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Article
Publication date: 9 December 2011

Ed Harding and Michelle Kane

This paper seeks to provide a critique on the overall readiness of joint strategic needs assessment (JSNA) to respond to the new roles and functions proposed by the Health…

Abstract

Purpose

This paper seeks to provide a critique on the overall readiness of joint strategic needs assessment (JSNA) to respond to the new roles and functions proposed by the Health and Social Care Bill 2011.

Design/methodology/approach

Commentary informed by a national survey of Directors of Public Health in early 2011, a 2010 regional survey of JSNA leads in the South East, and other thematic and case study research exercises commissioned by or associated with the 2009‐2011 DH JSNA Development Programme.

Findings

Despite significant progress in the quality of JSNA 2008‐2010, raised expectations pose a serious challenge. It is possible to identify a number of key issues that must be directly addressed if the process is to fulfil the new expectations. The paper concludes with a call to action for members of health and wellbeing boards to audit the quality of their existing JSNA around these main challenges.

Originality/value

A new perspective on JSNA in light of new policy changes, combining existing research, unpublished research (as of August 2011) and the authors' experience leading national JSNA policy and improvement at the Department of Health.

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Article
Publication date: 17 June 2011

Jo Ellins and Jon Glasby

This paper seeks to report the results of a national survey to explore preparations under way by local authorities and primary care trusts (PCT) for the duty to conduct a…

Abstract

Purpose

This paper seeks to report the results of a national survey to explore preparations under way by local authorities and primary care trusts (PCT) for the duty to conduct a joint strategic needs assessment (JSNA), key barriers and enablers to this, and the implications for future policy. In particular, the study focuses on JSNA in the context of current and future health and social care partnerships.

Design/methodology/approach

Using Department of Health e‐mail circulation lists, the authors conducted a national survey of all PCT chief executives, directors of adult social services and public health in England (a total of 459 people). A qualitative survey was e‐mailed in February 2008 at the time when health and social care communities were preparing to implement the new duty. All completed surveys were analysed by both authors using thematic content analysis. A grounded approach was taken whereby the thematic framework emerged from initial familiarisation with the data, to which any further themes emerging during the coding process were incorporated.

Findings

Although respondents felt that it was very early days, they had a number of aspirations for JSNA and identified a number of potential impacts and implications. First and foremost, respondents felt that JSNA had scope to raise the profile of the importance of jointly agreed approaches to needs assessment and to partnership working more generally. However, as many respondents pointed out, the extent to which JSNA is able to realise this potential depends on it being seen as a means to an end, rather than an end in itself.

Originality/value

Overall, the impression from this early survey was of a health and social care system taking the new duty seriously and with aspirations in some areas to make JSNA a future driving force for local service changes.

Details

Journal of Integrated Care, vol. 19 no. 3
Type: Research Article
ISSN: 1476-9018

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Article
Publication date: 29 March 2013

John Skinner, Sarah Salway, Daniel Turner, Lynne Carter, Ghazala Mir, Bushara Bostan and George Ellison

The purpose of this paper is to explore potential benefits in aligning Joint Strategic Needs Assessments (JSNAs) with implementation of the Equality Delivery System (EDS…

Abstract

Purpose

The purpose of this paper is to explore potential benefits in aligning Joint Strategic Needs Assessments (JSNAs) with implementation of the Equality Delivery System (EDS) to improve commissioning of healthcare for minority ethnic groups.

Design/methodology/approach

The paper draws on data gathered for a large research study carried out in England exploring the use of evidence in commissioning for multi‐ethnic populations, to present a reflective discussion on the potential synergies between JSNA and EDS processes. Qualitative data were collected from 62 interviews with stakeholders in Sheffield, Leeds and Bradford, who, as part of their normal role, had an active responsibility to contribute to decision making for commissioning healthcare. 19 individuals working in national roles with experience in evidence use, ethnicity and commissioning across NHS, local authorities and third sector were also interviewed. Observational data were collected through regular attendance at an NHS Equality Group, which had Equality Delivery System implementation within its remit, and from a regional workshop focussing on Joint Strategic Needs Assessment improvements. Observations also came via participation in local EDS implementation meetings across Sheffield, Leeds and Bradford. These data were supplemented by a review of local and national policy literature about implementing JSNA and EDS.

Findings

Formally strengthening the connection between JSNAs and the EDS has potential benefits for enhancing the evidence base about health and wellbeing needs of minority groups in general, and ethnic minorities in particular.

Originality/value

NHS and Local Authority organisations need to establish structural processes to formally connect these two workstreams and to ensure adequate resource is made available, with clear direction from senior management.

Details

Journal of Integrated Care, vol. 21 no. 2
Type: Research Article
ISSN: 1476-9018

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Article
Publication date: 31 December 2008

Luke Ward and Paul Cosford

On April 2008, the new statutory duty on local authorities and primary care trusts (PCTs) to work together with their local partners to produce a joint strategic needs…

Abstract

On April 2008, the new statutory duty on local authorities and primary care trusts (PCTs) to work together with their local partners to produce a joint strategic needs assessment (JSNA) came into effect. The purpose of these JSNAs is to identify the unmet health and well‐being needs and inequalities of the whole local population, and to provide a sufficiently broad joint evidence base for a locality. This enables increased joint working and co‐operation among all partners leading to improved outcomes for that population. For the first time, commissioners have the opportunity to create a ‘level playing field’ for identifying unmet mental and physical health needs within the same assessment process. This paper lays out why the structure and policy framework underpinning JSNA may offer a stronger prospect of successful implementation than its predecessors. It uses the findings of a quality assurance audit of JSNAs conducted in the east of England as a real‐world reference point.

Details

Journal of Public Mental Health, vol. 7 no. 3
Type: Research Article
ISSN: 1746-5729

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Article
Publication date: 7 April 2015

Susannah Baines and Chris Hatton

Joint Strategic Needs Assessments (JSNAs) are required for every local authority in England, and should contain information to allow for strategic health and wellbeing…

Abstract

Purpose

Joint Strategic Needs Assessments (JSNAs) are required for every local authority in England, and should contain information to allow for strategic health and wellbeing planning for the local population, including disabled people. A 2013 analysis of JSNAs showed that JSNAs were not routinely including information on the numbers and health needs of people with learning disabilities, particularly children. The purpose of this paper is to compare the information included in 2013 and 2014 JSNAs.

Design/methodology/approach

JSNAs for 141 local authorities in England were sought. Local authorities were contacted when JSNAs were not initially found online. All 137 JSNAs found were analysed for mentions and specific sections concerning people with learning disabilities, and content analysed concerning the specific information they contained.

Findings

In total, 72 per cent of JSNAs mentioned people with learning disabilities (vs 82 per cent in 2013); 24 per cent mentioned children (vs 39 per cent in 2013) and 72 per cent mentioned adults (vs 81 per cent in 2013). Overall, 13 per cent of JSNAs included a section on children with learning disabilities (vs 9 per cent in 2013), 65 per cent included a section on adults (vs 48 per cent in 2013) and 11 per cent included a section on older adults (vs 8 per cent in the 2013). More JSNAs contained information on current and projected future populations, health needs, social context and service usage concerning adults with learning disabilities compared to children. There was large regional variation in all these indicators.

Originality/value

Further work is needed for JSNAs to contain sufficient information on people with learning disabilities to allow for strategic planning, and for JSNAs to be accessible to the public.

Details

Tizard Learning Disability Review, vol. 20 no. 2
Type: Research Article
ISSN: 1359-5474

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Article
Publication date: 11 April 2011

Bob Hudson

The NHS White Paper (Department of Health, 2010) seems to herald the introduction of a greater role for local government in running health services in England than at any…

Abstract

The NHS White Paper (Department of Health, 2010) seems to herald the introduction of a greater role for local government in running health services in England than at any time since 1948. Partnership working between the NHS and local authorities is to be elevated to a higher level and a greater role for elected members is to be introduced to address the ‘democratic deficit’ in the centralised NHS. All of this will be underpinned by a raft of new inter‐organisational arrangements. Although these changes do indeed constitute a significant change, this article suggests that the impact may be less than many hope and expect.

Details

Journal of Integrated Care, vol. 19 no. 2
Type: Research Article
ISSN: 1476-9018

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Article
Publication date: 15 June 2012

Sylvia Bernard, Fiona Aspinal, Kate Gridley and Gillian Parker

This paper aims to report results from a national survey of primary care trusts (PCTs) that explored the strategic, organisational and practice context of services for…

Abstract

Purpose

This paper aims to report results from a national survey of primary care trusts (PCTs) that explored the strategic, organisational and practice context of services for people with long‐term neurological conditions (LTNCs). It seeks to provide benchmarks for integrated service provision and to discuss possible reasons for the variability in progress.

Design/methodology/approach

Earlier phases of the research identified three models of care that promoted continuity of care for people with LTNCs: community interdisciplinary neurological rehabilitation teams, nurse specialists and pro‐active day opportunities. Based on this evidence, a benchmarking questionnaire was developed and a telephone survey of PCTs in England undertaken in 2009.

Findings

The survey found that the prevalence of models of good practice varied widely across and within PCT areas. Strategic support and commissioning arrangements were also variable. A little over half of responding PCTs had completed a joint strategic needs assessment (JSNA) that included a reference to LTNCs and a quarter of PCTs had no joint commissioning arrangements in place for LTNCs. The complex interplay between strategy, organisational structures and models of delivery, in a context of competing priorities, may account for this variation and patchy progress.

Originality/value

Service provision for people with LTNCs is an under‐researched area, despite having major implications for long‐term care and support. The paper will be valuable to policy makers and commissioners in benchmarking organisational activity and models of good practice for integrated services.

Details

Journal of Integrated Care, vol. 20 no. 3
Type: Research Article
ISSN: 1476-9018

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Article
Publication date: 8 February 2013

John Wilderspin

The purpose of the paper is to provide an overview of issues being faced, and likely to have to be faced, in establishing effective health and wellbeing boards.

Abstract

Purpose

The purpose of the paper is to provide an overview of issues being faced, and likely to have to be faced, in establishing effective health and wellbeing boards.

Design/methodology/approach

The paper is based the perspective of the Department of Health's lead for implementation of these boards. Set in the context of national policy expectation, it draws on the early experiences of board development all over the country; and on discussions and seminars held to test their practical implications.

Findings

Transformation of the current pattern of services is needed to meet the preferred needs of the public. This is a major challenge at local level, and the leadership capacity and style of the new boards, and their communication skill, will be vital to the creation of responsive integrated services.

Originality/value

The paper draws together current thinking on a key policy initiative of the current government, and links it directly to integrated health and social care.

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Article
Publication date: 30 August 2010

Robin Johnson

This paper is an account of the discussions and recommendations by the exper t advisory panel on potential metrics and ‘sentinel indicators’ for improved outcomes in…

Abstract

This paper is an account of the discussions and recommendations by the exper t advisory panel on potential metrics and ‘sentinel indicators’ for improved outcomes in housing and mental health, as par t of an inter‐agency seminar called to advise on the development of metrics and measures for community mental health, for Fair Society, Healthy Lives: The Marmot Review (Marmot, 2010). The seminar covered all aspects of mental health in both its broadest and narrower senses.Much of the background material for these discussions, therefore, cuts across familiar knowledge silos between the fields of health and housing. Where it is necessary to elucidate the text, references are included to relevant research and policy frameworks that may be unfamiliar to the general reader. This paper is not, however, intended as a general literature review nor is it an evaluation of the available research. A paper on this subject will feature in a future issue of the Journal.1The conclusions from the panel discussion are presented in four main areas, reflecting the need to specify metrics across the wide‐ranging interface between housing and mental health, while still keeping the task manageable. Five current or potential health service metrics were proposed as having par ticular value as signal indicators. Two of these (relating to primary care prevention and public health) have no precision as yet, par tly as new services and approaches are still evolving. Among existing health datasets, the Mental Health Minimum Dataset (MHMDS) (NHS Information Centre, 2009a), SITuation REPor ts (SITREPS) (Department of Health, 2003), and the Summary Care Record data were singled out, though each is thought to need more work to improve the current data categories as well as data collection.One rather more fundamental point made was that the identifying, assessing and encouraging of effective inter‐sector par tnership work will be the key to tackling health inequalities. The use of other, non‐health services data therefore holds great potential for a better recognition both of needs and of outcomes in successful par tnership work, especially where this can be interpreted at local level. These wider comments are elaborated in the context of housing, but may be applicable to all effor ts to evidence and work with the social determinants and the social outcomes of mental health. For the future, a combination of well‐crafted nationally sanctioned metrics and the ‘soft intelligence’ of locally identified meaning may be most effective.Subsequent developments confirm the potential in cross‐sector development work, and indicate the potential for fur ther collaboration via the local performance framework. As policy frameworks continue to evolve rapidly, the ar ticle ends with a Codex, updating the relevant policy frameworks context since the seminar (in Spring 2009) and especially in the context of a new coalition government with aspirations to ar ticulate and promote public health in the context of the local performance framework and the ‘new localism’ agenda. This final section and comments therein are therefore entirely the responsibility of the author.

Details

Journal of Public Mental Health, vol. 9 no. 3
Type: Research Article
ISSN: 1746-5729

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Article
Publication date: 29 November 2013

Anna Goodman and Marianne Symons

The purpose of this paper is to provide an update on the progress of the Campaign to End Loneliness, and aims to illustrate how commissioners can be influenced to address…

Abstract

Purpose

The purpose of this paper is to provide an update on the progress of the Campaign to End Loneliness, and aims to illustrate how commissioners can be influenced to address loneliness in their localities.

Design/methodology/approach

The paper is a case study that draws upon an external evaluation of the Campaign to End Loneliness by Charities Evaluation Services, a review of local government strategies and case studies of good practice.

Findings

This paper focuses on the design, implementation and progress of Loneliness Harms Health, a series of local campaigns targeting health and wellbeing boards. It provides a case study of how evidence-based campaigning influenced newly formed health and wellbeing boards to address loneliness in their localities, and identifies implications for commissioner and provider practice.

Practical implications

This paper demonstrates how to successfully influence commissioning practice using a “pincer” movement of local campaigning, top-down advice and information. It highlights examples of good practice uncovered by the Campaign over the past 18 months including measurement of, and partnership working around, the issue of loneliness in older age. Three recommendations are made for local service providers and commissioners wishing to address loneliness: it should be linked to other priorities, cross-agency partnerships are vital and asset-based approaches can save money. It concludes with information about the future of the Campaign to End Loneliness and information on how to get involved.

Originality/value

This paper provides a detailed analysis of an innovative, policy-based, campaigning strategy to influence commissioning and practice around the issue of loneliness in older age. It is an issue which can be easily overlooked by care, public health and NHS professionals, but early results indicate the newly formed health and wellbeing boards can play a significant role in addressing it.

Details

Working with Older People, vol. 17 no. 4
Type: Research Article
ISSN: 1366-3666

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