Meeting documents

            Meeting: Cabinet (County Hall, Durham - Committee Room 2 - 25/09/2008 10:00:00 AM)

                  Item: A6 Joint Strategic Needs Assessment

         

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Report of Rachael Shimmin, Corporate Director, Adult and Community Services and David Williams, Corporate Director, Children and Young People’s Services. Councillor Morris Nicholls - Portfolio Holder for Adult and Community Services, Councillor Eunice Huntington - Portfolio Holder for Healthier Communities, Councillor Lucy Hovvels - Portfolio Holder for Safer Communities, Councillor Claire Vasey - Portfolio Holder for Children and Young People

Purpose of the Report

1 To provide Cabinet with information on the final County Durham Joint Strategic Needs Assessment (JSNA).

Background

2 The Local Government and Public Involvement in Health Act 2007 requires local authorities and primary care trusts, from the 1st April 2008, to work together to produce a JSNA, focusing on the health and wellbeing of their local community. The Department of Health published guidance to aid local authorities and primary care trusts in this process.

3 JSNA is defined as “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. JSNA identifies ‘the big picture’ in terms of the health and wellbeing needs and inequalities of a local population.” Department of Health Guidance on Joint Strategic Needs Assessment, December 2007.

4 As per the Department of Health’s guidance on the production of JSNAs, the Corporate Director of Adult and Community Services, the Corporate Director of Children and Young People’s Services and the Executive Director of Public Health have led the development of the County Durham JSNA through their role on the JSNA Project Board. This Board will approve the final JSNA document in September 2008.

5 Work started on the JSNA in September 2007 and a public consultation on the draft document was completed in July 2008. An equality impact assessment has also been completed on the JSNA during August 2008.

6 The JSNA is a key piece of work intended to underpin the Sustainable Community Strategy and subsequently the priorities and targets set by the Local Area Agreement. The JSNA will also inform future planning and commissioning activity to ensure more effective and targeted social care and health services.

7 The County Durham JSNA is structured around the seven LAA themes and also includes a section on demography along with a closer look at our communities - a detailed section analysing a range of indicators at a ward level. The following information provides a snapshot of each section of the document:

Demography

· The age profile of County Durham’s population is set to change significantly over the coming years. Between 2006/2011, the over 65, over 75 and over 85 age groups are set to rise by 9.3%, 10.4% and 24.5% respectively. Although growth in the same three age groups is being experienced nationally (at a rate of 8%, 5.8% and 13.6% respectively), these national increases are much lower than those forecasted for County Durham.
Health and Wellbeing

· Within County Durham, smoking prevalence is estimated to be highest in Wear Valley and Sedgefield. About 1 in 6 County Durham Year 10 pupils smoke and the majority of these are female.
· Rates of obesity in County Durham are rising in children and adults and are higher than the England average. Uptake of sport is lowest in the districts with the highest rates of childhood obesity (Easington and Sedgefield).
· Admissions to hospital for acute intoxication have increased throughout County Durham between 2001/02 and 2006/07.
· The number of secondary school pupils who drink alcohol is high and increases as pupils get older.
· Life expectancy for boys born in County Durham between 2003-05 is 75.6 years, 1.3 years less than the national average. Life expectancy for girls born in County Durham between 2003-05 is 79.4 years, 1.7 years less than the national average.
· Smoking is the biggest single contributor to the shorter life expectancy experienced locally and contributes substantially to the cancer burden.
· Durham Dales, Sedgefield, Easington and Durham and Chester-le-Street have a significantly high number of 5 year olds with decayed, missing or filled baby teeth compared to the England average, whilst Derwentside matched the England average.
· At 0.64%, Easington is the only area in County Durham which exceeds the national prevalence rate of mental health (national rate is 0.6%). However, there is a significant problem with high rates of incapacity benefit claimants due to mental health problems across the County when compared to the national average.
· An increasing number of people aged 18-64 (31%) were referred for an assessment of social care need between 2003/04 and 2007/08. This increase is significantly ahead of population increases (1.4% over the same period of time) for this age group.
· An increasing number of people aged 85 and over (21%) were referred for an assessment of social care need between 2003/04 and 2007/08. The population of this age group also increased by 23.1% over the same time period. As there seems to be a correlation between the increase in the number of referrals and the increase in the number of people in the 85 and over age group, we may assume that if this trend continues on to 2012, we will see approximately an additional 19% increase in referrals for needs assessments in this age group over this period.
· The number of people eligible for social care services is increasing. There has been an increase of 29.3% between 2004/05 and 2007/08.
· In Derwentside during 2007/08, there were a very high number of people with a ‘Substantial’ need relating to suspected abuse / neglect.
Safe

· County Durham communities are most concerned about drunk and rowdy behaviour.
· Criminal damage is the highest volume crime in County Durham.
· In County Durham, the average age for a victim of crime is most likely 30 for males (150 victims per 1000) and 28 for females (159 victim per 1000).
Achieve

· Although progress has been made, there remains a gap in attainment at foundation stage and GCSE between the highest performing children and lowest performing children at a local level.
· The number of looked after children care leavers achieving 1 GCSE at grade A*-G is high. However, the number of care leavers achieving 5 grade A* - C remains below the national average.
· The number of former children looked after in County Durham who successfully move into education, employment and training is significantly higher than the national figure.
· Compared to the national figure (44%), a large percentage of people within County Durham have qualifications below level 2 (56%). There are also large geographical variations in attainment across the County.
Enjoy

· Provision of entertainment facilities within the County is deemed to be poor.
Economic Wellbeing

· County Durham remains the most deprived shire County in England and will be amongst the most deprived unitary authorities after April 2009.
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· Productivity levels in the County, along with earnings, are lower than those in the rest of the North East and nationally. Although levels of both productivity and earnings are improving, they are not improving at the same rate as the rest of the country.
Positive Contribution

· Although there are mechanisms for the community to become involved in shaping services and influencing decisions, the community, especially those over 50, do not feel these opportunities are adequate.
· A large number of people within County Durham do not feel they are treated with respect and consideration by others.
· By April 2008, 198 agencies and organisations have achieved Investing in Children membership effectively demonstrating the engagement of young people in policy making.
Physical Place

· The rural nature of the County raises significant issues in relation to access to services.
· The number of social sector homes within the County meeting decent standards needs to be increased.
A Closer Look at Our Communities

· Where there is lower life expectancy in wards, those people who are assessed with adult social care needs were more likely to have ‘Critical’ needs.
· Where there is employment deprivation, those people who access adult social care services aged 18-64 were mostly assessed as having ‘Critical’ needs.
· Children’s social care indicators rank highly in those wards with multiple deprivation.
Next Steps

8 Following Cabinet, a professionally designed document will be produced and sent to colleagues within Durham County Council and County Durham Primary Care Trust, along with partners throughout the County, for use in their planning and priority setting processes to help inform the commissioning and provision of services to improve health and wellbeing within the County.

9 A workshop is being held in October 2008 to evaluate the process which we have been through to develop the JSNA and initiate discussions regarding JSNA refresh.

Recommendations and Reasons

10 Cabinet are asked to note the content of the JSNA and consider its application for priority setting and strategic planning.

Contact: Esther Kavanagh Tel: 0191 383 5677

Appendix 1: Implications

Local Government Reorganisation
N/A

Finance
N/A

Staffing
N/A

Equality and Diversity
The JSNA looks at issues of equality and diversity across the County.

Accommodation
N/A

Crime and disorder
The JSNA investigates issues relating to crime and disorder within the County.

Sustainability
N/A

Human rights
N/A

Localities and Rurality
The needs analysis within the JSNA is undertaken at both a Countywide, district and locality level.

Young people
The JSNA is a holistic document looking at the health and wellbeing needs of local people across their lifespan.

Consultation
The draft JSNA was subject to a six week consultation exercise running from 2nd June until 14th July. The final JSNA incorporates relevant comments received during the consultation period.

Health
The JSNA investigates the health and wellbeing needs of the local community. The results of the JSNA will be used to inform future planning and commissioning for health and wellbeing services.

Attachments

 JSNA.pdf