1. Improving Children’s Health and Wellbeing in the West Midlands Feedback from survey Present

2. To what extent did the JSNA really affect the priorities of the Health and Wellbeing Strategy? Mixed response Where JSNA did affect the priorities – Clarity of link – Order of development – Having consistency of Officer involvement Challenges – Speed of development – Work in progress

3. How to improve the development of JSNA/ Health and Wellbeing strategy Wider consultation Linking key health risks to key Marmot themes Contract Monitoring to align service/team impact to strategic priorities Dynamic relationship between JSNA and Outcomes frameworks

4. Best features of JSNAs Data Identifying the level of need in the population and Priority Neighborhood profiles Level of Detail from overview to comprehensive data depending on their individual requirements. Comprehensive coverage of topics Presentation Dynamic website, The way the information is presented in layers on website- Overview to allowing visitors to a greater level of detail, maps, data, etc, depending on their individual requirements. Process Collaborative process, Senior manager buy in

5. Possible additional priorities for the H&WB Strategy Qualitative indicators for child health Increase scope to incorporate deprivation in a wider context. Focus on life course Some respondents requested a decrease in the number of priorities

6. How will the H&WB Strategy really direct the services commissioned? By governance through the HWBB Focusing on the priorities Having teeth and being part of the DNA of the LA Encouraging joint commissioning Assigning a Board member as "champion" for each of the outcome areas. Agreeing the monitoring process Informing Public Health Priorities Challenges Public Health Priorities smaller list Interface between professional and public/patient

7. Improving the Health and wellbeing strategy Having a Strategy Wide spread consultation and engagement in the Strategies development Communicating Strategy to stakeholders/ Staff Refreshing Strategy once Board members established / board matures More detail

8. Best aspects of Health and Wellbeing Strategies Clear Governance Structures in place Identify work areas for priority Consultation with key stakeholders Links to other Strategies, Plans and priorities. Evidenced based targeted on clear and validated data Short, easy to read, comprehensive Whole system approach

9. Improving existing Governance arrangements Awaiting the Governance Structures for CCGs. Alignment of local structures/governance Ensuring all stakeholders are fully represented Improved communication between Boards

10. Managing relationships across the complex system Health and Wellbeing Board critical role Being Active rather than passive Focus collaboration on specific themes/ Services Ensuring strong collaborative relationships exist at all levels of structure. – Regular contact, – Mutual trust and respect, – Transparency, – Genuine desire to work differently – Commitment to new arrangements. Strong links in place based on existing working relationships – relationship building between key individuals where these don’t exist

11. Strengths of current joint commissioning Health Visiting services working in Children's Centres – Family and Child Centred – Sharing skills and expertise Joint commissioning posts – Enables all perspectives to be afforded equal importance School nursing service – Regular meetings with commissioners from health & LA

12. Strengths of current joint commissioning (Cont) Multi Agency Panels – Multi-agency group – Single Focus. All three agencies fully committed. – Budget Holders – joint decision Examples Joint Solutions Panel – Pooled Budget to support children with complex needs – Focus on sourcing better, cheaper, more local solutions to meet needs. Children and Young Person's Substance Misuse Group. – Comprehensive needs assessment process. Women and Children's joint commissioning group – Includes council's and NHS Provider services

13. Future Priority areas For joint commissioning Social support in pregnancy and early years Children's integration with adult commissioning CAMHS, School nursing, Health Visiting 0-19 Healthy Child Programme

14. Examples of joint delivery that are working well JSNA Triaging arrangement involving children's social care, health and police. Obesity Targeted Youth Support Panel Sexual Health Services CAF

15. Areas for further integration of delivery Priorities within HWB strategy Having an holistic approach to an individuals health and wellbeing. 5-19 healthy child programme Front line and preventative services Specific areas – School nursing, – Health visiting – CAMHS – Early years -Children’s centres, – Schools and colleges, – Youth services

16. Sharing best practice: Warwickshire County Council JSNA Website

17. Sharing best practice: Dudley’s Joint local protocol between adult drug and alcohol treatment services and local safeguarding and family services. : Link http://safeguardingchildren.dudley.gov.uk/information-for-professionals/safeguarding-children-procedures/children-in-special- circumstances/?assetdet549=106104 http://safeguardingchildren.dudley.gov.uk/information-for-professionals/safeguarding-children-procedures/children-in-special- circumstances/?assetdet549=106104

18. Sharing best practice: CAMHS West Midlands – Warwickshire and Coventry Tier 2 Targeted Services for Mental Health (TAMHS), – Wolverhampton Tier 3+ – Worcestershire Service redesign National SE Scotland redesigned Tier 4 across 3 NHS Board areas (Lothian, Fife, Borders) Tendering of Tier 2, 3 and 4 services

19. Sharing best practice: Public Health (0-5) – Family Nurse Partnership Programme (FNP) – Costs of the FNP are typically around £3200 per supported family per year based on supporting a caseload of 100 families. – Stoke, Staffordshire, Telford & Wrekin, Walsall, Birmingham, and Dudley. YP Substance misuse National Treatment Agency Guidance and Best Practice – http://www.nta.nhs.uk/young-people.aspx http://www.nta.nhs.uk/young-people.aspx London CAMHS Substance Misuse Specialist Service –(3 Las) Stoke – Outcomes Based Commissioning Worcestershire – payment by results – recovery based – outcome focused contract.

20. Sharing best practice: Disabled Children’s Services and complex health needs – Personalisation – http://www.opm.co.uk/wp-content/uploads/2012/10/MIP-word-doc-of-pdf-final- Oct-2012.pdf http://www.opm.co.uk/wp-content/uploads/2012/10/MIP-word-doc-of-pdf-final- Oct-2012.pdf Teenage pregnancy (and sexual health) – http://www.respectyourself.info/ http://www.respectyourself.info/ Joint commissioning of sexual health services Solihull and Birmingham (4PCTS) London Sexual Health Programme – http://www.londonsexualhealth.org/about-us.html http://www.londonsexualhealth.org/about-us.html Yorkshire and Humber – http://www.yorksandhumber.nhs.uk/what_we_do/improving_the_health_of_the_popul ation/sexual_health/ http://www.yorksandhumber.nhs.uk/what_we_do/improving_the_health_of_the_popul ation/sexual_health/

21. Links to JSNA Birmingham City Council http://bhwbb.net/wp-content/uploads/2012/09/New-One-JSNA- SUMMARY-2012-final.pdf Coventry City Council http://www.coventrypartnership.com/upload/documents/news/PIE%20 GROUP/JSNA%202012.pdf Dudley MBChttp://www.dudleylsp.org/jsna/ Herefordshire Council http://www.herefordshire.gov.uk/factsandfigures/docs/Research/JSNA_ 2011_Key_points_and_Recommendations_(V1.2).pdf Sandwell MBC Shropshire Council http://shropshire.gov.uk/jsna.nsf/viewAttachments/JSHW- 8WLCEF/$file/Shropshire_JSNA_SummaryDocument_2012.pdf Solihull MBChttp://www.solihull.gov.uk/akssolihull/images/att14595.pdf Staffordshire Ccunty Council http://www.staffordshire.gov.uk/health/PublicHealth/Staffordshire- Needs-Assessment-2012.pdf Stoke-on Trent City Council http://www2002.stoke.gov.uk/planning_uploads/Joint%20Strategic%20 Needs%20Assessment%202011.pdf Telford and Wrekin Council http://www.telford.gov.uk/downloads/file/4286/discussion_1- priorities_and_new_ways_of_working_to_improve_the_health_and_we llbeing_in_telford_and_wrekin Walsall Council http://cms.walsall.gov.uk/observatoryindex/wpo- needs_assessments/wpo-jsna.htm Warwickshire County Councilhttp://jsna.warwickshire.gov.uk/ Wolverhampton City Council http://www.wton- partnership.org.uk/UserFiles/File/JSNA%202009%20Update.pdf Worcestershire County Councilhttp://www.worcestershire.gov.uk/cms/pdf/JSNA-Summary-2012.pdf