LEICESTERSHIRE JOINT STRATEGIC NEEDS ASSESSMENT Stakeholder Engagement March 29 th 2012

1. LEICESTERSHIREJOINT STRATEGIC NEEDS ASSESSMENT Stakeholder EngagementMarch 29th 2012

2. Welcome from links MEMBER - DAVID KIRKWOOD

3. Welcome from Lead member for health - cllrernie white

4. Agenda • Welcome from LINks - TBC • Welcome from the Lead Member for Health and introduction to the Shadow Health and Wellbeing Board – Cllr Ernie White • The 2012 JSNA – key findings and priorities – Dr Peter Marks • Q&A Panel • Refreshments • Workshop - the key health and social care issues – Sandy McMillan • Workshop feedback – Sandy McMillan • Workshop – has everything been captured – Lesley Hagger • Voting session. What do you think are the top six priorities for Leicestershire county – Lesley Hagger • Next steps – Peter Marks

5. the 2012 jsna – key findings / priorities – dr peter marks

6. What is a JSNA • Joint Strategic Needs Assessment identifies “the big picture” in terms of the health and wellbeing needs and inequalities of a local population • Joint Strategic Needs Assessment describes a process that identifies current and future health and wellbeing needs in light of existing services, and informs future service planning taking into account evidence of effectiveness

7. JSNA Focus “all the current and future health and social care needs in relation to the area of the responsible authority – needs which are capable of being met, or affected to a significant extent, by the local authority, clinical commissioning group or NHS Commissioning Board functions” (JSNAs and joint health and wellbeing strategies – draft guidance)

8. JSNAs and joint health and wellbeing strategies

9. The Leicestershire JSNA and joint health and wellbeing strategy • SHWB agreed interim strategic priorities in September 2011 • Refresh JSNA March 2012 • Develop Joint Health and Wellbeing Strategy summer 2012 • Development of commissioning intentions aligned to strategy autumn 2012 • Develop an outcomes framework to monitor progress against the strategy

10. JSNA Publication • JSNA is published on LSR-Online http://www.lsr-online.org/reports/leicestershire_joint_strategic_needs_assessment_jsna1 • 22 detailed chapters – published by the 1st April 2012 • Executive summary – to be agreed by the SHWB in April 2012 • Clinical Commissioning Group level executive summaries – published May 2012 • District level executive summaries – published May 2012

11. JSNA chapter headings • Demography • Deprivation and the Economy • Housing • Children and Young People • Health Inequalities • Staying Healthy • Sexual Health • Long Term Conditions • Cancer • Mental Health • Learning Disabilities • Physical Disabilities • Older People • Dementia • End of Life Care • Carers • Offender Health • Wellbeing / Happiness • Primary Care • NHS Hospital Care • Adult Social Care – Service Usage, Assessment and Development in Social Care • Assets

12. Engagement • Long chapters have been through professional engagement • JSNA priorities • JSNA Steering Board • SHWB • Key stakeholders

13. Increasing life expectancy and reducing inequalities • For 2007-09 life expectancy was: • 79.7 years for males • 81.7 years for females • Gap in life expectancy between most and least affluent for men and women is rising • 6.1 years for men, 5.5 years for female • Gap increasing more quickly for women than for men

14. Reducing premature mortality

15. Impact of aging population Population Growth: Impact on health and wellbeing needs: By 2020 25% growth in CHD 19% growth in COPD 35% increase in people suffering from dementia 23% increase in carers providing unpaid care 2011-2026 • 11% increase in population • 45% increase in over 65’s • 70% increase in people age 85 years and over

16. GP Registers of long term conditions • 21,900 people with coronary heart disease • 11,000 with stroke or transient ischaemic attacks • 29,000 people with diabetes • 11,400 people with cancer • 4,000 people on mental health registers • 75,000 people on depression registers • 3,200 people with dementia

17. The Aging Population and NHS Utilisation Hospital admissions, occupied bed days and spend 2010/11; 2010 Population Source: HERA, Extracted 3/2/11; ONS Mid Year Population Estimates

18. NHS Spend (Programme Budget Data)

19. End of Life Care • Last 12 months of life • 50% of people express a wish to die at home • About 20% of people are supported to do this • 5840 deaths per year • ¾ deaths from end stage disease and can therefore be managed • Aim to have 35% of all deaths on GP palliative care registers, currently only 12%

20. Issue Aging Population –over 65 years Frail elderly Smaller Households Supported Housing Affordable Housing Sustaining Housing Impact Increase by 51,000 by 2033. Extracare provision, including mental health Additional 39,000 single person households and 31,000 couples Need for learning difficulties, floating support and move on housing Need for additional affordable units at around 2,700 a year Need for ongoing tenancy support for the vulnerable Housing

21. Health Improvement • Where are the greatest pressures and gains? • 100,000 Smokers • 133,000 obese adults • 105,000 adults binge drink

22. Assessing the evidence

23. Addressing the wider determinants of health • Marmot: • Give every child the best start in life • Enable all children, young people and adults to maximise capabilities and have control over their lives • Create fair employment/good work for all • Ensure a healthy standard of living for all • Create healthy sustainable places and communities • Strengthen ill health prevention

24. Improving the health and wellbeing of children • Early years and early (help) support • Disadvantaged families and children at risk of poor health (including children in care and leaving care) • Pre-conception and maternity services • Transition from children to adult services • Children and young people  to make healthy choices • Disabled children, those with complex needs (including  health needs), ASD, behaviour,  emotional and social difficulties and special educational needs, including educational audiology

25. Key priorities from the evidence • Frail elderly including dementia • End of life care • Carers/young carers • Preventing premature mortality • Long term conditions • Improving peoples health and wellbeing • Improving the health and wellbeing of children • Addressing the wider determinants of health

26. Question and answer session

27. The key health and social care issues – sandy mcmillan

28. Joint health and wellbeing strategies should prioritise the issues requiring the greatest attention, avoiding the pitfalls of trying to take action on everything all at once. They will not be a long list of everything that might be done; they will focus instead on key issues that make the biggest difference.

29. Prioritisation Criteria • Priorities for action: • Number of people that are affected • Effect on people’s health and wellbeing • Projected future position if no action taken • Scope for improvement • Resource impact • Contribution to inequalities • Local views • Triangulation with priorities from key commissioners, including Clinical Commissioning Groups and Leicestershire Together Commissioning Hubs • Other considerations

30. Identification of gaps – LESLEY HAGGER

31. votingWhat do you think are the top 6 priorities facing the health and wellbeing of Leicestershire in the next 5 years? – Lesley hagger

32. Next steps and close – peter marks