A Public Health Approach to Social Care and Wellbeing Services Tony McGinty Joint Assistant Director for Public Health Lincolnshire County Council and NHS Lincolnshire

The Approach Understand Your Population Understand Triggers Evidence Based Modelling Procure and Manage

Joint Strategic Needs Assessment (JSNA) Evidence based demand forecasting Wellbeing Support Service model Areas for discussion

Establish JSNA as a continuous process; Improve level and quality of engagement; Produce a succinct annual JSNA report; Focus report on the health inequalities Objectives for JSNA 2011 JSNA Objectives

35 topic areas identified based on the data. Each topic has an identified Owner. Owner issued with a template upon which to provide commentary. Commentaries underwent a peer review process JSNA Approach

JSNA Approach (2) What do we know? Indicator details Data, trends, profiles Targets and performance data Local views and engagement National and local strategies Current commissioned activity and services Key inequalities and equality impact What are the knowledge gaps? How are these impacting on effective service commissioning/delivery? What are the risks of us not delivering? What is coming on the horizon and what should we be doing next? What is this telling us?

New JSNA Website Joined up approach (IMD, Economic Assessment, etc) Additional ways of viewing the JSNA Brief Overview Report Presentation of JSNA

Presentation of JSNA (2)

Presentation of JSNA (3)

Promoting healthy lifestyles Improving health and wellbeing for older people Delivering high quality systematic care for major causes of ill health Improving health and reducing health inequalities for children Reducing Worklessness Identified Priorities from JSNA

JSNA Priority/Marmot Objectives Marmot Objective Priority Give every child the best start in life Enable all children, young people and adults to maximise their capabilities Create fair employment and good work for all Ensure healthy standard of living for all Create and develop healthy and sustainable place and communities Strengthen the role and impact of ill health prevention Promoting healthy lifestyles Improving health and wellbeing for older people Delivering high quality systematic care for major causes of ill health Improving health and reducing health inequalities for children Reducing Worklessness

Linked to JSNA priorities Developed in consultation with stakeholders (e.g. via Excellent Ageing) Focused on triggers which: –place people at risk of requiring more costly services; and/or –Indicate people may need some support, advice or assistance Evidence based demand forecasting

Areas of focus for demand forecasting: Evidence based demand forecasting In receipt of supporting housing Long term health conditions (Stroke, CHD, COPD, Dementia) Out of work benefits Fuel Poverty House re-possessions Estimated unclaimed disability benefits Adult social care (people assessed as not eligible combined with people exiting reablement services with no further services) Frail Older Peoples Project

Evidence based demand forecasting Category of Need Number (2010) People in receipt of Supporting People services 12,521 People with long term health conditions 70,926 Worklessness 48,170 Housing Need - Fuel Poverty 71,600 Housing Need - Repossessions 1,000 Unclaimed benefit claimants 97,420 Adult Social Care 4,045 Frail Older People Project 7,078 TOTAL312,760

Limitations of the model: Evidence based demand forecasting Some people will appear in more than one area Reliability/consistency when projecting and forecasting into future Other areas need to be forecast as well (Problem drug users, Smoking, Obesity, etc) Not all people will require the same level of support

Engagement A Little Bit of Help Please! Stay in touch with me Over lapping boundaries Accessible Acceptable

Next steps for the model: Evidence based demand forecasting Delphi approach to obtaining consensus with regards the forecasting Development of a model of support which recognises the differing levels of support people require Agree with colleagues in other services (social care) overlaps, hand off processes, risk/benefit sharing, etc

Numbers of People Service Need Community Support Acute Time Wellbeing Support Managed Advice Networks Stay in touch please

The Approach Understand Your Population Understand Triggers Evidence Based Modelling Procure and Manage