1. Joint Strategic Needs Assessment (JSNA) – The Manchester way Neil Bendel Manchester Joint Health Unit David Whyte NW Joint Improvement Partnership (NW-JIP)

2. Starting Point - What is a JSNA? What it is Common baseline to underpin the development of the Community Strategy, Local Area Agreement and Commissioning Strategic Plan (CSP) Tool for use by commissioners within both health and social care A starting point! What it isn’t An ‘super’ information profile of the City A detailed commissioning strategy An academic exercise A one-off piece of work

3. Process Multi-agency Working Group established Representatives from NHS Manchester (Public Health/Information/Commissioning) Adults Social Care Children’s Services Manchester City Council (Research and Intelligence/Policy Analysis Teams) Local Involvement Network (LINk) Overall project management/co-ordination through Joint Health Unit

4. Ownership and engagement Executive sponsorship by Public Service Board (PSB) Regular feedback to Adults Health and Wellbeing Partnership Board, Children’s Board and PBC Hubs Input from policy leads for relevant topic areas Local community and user engagement Representation from Manchester LINk on Working Group Talking Health Discovery Survey (NHS Manchester) Public summary produced with input from freelance journalist

5. Methodology Compilation of data from existing information reports, strategy documents and needs assessments Mixture of text, data tables and charts/maps “What do commissioners need to consider?” boxes Common framework for each chapter/sub-section Cross-referenced with existing strategies to ensure consistency of approach and recommendations

6. Example – Chronic Obstructive Pulmonary Disease (COPD) Headline statistics National models suggest that there are aprox.16,500 people with COPD in Manchester (5.5% of the population aged 15 and over). The prevalence of COPD in Manchester is higher than the England average but lower than other comparable cities (e.g. Liverpool, Newcastle) Between 2005 and 2007, 146 people presented to Adult Social Care due to COPD. What do commissioners need to consider (examples)? Use of spirometry in schools and community pharmacies to test lung function Investment in social marketing programmes to support public health messages about the links between smoking and COPD Identify models of service provision to support the care needs of people using Individual Budgets

7. Milestones December 2007 - Project Initiation Document (PID) agreed May 2008 - First draft presented to Manchester Public Service Board (PSB) June/July 2008 - Presentation to PCT Board, Adults Health and Wellbeing Partnership and Children’s Board July/August 2008 – Presentations to PBC Hub Boards October 2008 – Full reference document and public summary signed off November 2008 – Formal launch at IHiM Conference

8. Next Steps Further analysis Locality JSNAs to support PBC Hubs, Children’s Services and Adult Social Care Districts etc. Application of population impact measures to key areas of JSNA JSNA website (http://www.manchester.gov.uk/jsna) Hub for sharing documents and data Evaluation and self-assessment Feed into the LAA refresh, future community strategies and updated Commissioning Strategic Plan

9. NW Survey: JSNAs and Commissioning – What Helps? Is the JSNA written in such a way that it enables commissioners to identify the actions required of them? If the JSNA is written with commissioners in mind, then do they possess the skills required to deliver the agreed commissioning priorities? Commissioning Priorities Commi ssionin g JSNA

10. Manchester JSNA Partnership - Self-assessment Participated in regional review of JSNAs being undertaken by NW Public Health Observatory SWOT Analysis undertaken by members of JSNA Working Group Plans to assess views of wider-stakeholders using framework provided by JSNA Readiness Tool/Quality Assurance Toolkit

11. SWOT Analysis - Strengths “Further strengthened existing partnership arrangements” “Represents a collaborative and joined-up approach to needs assessment between sectors” “Strong support and ownership by key players” “Provides a very sound basis for raising challenging questions about the future commissioning of services”

12. SWOT Analysis - Weaknesses “Community Engagement - challenges of getting best bits from Children’s Services, ASC and NHS Manchester and emerging LINk and getting it all to gel together” “Not sure all commissioning staff are aware of/using the information – especially in PbC” “Available data may not fully meet the needs and expectations of commissioners” “Evaluation of impact on commissioning - discussed, but as yet not fully developed”

13. SWOT Analysis - Opportunities “Links to other needs assessment work under umbrella of PSB (e.g. Crime and Disorder) and LAA (review and refresh)” “Development of Joint Commissioning Approach - Manchester Model and better access to and utilisation of expertise in Universities (e.g. predictive modelling)” “To embed intelligent, needs-led commissioning processes across health and social care” “Locality JSNAs offer real and worthwhile opportunities to develop the thrust of the JSNA process and principles”

14. SWOT Analysis - Threats “Lack of consistency of commissioning streams e.g. PbC x3; Children’s services; NHS/MCC shared commissioning not fully developed” “Ensuring that the JSNA is not seen as the answer to everything - rather a crucial part of the intelligence required by a range of services to better understand what provision is required in the future” “Capacity of PBC and district level partners (Children’s and Adults) to take on Locality JSNA development”

15. Impact to date NHS Manchester Commissioning Strategic Plan (CSP) Adult Social Care Change Programme and Prevention Strategy Implementation Plan Manchester City Council Carers Strategy 2008-2011 Drugs and Alcohol Commissioning Strategy North West Strategic Migration Partnership

16. Making JSNAs work for commissioners How do we engage with commissioners across different parts of the system? NHS (PCT and PBC) Adult Social Care Children’s Services Third sector organisations How should we best design and structure the content and outputs of the JSNA to make it useful for commissioners? How might we evaluate the impact of the JSNA on commissioning behaviours and decisions?

17. What can we offer? Experience of making the best use of political structures across the NHS and local government to ensure wider ownership of JSNA beyond commissioning Understanding of joint working arrangements and links between JSNA, Community Strategy, LAA and CYPP Knowledge of ‘soft’ information sources held by local authority departments Links with other local partnerships to identify and access best practice across the North West

18. Contact details Neil Bendel Manchester Joint Health Unit Phone: (0161) 234 4089 E-mail: n.bendel@manchester.gov.ukn.bendel@manchester.gov.uk David Whyte David Whyte (Consulting and Contracting) Limited Phone: (0161) 408 6732 E-mail: davidwhyteccltd@googlemail.comdavidwhyteccltd@googlemail.com