Agenda item

It was a statutory duty to have a Joint Strategic Needs Assessment (JSNA). The aim of the information was to allow commissioners to make evidence based decisions about public health and to be able to reduce inequalities. Frances Howie asked Board Members to consider whether we make the best use of the data so that system leaders and commissioners have a shared understanding of vulnerability, risk and prevention.

People in Worcestershire were generally healthy but there were inequalities which were not being dealt with. It was important that people had a healthy life expectancy rather than having a long period of poor health which put a lot of demand on services.

The social gradient needed to be considered, with a significant difference between the most and least deprived populations, of how long people live and how long they live in good health. This was partly because those in deprived areas go for help at a later stage.

A large proportion of the population were overweight which was not normal or good. The current generation of children were more overweight than any previous generation so it was likely they would be the least healthy adults ever and would therefore have the greatest need for health services.

The main areas of focus in the Health and Well-being Strategy were:

-        Being active at every age

-        Mental well-being

-        Alcohol harm

Each district had different areas of concern which needed to be addressed. Countywide the areas of concern were:

-        The narrowing gap between Worcestershire and England

-        Infant mortality

-        Drug misuse deaths

-        Excess weight and diabetes

-        Violent crime

-        Homelessness

-        Autism spectrum disorder

In the ensuing discussion the following points and questions were raised:

·       Various members felt that the data was not being used effectively. It was suggested that prevention strategies should be applied to the emerging issues,

·       It was queried whether causation was being examined, as it was proven that adverse childhood events affected well-being and could lead to homelessness,

·       The data should be used to focus actions towards things which could be affected and improved,

·       The rates of smoking in the general population was not included in the data and should be addressed as an on-going concern, and specifically included in the JSNA for next year,

·       The priorities were multi-faceted and had various boards looking at the issues.  There should be more co-ordination so that countywide priorities could be identified. The data should be used to meet partnership priorities and maximise outcomes,

·       Was there enough presence in the communities, should the focus be on pockets of deprivation and carrying out work at a community level to make a difference to hard to reach people. Resources needed to be targeted differently,

·       It was confirmed that specific communities were being targeted in some areas of the county,

In response it was pointed out that there were positive messages and smoking levels were lower than before. It was recognised that there were clusters of unhealthy behaviours so there needed to be a single response to those in a vulnerable position and although adverse events could lead to homelessness there were some resilience factors which led to better outcomes.

There was a HWB private development session on 7 November which could concentrate on vulnerability and risk and look in particular at data and priorities so that we could consider what HWB members, as systems leaders, could do better together.

RESOLVED that the Health and Well-being Board:

a)     Noted the information on progress and issues relating to Health and Well-being Board Priorities, equality and inclusion,

b)    Noted the emerging issues and ensure commissioners and system partners to consider these for action during the next planning period;

c)     Noted the briefings and other further reports available and ensure the evidence is embedded across the health and care system; and

d)    Will use the development session on 7 November to assess the JSNA information and consider whether existing priorities are fully intelligence led and where new joint working may be beneficial.