The Salford Joint Strategic Needs Assessment

Headline issues and key recommendations

What is a JSNA• Current and future health and wellbeing needs • Short term (three to five years) to inform Local Area Agreements, • longer term future (five to ten years) to inform strategic planning • Commissioning services and interventions to achieve better

health and wellbeing outcomes and reduce inequalities. • Address outcomes described in National Indicator Set for local

authorities and partnerships, and “vital signs” for the NHS

JSNA is:• High Level• About priority setting• Horizon Scanning • An evolving process &

product• A process which must engage

commissioners• Some information to support

commissioning decisions

Not to be confused with….

Health Needs Assessment (HNA) or Equity audit activity

The Director of Public Health's Annual Report

Information which underpins commissioning

Deprivation and inequalitiesWard Rank Income Employment Health Education Housing Crime

Living

Environment

Langworthy 1

Irwell Riverside 2

Broughton 3

Ordsall 4

Little Hulton 5

Barton 6

Winton 7

Walkden North 8

Weaste & Seedley 9

Irlam 10

Swinton North 11

Swinton South 12

Pendlebury 13

Kersal 14

Eccles 15

Cadishead 16

Walkden South 17

Claremont 18

Worsley 19

Boothstown & Ellenbrook 20

Life Expectancy

2

LE Gap LE Gap LE Gap LE Gap

Men 71.6 -3 73.4 -3.1 73.8 -3.1 74.2 -3.1

Women 77.3 -2.4 78.3 -2.6 78.4 -2.7 78.7 -2.8

2003-05Baseline 1995-7 2002-04 2004-06

Population changes 2006-2025

Employment and worklessness

64.5

67.7

65.1

66.967.9

71.2

67.3

68.5

60

62

64

66

68

70

72

1997/98 1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05

Year

% i

n e

mp

loy

me

nt

Employment Rates in Salford, 1997-2005

Income support Claimants in 2006

Of 13,330 people claiming benefits, over half have being doing so for 5 years or more

Worsley has 135 claimants - Little Hulton 1060.

Nearly 3,000 claimants are aged between 50 and 59 years

Females significantly outweigh males

Young peopleIndicator North West Rank

Emergency hospital admission - males 4Special educational needs (statements) - secondary schools 4Hospital admission for lower respiratory tract infection - males 5Special educational needs (statements) - primary schools 5Hospital admission for asthma - males 6Emergency hospital admission - females 8Hospital admission for lower respiratory tract infection - females 8Child Protection Plan subjects 14Fixed period exclusions - secondary schools 30Authorised absence - secondary schools 32No decayed, missing or filled teeth - 5 year olds 34GCSE achievement 34Hospital admission for alcohol-specific conditions - males 38Income deprivation affecting children 39Lone parents with dependent children 39Absence - primary schools 39No decayed, missing or filled teeth - Year 6 40Conceptions 40Dependent on key benefits 40Unauthorised absence - secondary schools 41Measles incidence 42Obesity - Year 6 females 42Children looked after 42Permanent exclusions - secondary schools 43

Older people

Current & projected prevalence of dementia (estimates)

30-64 65-74 75+ Total % of people 65+ with dementia % of all people with dementia

2007 50 370 1845 2266 6.53 1.05

2021 55 384 2022 2461 6.76 1.14

Social Care needs

2008 2010 2015 2020 2025

Number of older people helped to live at home 4,048 4,035 4,255 4,340 4,560

Number of households receiving intensive home care for people aged 65 and over

763 761 802 818 860

Number of older people receiving community-based services provided or commissioned by the CSSR

6,090 6,072 6,402 6,530 6,860

Total number of older people in residential and nursing care during the year, purchased or provided by the CSSR

1,572 1,567 1,652 1,685 1,770

Number of older people admitted to supported permanent residential and nursing care

98 98 103 105 111

Number of carers aged 65 and over receiving services 487 486 512 522 549

TOTAL 15,066 15,029 15,741 16,020 16,735

SmokingGtr. Manchester Salford

Population 2,531,00 216,400

Smokers >16 540,000 46,170

£ spent by >16’s £629,000,000 £53,779,500

Smokers requiring hospital treatment 30,732 2,628

Hospital bed days due to smoking 92,722 7,928

Cost of hospital admissions due to smoking £37,000,000 £3,163,500

Cost of outpatient follow-up for smokers £4,600,000 £393,300

Deaths due to smoking 6,440 551

Life Years lost 34,000 2,907

Cost of premature deaths £94,000,000 £8,037,000

Working days lost due to smoking-related illness 1,500,000 128,250

Cost to business of smoking related illnesses 105,000,000 £8,977,500

Costs to business of cigarette breaks 364,000,000 £31,122,000

New jobs yielded by 40% reduction in smoking 5,750 492

Additional wages generated by new jobs 107,000,000 £9,148,500

Overall cost of smoking the local economy £630,000,000 £53,865,000

Potential savings yielded by a 1% fall in smoking 344,000,000 £29,412,000

Estimates from Dept. of Health North West Public Health Group Regional Tobacco Policy Team

Cardiovascular disease

Deaths before the age of 65 which are caused by heart disease and stroke

SMR

England & Wales 101

England & Wales 100

North West of England 120

Salford 151

SMRs for Heart Disease and Stroke in under 65s

StrokeStroke Mortality, Salford 2003-2006

England & Wales

North West

SalfordEngland & Wales

North West

SalfordEngland & Wales

North West

Salford

2003 128 148 196 126 141 168 127 144 1782004 115 133 165 115 124 152 115 128 1572005 107 119 146 108 116 140 108 117 1422006 100 115 144 100 113 133 100 114 137

Male Female All

Respiratory diseases

2008 2010 2015 2020 2025

Total population aged 65 and over predicted to have a longstanding health condition caused by bronchitis and emphysema

727 725 774 787 833

Cancer

SMRs for Common cancers in Salford, 2004-2006

Male Females PersonsBladder 41 126 64Breast N/A 84 N/ACervix N/A 213 N/AColon/Rectum 155 88 126Leukaemia 139 74 115Lung 158 214 180Malignant Melanoma 176 20 113Oesophagus (Gullet) 159 136 153Prostate 93 N/A N/AStomach 118 163 132

Alcohol

N.West

No. of hospital admissions

RateNational

RankRate

National Rank

RateNational

RankRate

Alcohol-specific hospital admission, under 18s

165 115.96 329 88.96 286 94.7 297 98.35

Alcohol-specific hospital admission, males

721 661.94 343 809.31 353 915.06 354 536.3

Alcohol-specific hospital admission, females

340 321.88 343 346.57 347 421.73 353 270.13

Salford Manchester Liverpool

N.West

No. of hospital admissions

RateNational

RankRate

National Rank

RateNational

RankRate

Alcohol attributable hospital admission, males

1,652 1,476.44 348 1581.45 353 1708.37 354 1,214.55

Alcohol attributable hospital admission, females

1,045 804.19 348 815.42 350 873.78 354 674.35

Salford Manchester Liverpool

Hospital admissions due to alcohol, Salford with comparators 2005-6

Obesity

Obesity in Salford 2007/08

Salford England Salford England

Obese 14.50% 10.00% 22.45% 23.70%

Overweight 15.00% 25.00% 39.00% 22.50%

Obese and overweight 29.50% 32.50% 61.45% 46.50%

Children Adults

Oral health

Mental health• In the UK, there are now more mentally ill people drawing

incapacity benefits than there are unemployed people on Jobseeker’s Allowance

• ONS figures suggest that there are currently nearly 21,000 people in Salford being treated for depression

• Anxiety and depression remain a considerable burden to elderly people in whom this aspect of health should be considered as high a priority

Hospital admission and community careAdmissions

Too few Too many

Arthritis of the knee Chronic bronchitis and emphysema

Arthritis of the hip Lung cancer

Skin cancer Bladder cancer

Prostate cancer Heart failure

Mental health conditions

Alcohol

Back pain

Procedures performed

Too few Too many

Knee replacement Gastroscopy

Hip replacement Hysterectomy

Skin lesion removal Tonsillectomy

Prostatectomy Drainage of middle ear

Angiography

Revascularisation

Sigmoidoscopy

Key health priorities:

• Circulatory Disease• Cancer• Respiratory Disease• Mental Health• Alcohol• Obesity

Future Agendas• Wider engagement• Clearer governance• Integration into planning approaches• Access to data which underpins it

• How will you use the JSNA findings in planning rounds this year?

• How do you wish to see the process for drafting the JSNA evolve and develop?

• Who should be key partners in the process?