A refresh on Warwickshire’s Joint Strategic Needs Assessment (JSNA) Kate Rushall JSNA Programme Manager

To cover today… What is the Joint Strategic Needs Assessment? Link between evidence and strategy Prioritisation and process 11 JSNA priority focus areas JSNA 2015 – 2018 Work Programme Next steps More information

What is the Joint Strategic Needs Assessment? The overall purpose of Warwickshire’s JSNA is to identify the current and future health & wellbeing needs of the local population. This intelligence is then used to establish a shared, evidence based consensus on the key local priorities across health & social care.

Joint Strategic Needs Assessment Joint Strategic Needs Assessment Framework for partnership involving all stakeholders in identifying and acting on need Strategic direction for commissioning of services Identify health & wellbeing inequalities, assets and gaps from existing information Include outputs that can be translated into action & recommendations to be taken forward

To form a key element in the Commissioning Cycle Provide the evidence base and inform the priorities in Warwickshire’s Joint Health & Wellbeing Strategy (JHWS) Link between evidence and strategy Informs How will deliver

A difficult balancing act! e.g. Dementia e.g. Substance Misuse E.g. Should dementia be more of a priority in Warwickshire than substance misuse? Weight of evidence

Prioritisation No single ‘best’ way of prioritising inherently complex and varied health & wellbeing issues ‘An art not a science!’  Any such process involves a certain degree of subjectivity. However, we have tried to introduce an element of  objectivity  robustness  transparency

Process Each topic run through tool Relevant evidence is assessed and ‘high’, ‘medium’ or ‘low’ scores given for each criteria Scores moderated by a group of analysts Scores totalled Topics ranked Process

Prioritisation Workshop – Summer 2014 Priority themes discussed  ‘Champion’ presentations Health & Wellbeing members voted on priorities and ranking Process

JSNA Priority Themes Looked After Children Educational Attainment of Disadvantaged Children Vulnerable Young People Mental Health Adults & Children Dementia Mental Wellbeing Cancer Cardiovascular Disease Long-Term Conditions Weight Management Smoking/Smoking in Pregnancy Substance Misuse & Alcohol Physical Wellbeing Young Carers Adult Carers Carers

Work Programme

Next steps JSNA Annual Update 2015/16  Published in September 2015 Delivering Year 1 priority Needs Assessments including:  Looked After Children  Carers  Mental Health Ongoing needs assessments Other Needs Assessment activity Foundation workstreams including:  Data Sharing  Alignment of commissioning cycles

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Warwickshire as a place Warwickshire Observatory Andy Davis

Population , , % 484, % +28.6%

Population , , , , , , , , , % 16.1% 17.4% 22.2% 12.9% 11.3%

Population The rate of growth increases with age, with the eldest age group (85+) projected to increase by a staggering 165% from 2014 to The age group is projected to increase 6% between 2014 and 2037 Dependency Ratio:

Population Warwickshire Internal Migration Flows will include flows made between LAs within the selected area Estimated Population ,729 Births5,937 Deaths4,814 Births minus Deaths1,123 Internal Migration Inflow26,787 Internal Migration Outflow26,354 Internal Migration Net433 International Migration Inflow3,476 International Migration Outflow2,320 International Migration Net1,156 Other153 Estimated Population ,594 Population Change2,865 % Population Change0.52%

Population

Housing

Workforce The number of people claiming Job Seeker’s Allowance (JSA) in Warwickshire is now lower than before the recession… However long-term unemployment has yet to return to levels witnessed a decade ago Medium residence-based gross annual earnings 2013= £28, = £27,377

Socio-demographic profile

Deprivation

2037

Health: Projecting numbers of residents with limited activity

Education 5+ A*-C incl. Eng & Math GCSE Eligible for free school meals Not eligible for free school meals

Headline Trends

District Trends

Assessing JSNA information

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Warwickshire’s JSNA – Key Messages Dr John Linnane Director of Public Health

JSNA Review Priority Themes Presented to HWB - January 2015

Education Attainment of ‘Disadvantaged’ Pupils Interestingly, differences are lower in North Warks than in South Warks: North Warks23% ppt gap Nun & Bed27% ppt gap Rugby29% ppt gap Warwick 36% ppt gap Stratford-on-Avon 39% ppt gap N.B. A disadvantaged pupil is defined by the Department for Education as any pupil eligible for free school meals at any time over the last 6 years, or Looked After Children (LAC).

Cancer It is estimated that more than 1 in 3 people in the UK will develop some form of cancer during their lifetime. 2.0% of the Warwickshire population are recorded as having been diagnosed with cancer (11,335 patients). Approximately 2,435 new cases of cancer each year. In 2012, there were 1,461 deaths due to cancer (28.1% of all deaths). 1 in 4 people will die from cancer.

Cardiovascular Disease 12.2% (53,100) of the population aged 16+ in Warwickshire estimated to be living with CVD, whilst 5.6% (24,600) are estimated to be living with Coronary Heart Disease (CHD), and 2.6% (11,300) with Stroke alone. Currently over 27,000 patients on GP registers for stroke and CHD which suggests a notable gap between the estimated and the observed prevalence.

Smoking in Pregnancy 11.5% of Warwickshire mothers were recorded as smokers at time of delivery during 2014/15 - comparable to the England rate (11.4%) but lower than in 2013/14 (13.1%). Smoking status at time of delivery (SATOD) by CCG, 2014/15 MaternitiesSATODPrevalence Coventry & Rugby5, % South Warwickshire2, % Warwickshire North2, % Source: HSCIC

Alcohol But…the rate of hospital admissions due to alcohol among the under 18s has fallen in line with that nationally.

Obesity Childhood Obesity Childhood Obesity 21.8% of in Warwickshire adults classified as obese. A further 43.0% estimated to be overweight (but not obese) hence almost 2 in 3 adults are defined as carrying excess weight.

Carers 11% of Warwickshire residents provide unpaid care for at least 1 hour a week. 3,589 children & young people (aged 0-24) are providing care to members of their families. 12,452 people provide 50+ hours unpaid care each week. Of these, almost 400 are aged Carers providing 50+ hours of unpaid care a week are more than twice as likely to report that their health is ‘not good’ compared with those who provide no care.

Mental Health – Children and Adults Hospital admissions for young people for self-harm significantly higher than England average (and increasing!). 10.6% of Warwickshire adults 18+ had depression in 2010/11 (England average 11.7%) In 2013, there were 42 suicides in Warwickshire. The suicide rate is comparable to both the West Midlands and England rate. rate

Looked After Children (LAC) Considerable educational attainment gaps between LAC and Non-LAC. Links to poorer future health outcomes.

Vulnerable Young People 13.2% of children live in poverty in Warwickshire 19.5% in Nuneaton & Bedworth v 9.1% in Stratford-on-Avon

Dementia Large projected increase From , dementia prevalence in Warwickshire projected to increase by 27.7% for those aged 65+, a faster rate than that for the West Midlands Region (+24%) and England (+23.5%). Still a large gap between those diagnosed and those expected to have dementia.

Other useful evidence/future work Director of Public Health Annual Report  2015 – Children & Young People Living in Warwickshire Survey  2013 Strategic issues analysis paper to HWB  New for 2015 – online, interactive survey of key HWB issues for Warwickshire residents More CCG / District & Borough based analysis

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