Agenda item

This report provides an update on the current JSNA work programme and outlines proposals for future projects. The paper presents two JSNA products for consideration and approval by the Health and Wellbeing Board.

Councillor Vivienne Lukey, Chair and Cabinet Member for Health and Adult Social Care welcomed Jessica Nyman, JSNA Manager, and Thilina Jayatilleke, Senior Public Health Analyst, for this item, which provided an update on the current programme of work and outlined future proposals for the work programme.  Toby Hyde, Head of Strategy, H&F CCG introduced the Young Adults JSNA, which highlighted the collaborative process that was followed.  A key aspect of the JSNA had been the identification of the needs of the local population, allowing invaluable correlations to be drawn from key data sets.  It was noted that the Online JSNA in particular offered the opportunity to extrapolate data and allow for deep dive analysis, which had been particularly useful for the report on Young Adults (18-25) JSNA. 

Jessica Nyman reported that the one of the key priorities in the JSNA forward plan was a deep dive JSNA on the needs of children and young people with Special Educational Needs and complex health needs, a key priority area for Children’s Services, giving the forthcoming inspection.  A mental health JSNA was also factored into the forward plan, to be undertaken in the next two years.  

Toby Hyde commented that the process in examining this particular cohort of the population was interesting, given its transient nature and higher rates of migration.  Young adults transitioning from 18-25 comprised 12.5% of the population, with historically very little evidence collected as to their needs.  It was explained that this cohort had shown the least improvement medically in the previous 50 years, with evidence suggesting that this was the point at which poor health choices became rooted in risky behaviour, manifesting themselves in later life in form of long term conditions.  More detailed evidence would help identify trends and formulate a broad pattern, to help pinpoint risk taking behaviour particularly in respect of substance misuse and mental health.  Social isolation amongst young adults was also known to be increasing significantly. 

From a health perspective, Toby Hyde continued that 45% of patients surveyed would not feel comfortable in talking to a GP, with a disproportionate percentage of 18 - 25-year-olds preferring to use urgent care centres.  There was evidence to suggest that improvements such as accessible digital platforms utilising smart technology might be more in line with expectations.  Key findings and themes were set out in paragraph 4.6 of the report.  Paragraph 4.7 of the report included summarised recommendations which included piloting an integrated primary care model at one or more GP surgeries and offering additional GP training. 

Councillor Rory Vaughan commented that the preference to attend urgent care centres by young adults was not a revelation, but it would be helpful to identify what evidence that was already known in terms of achieving a better understanding of risky behaviour patterns, post 18+.  Keith Mallinson, Healthwatch, suggested that drop-in sessions might be a better, more informal alternative, given that the traditional access to GP appointments was problematic for some groups, particularly in terms of addressing the needs of the homeless, for example, recognising the impact of homelessness on mental health.  Councillor Fennimore informed the Board that the Rough Sleepers Commission would be launched this week, to be chaired by the CEO of Crises.  It was anticipated that some of the recommendations would address mental health issues and the review findings of the mental health task group would also feed into the work of the new commission, and input into the redesign of services. 

Councillor Vaughan agreed, but asked how this would be addressed and work, particularly in terms of consultation and engagement with young people.  The ways in which young people accessed GP surgeries needed to extend beyond the traditional primary care settings and it was suggested that GP’s could be taken out of the surgery to offer alternative ways by which young people could access services.  Ian Lawry, Sobus, reported that they had led a youth partnership, to allow young people to comment and engage on universal redesign work.  He took the view that it was not necessary to make it an either or choice, provided the outcome was that GP services were more accessible.  Long term, the same cohort would still need to access GP services.  A balanced approach of outreach work and engagement with GPs in terms of creating a modernised way forward, was needed.  This could also be part of the Integrated Family Support Services (IFSS) conversation. 

Toby Hyde, continued the discussion referencing learning from The Well Centre, Lambeth case study (Agenda, page 39) and acknowledged the challenges around designing services that could be more like a youth centre rather than a GP surgery, integrated with modern technology.  Councillor Lukey related this to the example of substance misuse and a number of successful projects that were accessible and highly focused, and how these linked to the recommendations.  Toby Hyde responded that the key was to how to draw the work together, suggesting an initial development of an informal, model.  Councillor Vaughan asked if there was more information (other than risky behaviour) as to why young people preferred not to see GPs, what were the characteristics that defined them, if they were brought up locally, or transient and why they did not have a long standing relationship with a GP.  Toby Hyde confirmed that the higher migration rate of 30% in this cohort group could be a factor.  

Thilina Jayatilleke, Senior Public Health Analyst, introduced the online version of the JSNA.  The JSNA Highlight report was produced annually by Public Health and provided a holistic view of the population, highlighting key population demographic changes.  There were a number of key reasons for the development of a web based JSNA.  Primarily, it was difficult to source timely data that was both cost effective and low maintenance, excluding the development of a web application.  It was also explained that the Public Health team was keen to utilise in-house expertise.  The platform reproduced data from other organisations such as the Public Health England databases and required little input from Public Health.  A link was contained in the report and members of the Board were invited to explore the tools and available facilities for themselves to provide user feedback.  Referencing the PH England database, the key point to note was the difficulty in locating the required data, if accessed at source, it still required an understanding of how to navigate the database.  Looking forward, it would be possible to refresh that data and for this to be included in annual reports so that the most up to date figures could be reported.  Councillor Fennimore welcomed the Online JSNA, which could prove to be an invaluable tool for officers, particularly those involved in policy development, supporting the work of the Commissions, who would be able to provide useful feedback.  Sarah McBride, Director for Partnerships commended the work as easy to access and very useful, and speculated about the possibility of marketing the concept more broadly.  It was agreed that the Communications Team would assist by drafting a press release, highlighting the benefits and facilitate access across the different departments of the Council. 

ACTION: Board members / LBHF Policy and Communication Teams

It was noted that Information as to who accessed the tool, how often and the kind of data sought, was not retrievable at this time but could be explored in the future, given the value of recording information about who was using the online tool.  It was agreed that a demonstration session be organised for NHS colleagues.  Jessica Nyman observed that the Online JSNA would be a useful tool in supporting the deep dive work on children and young people, aged 0-25, with complex health and care needs, supporting the JHWB strategic priority on supporting children and young people, best possible start in life.  The work would be undertaken by Steve Buckerfield, Head of Children’s Joint Commissioning and Steve Comber, Policy Officer, to be completed by the end of the year.

Board members thanked Thilina Jayatilleke and Public Health colleagues for their invaluable work on producing the Online JSNA.  

ACTION: Public Health / CCG

RESOLVED

1.    That the Young Adults JSNA, be approved for publication;

2.      That the points made during discussion by the Board, be noted, and that further feedback as to the user experience of the JSNA Highlight Report (Online JSNA) be provided from each of the Board’s member organisations;

3.      That the Public Health Intelligence Team, will on a rolling basis, as and when available, update the data in the JSNA Highlights Report (Online JSNA) and provide an annual summary of changes made, to the Health and Wellbeing Board; and

4.      That the proposals for the future JSNA work programme for 2017/18, incorporating the Children with Complex Needs JSNA, be approved.