1. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk JOINT STRATEGIC NEEDS ASSESSMENT FOR CAMBRIDGESHIRE Phase 2

2. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk The Cambridgeshire Approach In Cambridgeshire we have produced six JSNAs to date. These focus on different groups within the population. While there is some overlap between the different JSNAs, each looks at their particular population in detail. The JSNAs have been led through existing PCT/CCC joint strategy and commissioning groups. More recently a ‘community views’ JSNA has been produced, bringing together material from several local and national consultations

3. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk The combined JSNA Process

4. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk Updating the JSNAs The JSNA are being continuously updated as new demographic and other information becomes available. Phase 2 includes, County Council Research Group population estimates and forecasts as well as the revised Index of Multiple Deprivation (IMD)

5. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk Key Demographics Table 3: Total population : population forecasts, mid 2006 based (CCCRG) Source: Cambridgeshire County Council Research Group Mid-2006 district level population forecasts by age and gender By 2021 it is estimated that there will be a further 86,000 people living in Cambridgeshire. The biggest actual increases and also proportional increases are expected in South Cambridgeshire and Cambridge City.

6. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk Index of Multiple Deprivation, 2007 Table 6:Fifth most deprived wards in Cambridgeshire Table 5: Local Authority, average of SOA scores NB: *LA rank (England): the rank for 5 district authorities represents the relative rank within the 354 tier 2 local authorities in England where rank 1 is the most deprived authority and rank 354 the least deprived. The rank for Cambridgeshire represents the relative rank within the 149 tier 1 local authorities where rank 1 is the most deprived authority and rank 149 the least deprived. Source: The English Indices of Deprivation 2007, Department for Communities and Local Government (DCLG)

7. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk Life Expectancy Cont’d Most of the wards with significantly higher levels of deprivation are in Fenland, but some are in north east Cambridge, Huntingdon and East Cambridgeshire. Those in the 40% of wards with the least levels of deprivation (ie Q4 and Q5) have statistically significantly higher life expectancy than the county average. Source: Population data: Research Group of Cambridgeshire County Council population estimates.

8. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk Children and Young People Key Findings Summary Currently some 139,000 children and young people aged 0-19 live in the county, with Huntingdonshire currently having the largest such population. On average there are around 7,000 in each single-year age group. Forecast growth in the population aged 0-19 in Cambridgeshire between 2006 and 2021 is 4% (5,300 children). The 0-19 population is forecast to fall by 17% in Huntingdonshire (6,800 children) and to rise by 40% in Cambridge City (9,600 children) and 14% in South Cambridgeshire (4,700 children).

9. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk Children & Young People - Lifestyle Issues In Cambridgeshire as a whole: About 8% of children in reception and 16% of children in Year 6 are obese About one in ten boys and one in six girls aged 14-15 smokes regularly Nearly a quarter of Year 8 children had had an alcoholic drink in the last week and a half of Year 10 children About one in thirty-five girls aged 15-17 become pregnant each year, with the highest teenage pregnancy rates in Fenland and Cambridge City. About 6% of young people aged 15-24 in Cambridgeshire screen positive for Chlamydia (a sexually transmitted infection)

10. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk Children ‘in need’ cont. Across the county 3.2% of pupils have a statement of special educational need; a further 5.2% are identified as having significant educational needs. The majority of these have moderate or specific learning difficulties, behaviour, emotional and social difficulties or speech, language and communication needs. In April 2007, there were 365 non-respite children in care, with the majority aged between 10–15 years. These children are most at risk of having poor educational outcomes, at risk of becoming young offenders and teenage parents, and vulnerable to mental health problems.

11. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk Community Views – Children and Young People Children and young people in Cambridgeshire describe themselves as living quite sedentary lives. They may not undertake enough physical activity, may have a poor diet and are often bored. Young people believe that this is because their leisure options are restricted Young people in Cambridgeshire are aware that STIs exist and that the incorrect use of contraceptives could also lead to unwanted pregnancies. However, they believe that a more effective and timelier sexual health education could help decrease the incidence of diseases and unwanted pregnancies.

12. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk Mental health problems, mainly anxiety and stress, are often a result of bullying, disagreement and poor communication with parents or family and because of boredom. A poor physical environment at home can also increase children and young people’s anxiety and stress. Smoking, drinking and consumption of substances are mainly caused by imitation and peer pressure. Anti-social behaviour is often linked to these activities. Minority groups such as Gypsy and Traveller children and young people describe themselves as being at risk of mental health problems and a decrease of their general well-being because of bullying and racism Community Views Cont’d– Children and Young People

13. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk Table 32: Taking forward the findings of individual JSNAs Children and young people Many of the needs identified in this assessment are already being addressed through The Big Plan, and the JAR Action Plan. The next steps will be to compare the services being provided with the needs identified and look for gaps in services and for services where there is room for improvement as part of the update of The Big Plan. Adults of ‘working age’ Specific work will be undertaken to better understand preventative needs from the perspective of the population and service providers. This work will be overseen by a new county-wide Health and Well Being Partnership. Adults with mental health problems The JSNA on adults with mental health problems will inform the development of a Mental Health Promotion Strategy for Cambridgeshire and the joint commissioning of mental health services. Adults with learning disabilities The JSNA will inform the Joint Commissioning Strategy for people with learning disabilities. The JSNA will be revised in the light of new developments and guidance; changing needs and priorities and ongoing consultation. Adults with physical and sensory impairment and long term conditions The JSNA will be used to inform the Joint Commissioning Strategy for Physical Disabilities and Sensory Impairment. The JSNA is also informing the update of the PCT Long Term Conditions Action Plan. Older people The data from the JSNA on Older People underpins the PCT Long Term Conditions Strategy and is informing the multi-agency Older People’s Strategy which focuses on the broader determinants of health. It will also inform the Joint Commissioning Strategy for Older People.

14. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk SWOT analysis – strengths The care group approach allowed richness of data collection for each care group, and supported the direct use of JSNA in joint service commissioning strategies. The Community Views JSNA brought together a wide range of consultation material into one place, in a way which hadn’t been done before

15. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk SWOT analysis - weaknesses The care group approach made overall co- ordination of the phase 1 and phase 2 JSNA more challenging, particularly as we did not have a dedicated JSNA project manager The PH analyst team had to divide their time between several JSNA strands at once

16. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk SWOT analysis - opportunities The appointment of a new JSNA co- ordinator post will enable a structured programme of updates, stakeholder engagement and communications for the JSNA This appointment will also enable more detailed logging of the impact of JSNA on service planning

17. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk SWOT analysis - threats Council elections may mean that a new set of communications activities are required to ensure that members are aware of and engaged with JSNA There is a risk that the JSNA will be well used internally by public sector organisations but not owned by local communities.

18. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk Gaps in guidance and support Timeliness of JSNA guidance in 2007: It was good when it arrived, but too late to meet requirements of the Local Area Agreement process.

19. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk Data and information analysis – support from PHO or IC Acknowledgement of Local Authority population estimates/forecasts Skills – e.g. predictive modelling and sensitivity analysis There may be some rich data at PHO/IC level which we are not fully aware of in PCTs.

20. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk Possible new pieces of work Improving outward facing communication with the public – web-based materials and active publicity Evaluation of how JSNA has been used in service planning, its impact on front line services – and taking the learning from this. (Working with additional data sources - e.g. police/housing).

21. NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.ukwww.cambridgeshire.nhs.uk