What is a Joint Strategic Needs Assessment (JSNA)?
JSNA are assessments of the current and future health and social care needs of the local community – these are needs that could be met by the local authority, Clinical Commissioning Group (CCG), or the NHS Commissioning Board. Local areas are free to undertake JSNAs in a way best suited to their local circumstances. There is no template or format that must be used and no mandatory data set to be included.
A needs assessment is ‘a systematic method for reviewing the health and wellbeing needs of a population, leading to agreed commissioning priorities that will improve health and wellbeing outcomes and reduce inequalities' (Department of Health JSNA Guidance 2007, p.7).
The most recent Department of Health guidance on JSNA.
The Southampton JSNA
In Southampton the current JSNA is a comprehensive online resource. It aims to identify the ‘big picture’ for health and wellbeing through analysis of a wide range of data sets and through stakeholder and public engagement.
Maintaining a needs assessment is a dynamic iterative process rather than a product and builds on the first JSNA, published in 2008. The local data compendium lies at the heart of that process. The data will be used to inform future commissioning decisions and spending priorities. The data compendium will be regularly updated with current data during the lifetime of this second JSNA as new data sets and analysis become available. This assessment also integrates the six key recommendations from Sir Michael Marmot’s report Fair Society (2010), probably the most important evidence based commentary on health for a generation.
This version of the JSNA informs developments following a time of substantial change for the NHS and the city council. The Primary Care Trust ceased to exist in April 2013, and the new GP led Clinical Commissioning Group (CCG) has taken over responsibility for commissioning most of the health services required for local people. The public health function has transferred to the local authority and Public Health England has been established. This JSNA will help to inform commissioning decisions during the tightest public spending environment in a generation.
The JSNA illustrates that improving health and wellbeing in a city such as Southampton will not simply be about delivering more health and social care services. It recognises that enabling people to live healthier lives is as much about helping people maximise their own individual potential and, helping them to create a safe and pleasant environment to live in, as it is about improving the quality and accessibility of services. Ultimately each individual has a personal responsibility to make mature and sensible decisions for their own health and to help their children to make good decisions about diet, exercise, drugs, alcohol and sexual health.
Many people are shocked by the scale of health inequalities that exist in Southampton. We have a highly valued NHS and the overall health of the population in the city has improved greatly over the past 50 years. Yet in the wealthiest part of Southampton, in Bassett, a man can expect to live to 80.6 and women 84.0 years, while a few kilometres away in Bitterne, one of the cities poorer wards, life expectancy is 75.3 and 79.9 years for males and females respectively. These differences in life expectancy of 5.3 and 4.1 years respectively for men and women are significant enough not to be a coincidence. Dramatic health inequalities are still a dominant feature of health in Southampton (adapted from Marmot 2010).
Health inequalities are not inevitable and can be significantly reduced. They stem from avoidable inequalities in society: of income, education, employment and neighbourhood circumstances. Often inequalities present before birth set the scene for poorer health and other outcomes accumulating through the course of our residents lives.
Within this JSNA an initial attempt has been made to describe some of the health assets which include factors or resources which enhance the ability of individuals, communities and populations to maintain and sustain health and well-being. These assets can operate as protective and promoting factors to buffer against life’s stresses. Indeed, asset based community development (ABCD) presents an evidence-based framework to help practitioners recognise that as well as having needs and problems, communities also have social, cultural and material assets. These are what help them overcome the challenges they face. The asset approach does not replace investment in improving services or tackling the structural causes of health inequality. While it may help reduce demands on services in the long term and bring about more effective services, it is not a no-cost or a money-saving option.
Other major developments that affect future services are the recommendations from the Munro Review of Child Protection (2011) and the changes in autonomy of schools and their funding.
Following extensive public and stakeholder consultation nine key themes for a healthier population have been identified (see figure below). These are underpinned by a good understanding of Southampton’s changing population – each theme also dovetails to the Marmot 2010 main policy recommendations in a ‘Fair Society, Healthy Lives’ to ensure consistency with national requirements of local services.
Each of the key themes is explored in detail within this website. Each theme has it's own dedicated web page which is presented in a uniform format, addressing a number of key issues which are listed below:
Who is at risk and why?
The level of population need
Current services in relation to need
Projected service use and outcomes
Evidence of what works
Resources (includes data compendium)
The steps leading up to the creation of this assessment have been:
The creation of a comprehensive consultation document: The Joint Strategic Needs Assessment (JSNA) Refresh Consultation 2010 was produced in July 2010 to identify the needs and consult with stakeholders.
Consulting with the public and stakeholders: Using the large document above and a magazine summary called Health Matters 3, a four month consultation was completed at the end of 2010. Please see the report of the consultation.
Discovering 9 key themes: Using consultation feedback and public health knowledge, 9 key themes were identified and used as the basis of this website.
Creating a website as a dynamic tool for the use of information: The information on this website will be updated regularly to ensure that professionals and communities are able to access the most recent data available.
In June 2012 there was a stakeholder workshop held to help drive forward and improve the JSNA process in Southampton. Dr Angela Donkin from the UCL Institute of Health Equity gave an opening presentation to set the context of the JSNA. There was good engagement and many useful suggestions made at the workshop, many of which have now been implemented. These include the establishment of quarterly strategic and analysts groups. The terms of reference and meeting minutes for these groups can be found at the bottom of this page.
The nine themes of the JSNA are updated according to a rolling timetable. This timetable is updated regularly; the current version is also available to download at the bottom of the page.