1. JSNA briefing for Royal Borough Windsor and Maidenhead
NHS Berkshire East
Update 5th November 2009
Dr Pat Riordan
Director of Public Health

2. Guidance on Joint Strategic Needs Assessment
The Local Government and Public Involvement in Health Act (2007) places a duty on local authorities and PCTs to undertake Joint Strategic Needs Assessment (JSNA).
JSNA is a process that will identify the current and future health and wellbeing needs of a local population, informing the priorities and targets set by Local Area Agreements
It should lead to agreed commissioning priorities that will improve outcomes and reduce health inequalities
The JSNA should inform the sustainable community strategy as well as WCC strategic and operational plans

3. Questions the JSNA should address

4. What has happened since last year?
Accomplished
Smoking cessation – targets met
Alcohol
Recommissioned Tier 3 service
Introduction of arrest referral officer
Pan flu response practice
HIV service commissioned
Carers respite services
Telecare equipment evaluated, positive outcomes
Improved delayed discharge arrangements
Ongoing/to do
Children's Trust priorities for;
Pakistani and traveller
groups,
Healthy Minds programme
Childhood obesity
Older people; joint commissioning
plans for dementia
Long term conditions needs
assessment
Introduce national recommendations
for improving the falls service
Review Carers Services
Transforming Social Care
Prevention Agenda

5. Modelling the effect of the recession
Audit Commission report (2009) requires councils and PCTs to have recession management plans in place. There is evidence that Wave 1 has commenced with rising unemployment and negative growth - a reduction in housing prices and a rise in acquisitive crime has also occurred.
The Audit Commission report forecasts that in Wave 2 there will be an increase in mental health problems, domestic violence, alcoholism and addiction; with longer term ill health sustained in some areas whereas other areas will recover quickly once the recession ends.
A full pdf of valuable interventions that businesses can take is available at

6. The next 5-10 years Financial climate: (-) growth
PCTs/ LAs need recession management plans
Wave 1: increase unemployment, decrease house prices
Wave 2: increase mental health problems,domestic violence, alcohol/ addiction
Wave 3: unequal recovery, growth back to trend
Inequalities increase

7. rs Significant increase in older people
Increased pressure on health and social care services and carers
Long term conditions
Mental health problems
Significant rise in dementia

8. What do National Health Profiles say?
Health of people in RBWM generally better than England average
Pockets of deprivation: male life expectancy 5 years lower in most deprived areas
2800 children+ living in poverty, 900 eligible free school meals

9. JSNA outcomes supported by evidence
Violent crime is a problem
Rate is higher than England average
18.4 per 1000 population (England 17.4)
= 2564 incidents 2007/08

10. Population % change

11. RBWM Deprivation Profile

12. Life expectancy by quintile of deprivation nationally
No fifth quintile is shown for Bracknell as the total male or
female population is below 5000 (2003-7)

13. All Age All Cause Mortality
New national measure to show how PCTS & Las are tackling inequalities
Evidence shows that most effective way to achieve 1 year increase in life expectancy and narrow the gap between worst and best wards is by targeting
Male cardiovascular disease
Female COPD

14. RBWM AAAC

15. Standardised years of life lost <75 2005-7

16. RBWM Deaths from CVD

17. RBWM Deaths From Cancer

18. RBWM LTC Projections 2009 2014 2019 % Change CHD 3902 4198 4460 14%
Heart Failure
437
482
550
26%
Stroke
1968
2131
2273
15%
Hypertension
14700
15520
16229
10%
Diabetes
4164
4419
4624
11%
Epilepsy
672
686
702 4%
COPD
1303
1442
1615
24%
Cancer
1124
1182
1241
Hypothyroidism
3298
3590
3858
17%
Mental Health
635
644
660
Asthma
7103
7384
7557 6%

19. Prevalence of stroke

20. Stroke prevalence forecast

21. Dementia

22. Asthma

23. COPD (Qof prevalence by ward)

24. Estimates of alcohol misuse

25. Smoking prevalence by ward (QoF 2008/9)

26. Percentage of obese children in year 6, 2008/9
The key message is that the RBWM results are below the national rates however not below the LAA trajectory rates. This is because the national information centre pools data from out of the area i.e students may attend schools in Bucks or Surrey

27. Prevalence adult obesity by ward (QoF)

28. Questions?