nhs cambridgeshire (formerly cambridgeshire pct) web site: joint strategic needs assessment for...

NHS Cambridgeshire (formerly Cambridgeshire PCT) Web site: www.cambridgeshire.nhs.uk

JOINT STRATEGIC NEEDS ASSESSMENT FOR CAMBRIDGESHIRE

Phase 2


The Cambridgeshire Approach

• In Cambridgeshire we have produced six JSNAs to date. These focus on different groups within the population. While there is some overlap between the different JSNAs, each looks at their particular population in detail.

• The JSNAs have been led through existing PCT/CCC joint strategy and commissioning groups.

• More recently a ‘community views’ JSNA has been produced, bringing together material from several local and national consultations


The combined JSNA Process

JSNA: Adults of working age

JSNA:Older people

JSNA: Children and young people

JSNA: Adults with learning disabilities

Combined Joint Strategic Needs Assessment

JSNA: Adults with mental health problems

Local Area Agreement and other local outcomes and targets

Commissioning of services

JSNA: Adults with physical disability and sensory impairment and long term conditions

JSNA: Community

views


Updating the JSNAs

• The JSNA are being continuously updated as new demographic and other information becomes available.

• Phase 2 includes, County Council Research Group population estimates and forecasts as well as the revised Index of Multiple Deprivation (IMD)


Key Demographics Table 3: Total population : population forecasts, mid 2006 based (CCCRG)

Local Authority Year % change 2006 to 2021

2006 2011 2016 2021Cambridge 113,690 131,910 147,470 148,920 31.0%East Cambridgeshire 76,290 80,650 81,870 80,710 5.8%Fenland 89,910 91,550 94,870 99,250 10.4%Huntingdonshire 160,830 168,170 165,510 165,690 3.0%South Cambridgeshire 138,080 149,910 160,930 170,470 23.5%Cambridgeshire 578,630 622,020 650,550 664,910 14.9%

Source: Cambridgeshire County Council Research Group Mid-2006 district level population forecasts by age and gender

By 2021 it is estimated that there will be a further 86,000 people living in Cambridgeshire. The biggest actual increases and also proportional increases are expected in South Cambridgeshire and Cambridge City.


Index of Multiple Deprivation, 2007Local Authority Ward IMD 2007 scoreFenland Waterlees 41.52Fenland Clarkson 32.83Fenland Medworth 32.01Fenland Staithe 31.21Huntingdonshire Huntingdon North 27.00Fenland Elm and Christchurch 25.73Fenland Parson Drove and Wisbech St Mary 25.39Cambridge King's Hedges 25.10Fenland Hill 24.41Fenland Kirkgate 24.36Fenland Kingsmoor 23.01Cambridge Abbey 21.93Fenland Roman Bank 21.24Fenland Peckover 20.42Fenland March East 20.08Cambridge East Chesterton 20.03East Cambridgeshire Littleport West 19.47Cambridge Arbury 18.97Fenland March North 17.83Fenland Lattersey 17.24Fenland Birch 16.78Fenland March West 16.49East Cambridgeshire Littleport East 16.48Fenland Wenneye 16.06Fenland Wimblington 15.55

Local Authority IMD 2007 score (average of LSOA

scores)

LA rank (England)*

Fenland 20.50 139Cambridge 13.87 236East Cambridgeshire 10.84 285Huntingdonshire 9.31 311South Cambridgeshire 6.55 350

Cambridgeshire 11.49 135

Table 6:Fifth most deprived wards in CambridgeshireTable 5: Local Authority, average of SOA scores

NB: *LA rank (England): the rank for 5 district authorities represents the relative rank within the 354 tier 2 local authorities in England where rank 1 is the most deprived authority and rank 354 the least deprived. The rank for Cambridgeshire represents the relative rank within the 149 tier 1 local authorities where rank 1 is the most deprived authority and rank 149 the least deprived.

Source: The English Indices of Deprivation 2007, Department for Communities and Local Government (DCLG)


Life Expectancy Cont’d

Most of the wards with significantly higher levels of deprivation are in Fenland, but some are in north east Cambridge, Huntingdon and East Cambridgeshire. Those in the 40% of wards with the least levels of deprivation (ie Q4 and Q5) have statistically significantly higher life expectancy than the county average.

Life expectancy 2003-2005 by quintiles of IMD score (electoral wards)

Cambridgeshire (CCC) Q1 and Q5 based on IMD scores for wards

74.00 75.00 76.00 77.00 78.00 79.00 80.00 81.00 82.00

Q1

Q2

Q3

Q4

Q5

County average

Cam

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03-

05

Cam

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03-

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Cam

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03-

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Cam

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03-

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Cam

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03-

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Cam

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03

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Life expectancy at birth (in years)

Quintiles IMD

Source: Population data: Research Group of Cambridgeshire County Council population estimates.


Children and Young PeopleKey Findings Summary• Currently some 139,000 children and young people aged 0-19

live in the county, with Huntingdonshire currently having the largest such population. On average there are around 7,000 in each single-year age group.

• Forecast growth in the population aged 0-19 in Cambridgeshire between 2006 and 2021 is 4% (5,300 children). The 0-19 population is forecast to fall by 17% in Huntingdonshire (6,800 children) and to rise by 40% in Cambridge City (9,600 children) and 14% in South Cambridgeshire (4,700 children).


Children & Young People - Lifestyle IssuesIn Cambridgeshire as a whole:• About 8% of children in reception and 16% of children in Year

6 are obese• About one in ten boys and one in six girls aged 14-15 smokes

regularly• Nearly a quarter of Year 8 children had had an alcoholic drink

in the last week and a half of Year 10 children• About one in thirty-five girls aged 15-17 become pregnant

each year, with the highest teenage pregnancy rates in Fenland and Cambridge City.

• About 6% of young people aged 15-24 in Cambridgeshire screen positive for Chlamydia (a sexually transmitted infection)


Children ‘in need’ cont.

• Across the county 3.2% of pupils have a statement of special educational need; a further 5.2% are identified as having significant educational needs. The majority of these have moderate or specific learning difficulties, behaviour, emotional and social difficulties or speech, language and communication needs.

• In April 2007, there were 365 non-respite children in care, with the majority aged between 10–15 years. These children are most at risk of having poor educational outcomes, at risk of becoming young offenders and teenage parents, and vulnerable to mental health problems.


Community Views – Children and Young People

• Children and young people in Cambridgeshire describe themselves as living quite sedentary lives. They may not undertake enough physical activity, may have a poor diet and are often bored. Young people believe that this is because their leisure options are restricted

• Young people in Cambridgeshire are aware that STIs exist and that the incorrect use of contraceptives could also lead to unwanted pregnancies. However, they believe that a more effective and timelier sexual health education could help decrease the incidence of diseases and unwanted pregnancies.


• Mental health problems, mainly anxiety and stress, are often a result of bullying, disagreement and poor communication with parents or family and because of boredom.

• A poor physical environment at home can also increase children and young people’s anxiety and stress.

• Smoking, drinking and consumption of substances are mainly caused by imitation and peer pressure. Anti-social behaviour is often linked to these activities.

• Minority groups such as Gypsy and Traveller children and young people describe themselves as being at risk of mental health problems and a decrease of their general well-being because of bullying and racism

Community Views Cont’d– Children and Young People


Table 32: Taking forward the findings of individual JSNAs

Children and young people

Many of the needs identified in this assessment are already being addressed through The Big Plan, and the JAR Action Plan. The next steps will be to compare the services being provided with the needs identified and look for gaps in services and for services where there is room for improvement as part of the update of The Big Plan.

Adults of ‘working age’Specific work will be undertaken to better understand preventative needs from the perspective of the population and service providers. This work will be overseen by a new county-wide Health and Well Being Partnership.

Adults with mental health problemsThe JSNA on adults with mental health problems will inform the development of a Mental Health Promotion Strategy for Cambridgeshire and the joint commissioning of mental health services.

Adults with learning disabilities

The JSNA will inform the Joint Commissioning Strategy for people with learning disabilities. The JSNA will be revised in the light of new developments and guidance; changing needs and priorities and ongoing consultation.

Adults with physical and sensory impairment and long term conditions

The JSNA will be used to inform the Joint Commissioning Strategy for Physical Disabilities and Sensory Impairment. The JSNA is also informing the update of the PCT Long Term Conditions Action Plan.

Older people

The data from the JSNA on Older People underpins the PCT Long Term Conditions Strategy and is informing the multi-agency Older People’s Strategy which focuses on the broader determinants of health. It will also inform the Joint Commissioning Strategy for Older People.


SWOT analysis – strengths• The care group approach allowed richness

of data collection for each care group, and supported the direct use of JSNA in joint service commissioning strategies.

• The Community Views JSNA brought together a wide range of consultation material into one place, in a way which hadn’t been done before


SWOT analysis - weaknesses• The care group approach made overall co-

ordination of the phase 1 and phase 2 JSNA more challenging, particularly as we did not have a dedicated JSNA project manager

• The PH analyst team had to divide their time between several JSNA strands at once


SWOT analysis - opportunities• The appointment of a new JSNA co-

ordinator post will enable a structured programme of updates, stakeholder engagement and communications for the JSNA

• This appointment will also enable more detailed logging of the impact of JSNA on service planning


SWOT analysis - threats• Council elections may mean that a new

set of communications activities are required to ensure that members are aware of and engaged with JSNA

• There is a risk that the JSNA will be well used internally by public sector organisations but not owned by local communities.


Gaps in guidance and support • Timeliness of JSNA guidance in 2007: It

was good when it arrived, but too late to meet requirements of the Local Area Agreement process.


Data and information analysis – support from PHO or IC

• Acknowledgement of Local Authority population estimates/forecasts

• Skills – e.g. predictive modelling and sensitivity analysis

• There may be some rich data at PHO/IC level which we are not fully aware of in PCTs.


Possible new pieces of work • Improving outward facing communication

with the public – web-based materials and active publicity

• Evaluation of how JSNA has been used in service planning, its impact on front line services – and taking the learning from this.

• (Working with additional data sources - e.g. police/housing).

nhs cambridgeshire (formerly cambridgeshire pct) web site: joint strategic needs assessment for...

Documents

nhs cambridgeshire

cambridgeshire table

cambridgeshire phase

east cambridgeshire

south cambridgeshire

cambridgeshire approach

cambridgeshire pct web

relative rank