Joint Strategic Population Needs Assessment – getting started in Nottingham

1. Joint Strategic Population Needs Assessment – getting started in Nottingham Jeanelle de Gruchy With thanks to Liam Flynn, Graham Gardner and Luke Murray from Nottingham City Council Presented by Jean Robinson Analysts Forum 27th April 2007

2. Guidance • Guidance on the Statutory Chief Officer Post of the Director of Adult Social Services (May 2006) • Strategic needs assessment – statutory requirement of DASS; • Focus on adults with actual or potential social care needs, families, carers • Commissioning Framework for Health and Well-being • Consultation document; • Raises possibility of statutory responsibility extending to DPH and Director of Childrens Services • Highlighted links LAA and community plan; • Increased emphasis on children and young people; • Population vs individuals

3. Nottingham City • Strategic steering group co-ordinated by AD working to DASS, including representation from Children’s services and PCT; • Sub-group worked up a strategic approach, agreed by steering group, to be taken to 3 Directors end May (Chris Packham, DPH; Sallyanne Johnson,, DASS and Edwina Grant, DCS).

4. Nottingham City approach • We need to be clear about the questions we want to answer. • We need to build on what we’ve got…NOT start from scratch. • Community plan is the vision – needs to be linked with LAA, FTAPs. • This needs to be developed in-house in an integrated, sustainable manner. (ie not to hand over to consultants) • We should use an existing model which is known to work reasonably well (ie Health Needs Assessment Workbook) http://www.nice.org.uk/page.aspx?o=502009 • We should utilise and integrate with existing resources eg. NOMAD+ • We should work out what resources we have available from the start

5. JSNA: Getting started • What population? • What are we trying to achieve? • Who needs to be involved? • What resources are required? • What are the risks?

6. 1a. What population? • Adults with social care needs, families, carers (from DASS Guidance): • ‘should reflect local priorities as defined by local service users, their families and carers’ • ‘adults and families with actual or potential social care needs across the LA area’ • ‘all people with social care needs … all people who meet eligibility criteria’ • ‘the needs of all adults with social care needs in the LA area including the needs of carers and BME groups.

7. 1b. What population? (from DASS Guidance): • ‘Adult users’: • Fair access to care services eligibility criteria (FACs).. • Above threshold: Critical / Substantial / High moderate • Below threshold: Low moderate / moderate • But… use and not need? Variable interpretation and judgment about need; • ‘Carers’ • Census (2001): 24 000 carers in Nottingham – But only 800 known to services; • ‘Families’ • All children known to social care services or children of adults known to social care services? • Those children with needs, but not known to services? • ‘Potential users’ • Children known to social care services?

8. 1c. What population? • Has the Commissioning Framework widened the focus more explicitly to include children and young people?

9. 2. What are we trying to achieve? • Aims • Using intelligence to improve outcomes through more effective service delivery; • Improve evidence-based policy-making; • Objectives • Meet our statutory requirement; • Catalyst for improved data collection eg. Ethnic monitoring (p.16); • Determine the priority databases from partner agencies that need to be brought together, ensuring systematic, sustainable, fit-for-purpose information-rich population profiles easily available to all on NOMAD+ (see p.15); • Analysis presented in a format to inform strategic development, including to identify priority areas where there are gaps in delivery (eg. Dementia?) • Analysis presented in a format to bring about more effective service delivery; • Facilitate systematic, accessible information for performance management and monitoring and evaluation

10. 3&4. Who needs to be involved / resources? • Requirements • A project team: • requires skills eg technical, analytical, strategic • project leader to lead and oversee process, ensure methodological quality and co-ordinate; • Steering group with key partners; • User involvement; • Data-sharing management through NOMAD+; • Considerations • Time; • Funding; • Sustainability; • Commitment to data-sharing.

11. Mushrooms into massive undertaking Insufficient resource Data and not intelligence Intelligence sits on a shelf / NOMAD+ Information gaps mean real needs overlooked Ensure remain focused on manageable priority areas with clear outcomes; Resources need to be made available (specialists, NOMAD+); Make sure the data tells a story Intelligence informs strategy and services Keep an open mind 5. What risks?

12. Recommendations • Timing: every 3 years – need to ensure done in timely and sustainable way, not rush-rush; fit with LAA and Community Plan?; fit with City Council business planning? • Project manager, team to include specialist capacity for analysis; • Steering group to report to the 3 Directors; • Representation from social care, housing, health, children’s services, corporate intelligence, public involvement, County, One Nottingham; • Users to be engaged as appropriate; • Voluntary organisations and other service providers to be engaged as appropriate.