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What is JSNA?
JSNA stands for ‘Joint Strategic Needs Assessment’. The purpose of JSNA is to pull together in a single, ongoing process all the information which is available on the needs of our local population (‘hard’ data i.e. statistics; and ‘soft data’ i.e. the views of local people), and to analyse them in detail to identify:
a) the major issues to be addressed re health and well-being, and
b) the actions that we as local agencies will take to address those issues.
The national guidance on JSNA is set out in section 1 below, and our local approach in Blackburn with Darwen is set out in section 2.
1. JSNA: the national picture JSNA is an ambitious new programme, specified nationally but delivered at local level, to improve the way information on needs is used to inform service planning. The Local Government and Public Involvement in Health Act (2007) placed a duty on upper tier local authorities and PCTs to undertake Joint Strategic Needs Assessment (JSNA). The duty commenced on 1st April 2008. Guidance released in December 2007 specified that JSNA is a process that should:
- identify the current and future health and wellbeing needs of the local population over both the short term (three to five years) to inform the Local Area Agreement and PCT Strategic Plan, and over the longer term (five to ten years) to inform future planning.lead to agreed commissioning priorities that will improve health and wellbeing outcomes and reduce health inequalities.
- reflect the competencies of a world class commissioner, being underpinned by:
- partnership working;community engagement;
- evidence of effectiveness: identifying relevant best practice, innovation and research to inform how needs will best be met.
- be continuous (see Figure 1 below).
Fig. 1 - The Joint Strategic Needs Assessment Process
The basis for JSNA is described in the Department of Health’s Commissioning Framework as: “A good strategic needs assessment, which many areas are already doing, is based on a joint analysis of current and predicted health and well-being outcomes, an account of what people in the local community want from their services (those provided by the statutory sector and the wider market) and a view of the future, predicting and anticipating potential new or unmet need.”Commissioning Framework for Health and Well-being DH, March 2007And it should cover:
- Demography, vulnerable populationsHealth status of populationsCurrent met and unmet needsPublic, patient - local views on current needs and services, “groups getting raw deal”
- Analysis of inequalities, service access
The principles for JSNA include:
- Local authorities and PCTs must provide the strategic leadership.JSNA should be undertaken across all the relevant organisations in a locality to produce a joined-up assessment of need.JSNA should not be predominantly analysis of data. The ‘voice’ agenda, which is the qualitative understanding of the views of the local population and service users, should feature strongly.JSNA should be used to identify the most important key areas for change: health outcomes that are not being met; health inequalities to be addressed; client groups with unmet needs, and services that require change.The findings of JSNA should be owned by the PCT, the Local Authority and the Local Strategic Partnerships, including the health and well-being partnership or its equivalent.The findings of JSNA should feed strategic priority setting, the sustainable community strategy, and the identification of health and well-being priorities for the Local Area Agreement (LAA). Partnerships will be challenged to demonstrate the local evidence and the process used to establish their priorities in the new LAA.
- JSNA will be an on-going process involving refreshing and revisiting work already undertaken and delving more deeply into certain topics/client groups or determinants of health.
2. JSNA in Blackburn with Darwen JSNA in Blackburn with Darwen has been developed as a partnership across a wide range of local agencies. The JSNA working group, chaired jointly by the Director of Adult Social Services and the Director of Public Health, has membership from key directorates in the Council and the PCT, and also local 3rd Sector organisations. As JSNA delivers its findings it will report not only to the Council and PCT through the Partnership Board, but also into the Local Strategic Partnership (LSP), given the key role of JSNA in influencing the setting and refreshing of Local Area Agreement (LAA) targets.In developing JSNA in Blackburn with Darwen we are not starting ‘from scratch’. Joint work on identifying and addressing issues of health and well-being is already firmly established, for example through the development of the local Health and Well-being Strategy in 2007, which set the initial focus for JSNA and fed into our new LAA.What JSNA does, though, is provide us with a robust and ongoing process to which all local partners are committed, and which we can used to inform our future planning.
The Blackburn with Darwen JSNA model: To be effective JSNA must be an ongoing process, and to this end we have designed a web-based JSNA model for Blackburn with Darwen. The model has four elements, which are set out in the four ‘quadrants’ you can access through the home page.
The quadrants are as follows:
- Data: This quadrant of the JSNA site is where we capture figures, the ‘hard data’, which tell about needs in Blackburn with Darwen (sometimes called ‘quantitative data’). Some of this information is from local sources (e.g. from the Council’s Policy Department, or the PCT), but much of it is regional and national. By adopting a web-based approach, we are able, through ‘hyperlinks’, to access live data in websites regularly updated by other bodies, e.g. the Department of Health, the Office for National Statistics, etc.
- People: This quadrant of the JSNA site is where we capture the views of local people on their needs in relation to health and wellbeing. This is sometimes known as ‘soft’ or ‘quantitative’ data. Local people let us have their views through a wide range of mechanisms: formal consultations, special engagement exercises, complaints. We need to have this ‘soft’ information, as well as the ‘hard’ data, if we are to ensure that our future plans will really meet local aspirations.
- Issues: This quadrant of the JSNA site is where we identify the main health and well-being issues which have emerged from the first two stages of the JSNA process, from the ‘hard’ and the ‘soft’ data. Existing known issues are already captured in this section of the site. As new issues emerge they will be posted in this area, with information on the data analysis which has led to them be identified as priorities.
- Action: JSNA is not an ‘academic’ process; its purpose is to make changes in the way we plan and deliver services. So, this final quadrant, ‘action’, is really crucial. This is where we identify changes we are making in our service plans and commissioning strategies, to address the issues identified in quadrant three. You will also find the Local Strategic Partnership (LSP)’s Local Area Agreement (LAA) targets here.
The 2008 JSNA ‘stock-take’: JSNA is an ongoing and developing process, hence the web-based model set out above. However, it is also important for us to take stock on a regular basis of the main issues emerging from JSNA, in order to ‘capture’ them in one place and to ensure they are fed into the planning processes of the Council, PCT and other local partners. To do this, we will in autumn 2008 undertake a full JSNA ‘stock-take’ process, and the resulting issues and recommended actions will be fed into the formal decision-making mechanisms of all JSNA partners. The JSNA stock-take report will be a public document, and a summary version will be made available to local people, e.g. through the ‘Shuttle’ newspaper, and through publicity in the local press.
Any questions?
If you have any questions about the JSNA process in Blackburn with Darwen, or you want to make your views known please contact us.
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