SEND), neurodiversity and learning disabilities (children and young people aged 0 to 25).

Type

Stage 2: potentially commissioned research and engagement. This will be based on stage 1 findings. Potential for new data collection, for example qualitative data; views of stakeholders, those with lived experience or service users; young person and families voice evidence for example with a targeted focus on under-represented group and/or intersectional lived experience qualitative insights.

Stage by July 2025

Scope.

3.

Topic

Neurodiversity and learning disabilities, adults aged 18 and over.

Type

An in-depth look at needs and assets overseen by a Steering Group that represents key stakeholders. To include: collation of currently available data; new data collection (e.g. qualitative data); views of stakeholders, those with lived experience /patients /service users and the public; service mapping and access to services; evidence reviews on inequalities, needs and assets, effective interventions/models of care, and makes recommendations.

Stage by July 2025

Scope.

Proposed JSNA programme of summary products - Year 2, July 2024 to July 2025

1.

Topic

Ageing well.

Type

Short summary (refresh of 2018). Data from the Health Counts survey is a key source of evidence.

Stage by July 2025

Complete.

2. 

Topic

Carers

Type

Short summary, data from the Health Counts survey and Safe And Well at School Survey (SAWSS) are key sources of evidence to add to Census profile.

Stage by July 2025

Complete.

3.

Topic

Gypsy, Roma and Traveller.

Type

Census and data profile.

Stage by July 2025

Complete.

4. 

Topic

Sensory impairments.

Type

Summary,

Stage by July 2025

Complete.

5.

Topic

Healthy people.

Type

Summary, same format as Health places summary.

Stage by July 2025

Complete.

6.

Topic

Learning disabilities - all ages.

Type

Data profiles, equalities. Linked to the timing of the related in-depth needs assessments.

Stage by July 2025

Initiate.

7.

Topic

Globally displaced communities.

Type

Summary with focus to be confirmed following consultation, different communities’ considerations, recent evidence and data availability. Last in-depth needs assessment on international migrants 2018.

Stage by July 2025

Scope.

8.

Topic

Sex workers.

Type

Summary; Engage with stakeholders and consult community groups to explore evidence gaps. Last summary 2016.

Stage by July 2025

Scope.

9.

Topic

Care leavers and care experienced.

Type

Data profiles, equalities. Need to explore data available.

Stage by July 2025

Scope.

10.

Topic

Gender equity

Type

Scope type, for example summary.

Stage by July 2025

Scope.

Proposed JSNA programme of in-depth needs assessments - Year 3, July 2025 to July 2026

1.

Topic

Neurodiversity and learning disabilities. Aadults aged 18 and over.

Type

See above. To be confirmed depending on scoping.

Stage by July 2025

Initiate.

2.

Topic

Stage 2: Special Educational Needs and Disabilities (SEND), neurodiversity and learning disabilities, children and young people aged 0 to 25.

Type

See above. To be confirmed depending on agreed need and scope. Potential for commissioned research and engagement.

Stage by July 2025

Initiate if required.

3.

Topic

Reproductive health. The JSNA SG has been provisionally discussing this as an in-depth NA, with “reproductive health” as the working title.

Type

To be scoped. Menstrual health, period poverty and gynaecological conditions. Fertility, pregnancy, pregnancy loss and postnatal support. Menopause. Set of summaries or in-depth needs assessment. Title and scope to be refined and further discussed with consideration of the Sussex Women’s Health Strategy work that is underway.

Stage by July 2025

Scope.

4.

Topic

Young people in transition between services, aged 16 to 25.

Type

Review if needed after SEND, LD and ND and LD and ND+18 have been completed. Children and young people with long term health conditions, for example diabetes, epilepsy and asthma, mental health needs, disability, children in care and care leavers.

Stage by July 2025

Review if required after the children and young people, and adults needs assessments.

Proposed JSNA programme of summary products – Year 3, July 2025 to July 2026

1.

Topic

Globally displaced communities.

Type

Summary with focus to be confirmed following consultation, different communities’ considerations, recent evidence and data availability, last in-depth needs assessment on international migrants 2018.

Stage by July 2025

Initiate.

2.

Topic

Sex workers.

Type

Summary; Engage with stakeholders and consult community groups to explore evidence gaps. Last summary 2016.

Stage by July 2025

Initiate.

3.

Topic

Care leavers and care experienced.

Type

Data profiles, equalities. Need to explore data available.

Stage by July 2025

Initiate.

4.

Topic

Gender equity.

Type

Scope type, for example summary.

Stage by July 2025

Initiate.

5.

Topic

Healthy Lives.

Type

Summary, same format as Health places summary.

Stage by July 2025

Complete.

6.

Topic

Gypsy, Roma and Traveller.

Type

Summary, using health counts and SAWSS data and qualitative data.

Stage by July 2025

Scope.

7.

Topic

Childhood immunisations.

Type

Data profile.

Stage by July 2025

To be confirmed based on data from NHS England.

8.

Topic

Asthma, Children and young people.

Type

Data profile.

Stage by July 2025

Scope.

9.

Topic

Diabetes, Children and young people.

Type

Data profile.

Stage by July 2025

Scope.

10.

Topic

Epilepsy, Children and young people.

Type

Data profile.

Stage by July 2025

Scope.