Service Insight: Joint Strategic Needs Assessment JSNA

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Service Insight Joint Strategic Needs Assessment
(JSNA)

• Louise Dibsdall
• NHS Havering
• 13th August 2009

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What the JSNA is telling us

• People born in Havering have a slightly lower
  overall life expectancy than the rest of London,
  but higher than the average for England
• Although Havering is not overall deprived, there
  are pockets of deprivation
• 1/3 of residents of Gooshays ward live in SOAs
  identified as being in the top 20 deprived
  LSOAs in England
• Children are more likely to live in deprived
  areas 21.9 of children live in the 20 most
  deprived SOAs in Havering
• Older people are more likely to live in more
  affluent areas
• Havering has lower average household incomes than
  London - 33,492 compared with 38,781
• There are low levels of adult educational
  attainment and higher proportions of lower
  skilled and lower paid jobs than London or England

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What the JSNA is telling us

• JSNA highlighted the issues of an increasing
  older population
• Havering has the highest percentage of older
  persons out of every London Borough, and is
  projected to continue to increase to 2023.
• 17 aged 65 compared with 12 in London
• 23 increase in 65 49 increase in 85 by 2023
• The likelihood of ill health, and requirement for
  health and social care increases with age.

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Health Needs of Older People

• The number of coronary heart disease cases are
  predicted to increase by 44, heart failure cases
  by 54, and cases of atrial fibrillation
  (irregular heart rhythm) by 46.
• The number of sufferers of Alzheimers and
  Dementia living in care homes is expected to
  double by 2028, with a 50 rise in the number of
  patients aged 75 to 84 years.
• In Havering, around 250 people are admitted to
  hospital annually with hip fracture, around half
  of whom are over 85.
• Around 820 hospital admissions a year in Havering
  are for COPD, and around two thirds of these are
  for people aged over 65. Locality variations in
  hospitalisation for COPD show they are higher in
  deprived wards
• Around 7,500 hospital admissions by Havering
  residents annually are for cancer, with 3,500 by
  people over 65.

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Delivering the Right Health Services

• Darzi Report A Framework for Action, 2008
• The hospital is not always the answer
• We are not using our workforce and buildings
  effectively

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Polyclinics

• offer a far greater range
• of services than currently
• offered in GP practices,
• whilst being more
• accessible and less
• medicalised than
• hospitals

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Introducing Polysystems in Havering

• The model for Polyclinics is to offer a range of
  healthcare services
• However, health needs go beyond medical care
• In Havering, we are proposing the term Polysystem
  to describe the range of health AND social care
  services that could be provided in centres (hubs)
  or satellite clinics (spokes) in locations much
  closer to peoples homes or offer signposting to
  these wider services
• GP, dental, physio services
• Health visiting, ante-natal clinics
• Social services
• Debt, housing and financial advice

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Proposed Polysystem Areas

• Harold Hill
• Gooshays
• Heaton
• Harold Hill

• Queens
• Hylands
• Romford Town
• Brooklands
• Mawneys
• Havering Park
• Pettits
• Squirrels Heath
• Emerson Park

• St. Georges
• Upminster
• Cranham
• Elm Park
• Hacton
• St. Andrews

• Rainham
• Rainham Wennington
• South Hornchurch

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Polysystems Mosaic Groups
Symbols of Success
Happy Families
Small compared to other areas
Blue collar
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Next Steps

• JSNA is ongoing
• Requires more in-depth and systematic needs
  assessment collated from individual service areas
• Essential to provide support to Havering
  Intelligence Unit to ensure data warehousing and
  sharing
• Community engagement in needs assessment is a
  priority
• Focus on hard-to-reach communities to ensure
  their voices are heard and needs are met