Agenda item

The production of the Joint Strategic Needs Assessment (JSNA) was a statutory duty of the HWB. The development of the Joint Local Health and Wellbeing Strategy had been led by the JSNA, and the Integrated Care Strategy would also be influenced by the JSNA.

Matt Fung presented the annual summary and explained that the format of the summary had been updated to make it more accessible. Members of the HWB were asked to study the parts of the JSNA which were relevant to their particular organisations and to use it in their own plans and strategies.

Various points were highlighted:

·       It was known that the demographics were changing across the county, with an aging and growing population. The ethnicity data would be refreshed over the coming weeks with the publication of the 2021 census data.

·       In general the population of Worcester was healthy, although there were pockets of inequality and poor health. It was known that the rising cost of living was likely to impact health and wellbeing, for example the 14.5% of people in Worcestershire in fuel poverty was likely to increase (national estimates were now at more than 50%).

·       The effects of COVID still persisted.

·       There were some health indicators which were performing poorly but many of those already had a strategy to address that.

Board members made the following comments:

·       The Chair was interested in the statistic of healthy life expectancy and queried what could be done to improve that and in what timeframe. It was admitted that a lot of the strategies would take a long time to have an effect on people’s healthy life expectancy.

·       The piece of work was praised for being accessible.

·       The charts were clear but there was a comment that after reading about the infant mortality figures where should you go to find the strategy that addresses the issue, and was the worsening figure a concern or do the figures fluctuate over time? It was explained that the job of the JSNA was to flag the figures to a wide audience. A deep dive investigation was going on to see what was behind the figures, but they were sensitive to small changes and to a wide range of factors. When the deep dive had been concluded and a strategy created, it would come back to the HWB.

·       Journey time to key services was listed as 19.8 minutes. It was explained that the average time came from modelled information so if things had changed the journey time could have deteriorated.

·       It was commented upon, that areas of deprivation in Worcestershire were similar to previous years, without reporting any change. It was hoped that there would be some change with the emergence of the Integrated Care System. It was not just about ensuring that new resources were targeted towards deprived areas but about moving existing resources and levelling up in whatever way was possible.

·       More detailed information would be available at district level once the updated census information was available. Also, the Worcestershire Insights Website provided information at district level. It was acknowledged that this tool provided useful data and it would be interesting to see how the data could be used to influence local strategic plans.

·       It was queried whether the cost of living crisis could be used as an opportunity to help people give up smoking, although there was a concern that people would turn to illicit sources of tobacco, which would then become a trading standards issue. The Youth Parliament felt that smoking among young people was at a low level, but that vaping was increasing. This posed the question over whether vaping should be seen as a solution for older people and a threat for younger people as it could be a gateway drug to move into smoking. It was mentioned that emerging research was suggesting that vaping could cause harm, as well as having the potential to lead to smoking tobacco. The benefits were not so clear cut as it once appeared. There was a concern that with the cost of living crisis, that smokers would not choose to give up cigarettes but would choose to give up food. It was therefore important to get the communication strategy right to explain that a way of coping with the cost of living crisis was to give up cigarettes, and Partners needed to talk seriously about how to get that message across.

·       The JSNA Chapter headings were thought to be positive as they referred to the wider determinants of health and wellbeing, rather than just having health issues.

·       The Board sought reassurance that there was a plan in place and that each of the headings were being looked at, while at the same time accepting that it was a collaborative approach involving all partners. The Chair responded that she saw this information as being passed to the District Collaboratives who should be supported in taking forward the action plans. The challenge to this was that although the District Collaboratives were capable of taking action, the ICS was required to change its thinking and rather than focussing on organisational boundaries, focussing on the person, along with providing increased resources. A representative from the ICB clarified that the ICS was everyone, not just the ICB and Health Partners. It would be the role of the Integrated Care Strategy to make the money follow the need and allocate the resources according to need rather than to organisations. The ICB now had a statutory duty to tackle health inequalities which the CCGs had not had.

Conversation took place around the important role of the District Collaboratives driving action, with ‘Place’ leading rather than ‘top down’. The Chair reiterated that there was no hierarchy in the Integrated Care System. That District Collaboratives should access the data and work with the ICB on how issues could be addressed. There were further discussions around focussed investment and health inequalities.

RESOLVED thatthe Health and Wellbeing Board (HWB) noted the content of the Joint Strategic Needs Assessment (JSNA), including:

a)     Emerging focus indicators and needs of Worcestershire’s population; and

b)     Key themes:

§  Widening inequalities

§  Ageing population

§  Pressure on health services

§  Mental health and wellbeing

o   Worcestershire Insights Tool data platform