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Welcome

Welcome. Joint Strategic Needs Assessment Commissioners Workshop Event. John Rutherford. Director of Adult and Community Services. Why is the JSNA important?. JSNA identifies what services the people of Bolton want Provides a delivery plan for those services

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Welcome

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  1. Welcome Joint Strategic Needs Assessment Commissioners Workshop Event

  2. John Rutherford Director of Adult and Community Services

  3. Why is the JSNA important? • JSNA identifies what services the people of Bolton want • Provides a delivery plan for those services • Highlights gaps in service provision • Most efficient way of determining needs assessment

  4. Why is the JSNA important? Ongoing process Working with partners and partner organisations Contains valuable, detailed information ‘The big picture’ for the health and wellbeing of the people in Bolton

  5. WHAT IS JSNA? Tim Bryant Head of Commissioning

  6. Agenda for the day • Setting the scene • Themed presentations • ‘World Café’ style discussions • Refreshment break • Further presentations and discussions • Summary and next steps

  7. What is the JSNA? • ‘A Joint Strategic Needs Assessment (JSNA) is a means by which PCTs and local authorities describe the future of health and wellbeing needs of local populations and the strategic direction of service delivery to meet these needs’ (Commissioning for Health and Wellbeing 2007)

  8. Objectives and Outcomes of today • To summarise the contents of the JSNA and discuss the ‘wicked’ issues that need to be tackled in Bolton • To discuss what the JSNA means for you and how the information will help inform your commissioning strategy • To identify any gaps in the information • To outline the next steps for the JSNA process

  9. What is the JSNA process? Previous versions mainly health Set up a widely representative Council/NHS coordination group Undertook a best practice search and decided on our model Massive undertaking and we have a much more comprehensive JSNA this year We look forward to hearing your views on involvement for next year

  10. What it looks like http://www.boltonvision.org.uk/jsna_draft.asp

  11. What are the big issues? Bolton’s Demographic and Socio-Economic Profile - Clare Gore Bolton’s ‘Big Killers’ and lifestyle issues – David Holt Long term conditions and disabilities – Mel Carr Children and young people – Anne Gorton

  12. What does it mean for you? Highlight the ‘wicked’ issues and influence our commissioning strategies to address these issues Challenge our recommendations Consider our priorities and remodel our services accordingly to deliver better outcomes Your feedback is valuable – please complete and return the feedback forms

  13. Bolton’s Demographic and Socio-Economic Profile Clare Gore Housing Strategy Manager (Policy & Research) Strategic Housing Unit

  14. Bolton OverviewPopulation 2008 Mid Year Population Estimates

  15. Bolton OverviewGeographical Variation

  16. Bolton OverviewGeographical Variation

  17. Bolton OverviewBirths, Deaths and Migration Fertility rates in Bolton are higher than seen regionally and nationally and have been increasing at a faster rate. The general fertility rate in Bolton for 2008 was 73.3 live births per 1000 women aged 15-44 years, compared to 63.8 in the North West and 63.9 in England as a whole Across the Borough changes in birthrates vary significantly from a decreasing rate of -3.6% in Heaton and Lostock, to an increase of 17.3% in Crompton Between 2007 and 2008 Bolton’s overall population is estimated to have increased by around 480 people. There were an additional 1,190 people as a result of natural change, i.e. there were 1,190 more births than deaths. However, there was also an estimated overall net loss in the population of 730 people due to migration

  18. Bolton OverviewEthnicity (2001 Census) Bolton’s White population consists of 232,366 people or 89% of the total The largest of Bolton’s minority groups is that of Indian background. With 15,884 people, 6.1% of the Borough’s population, this is the largest such community in North West England Bolton’s population of Pakistani background numbered 6,487 people in 2001, 2.5% of the Borough’s population. This makes it the sixth largest such community in North West England

  19. Bolton OverviewReligion (2001 Census) • Three quarters of Bolton’s population identifies as Christian, a little higher than the national average (72%) • The next largest religious groups in the borough are Muslims, constituting 7% of Bolton’s population and Hindus, constituting 2%. In both cases involving a higher proportion of the population than is the case nationally • A much lower proportion of people in Bolton (9%) claim to have no religion compared with England and Wales as a whole (15%)

  20. Bolton OverviewDeprivation

  21. Bolton OverviewUnemployment: JSA Claimants

  22. Bolton OverviewWorklessness In August 2009 there were 28,890 people in Bolton claiming either job seekers allowance, employment support allowance, incapacity benefit, severe disablement allowance, income support for lone parents, or other income-related benefits This gave Bolton a worklessness rate of 18.1%, which was an increase of 2.3 percentage points from last year and an increase of 0.2 percentage points as the previous quarterly figure In August 2009 the largest group of workless people in Bolton were those on sickness benefits, who made up 10.2% of the total working age population This was followed by jobseekers with 5.1% of the working age population, lone parents with 2.3% and others on income related benefits with 0.6%

  23. Bolton Overview Income Distribution

  24. Bolton Overview Child Poverty

  25. Bolton OverviewEffects of the Economic Downturn House prices have fallen. In January 2010 they were 16.8% lower than two years ago, and 4.8% lower than the same time last year The number of house sales has also slowed over the past 2 years but this number has begun to increase At the start of the credit crunch (July 2007) repossessions in Bolton increased as a result of people getting into difficulty with mortgage payments. More recently, during 2009, this number has dropped Unemployment in Bolton has continually increased since September 2007 and at January 2010 was 5.4% of the working age population. February 2010 saw the first decrease in unemployment levels since the recession began. Unemployment now stands at 5.3% The last two years have seen a steady decline in the number of business property enquiries, which gives an indication of interest in Bolton as a place to do start up or relocate their business

  26. Bolton OverviewEffects of the Economic Downturn: Unemployment since 2007 2006 Based Projections by Broad Age Group

  27. Bolton OverviewFuture Projections Bolton’s population is projected to increase by approximately 20,300 people in the next twenty-five years with an average gain of 812 people per year Bolton’s projected increase is below both the national rate of 19%, and the Greater Manchester rate of 15.4% Bolton’s age structure is also due for significant change in the next twenty-five years. The proportion of the population aged 65 and above is set to increase from 15.1% in 2006 to 21.2% in 2031

  28. Bolton OverviewFuture Projections 2006 Based Projections by Broad Age Group

  29. Bolton OverviewInfluence on Health and Wellbeing The Dahlgren and Whitehead model (1991) illustrates the main factors determining health The model shows how demographic and socio-economic factors are integral to determining health • Differences in demographic factors result in expected inequalities in health and well being i.e. older people suffer more from ill health than younger people. However, differences in health as a result of geography or ethnicity tend to be the main impact of a range of social and environmental factors

  30. Bolton OverviewInfluence on Health and Wellbeing: Housing

  31. Bolton OverviewInfluence on Health and Wellbeing: Housing • Homelessness: • People who are homeless, or living in temporary accommodation are more likely to suffer from poorer physical, mental and emotional health than the rest of the population • Older People and Housing: • As the older population tend to spend more time in the home, they are more likely to be at risk from housing that is not suitable to their needs and defective housing • Falls particularly affect the older population because of declining balance, co-ordination or strength as we age. Where falls occur in the older population they tend to have a greater health implication • Housing Condition: • Overcrowding and mental health • Damp and mould growth and asthma • Excess cold and mortality

  32. Bolton’s ‘Big Killers’ and lifestyle issues David Holt Head of Public Health Intelligence NHS Bolton

  33. Life expectancy

  34. Geographical inequalities 12.8 year gap

  35. Mortality & Deprivation

  36. Cause of male gap in life expectancy

  37. Cause of female gap in life expectancy

  38. Our main killers Smoking Diet/obesity Alcohol Physical activity Cardiovascular disease Respiratory disease Lung cancer Liver disease

  39. Inequalities across ethnicity

  40. Inequalities across deprivation

  41. Lifestyle factors Obesity Childhood obesity – not increasing as expected YET 9.1% reception, 17.5% Yr 6 Consistently below regional and national average Adult obesity – BHS 13.4% to 17.5% 2001 to 2007 Modelled estimate – 25.1% (50,000 people), Eng 23.6% Physical activity Levels of activity seem to be improving Active People Survey – 14% to 19% in last 3 years Lower levels of activity in BME groups

  42. Lifestyle factors Smoking Prevalence is falling – slightly faster in women Suggestion of high start up rate still in youths Drug use Estimated 2,788 problematic drug users (16.3/1000) 1,443 in effective treatment Changing drug use trends – moving away from heroine & crack to ACCE

  43. Alcohol Estimates of drinkers in Bolton Hazardous 38-55,000 Harmful 11-17,000 Binge 44-58,000 Dependent 5-10,000 Treatment 10% dependent drinkers 1% hazardous/harmful Potentially enormous demand

  44. Overview of recommendations Key diseases Early presentation, identification, diagnosis and treatment are key Continue to improve quality of disease management within primary care, particularly management of long term conditions and encouragement of self care techniques Lifestyle factors – intervention/support needs to be focussed on settings – schools, workplaces, particularly high risk groups and communities Obesity& physical activity – ‘leptogenic environment’ – undertake Health Impact Assessments on planning decisions across the borough Alcohol – greater involvement of primary care in both provision of acute care and prevention & lobbying for minimum price Smoking – increase work on smoke free homes and cars Reducing inequalities – pay attention to the slope index of inequality to ensure that interventions are tailored to meet the needs of people in different deprivation deciles –proportionate universalism approach recommended by Marmot

  45. Key questions What does the information tell us? What recommendations does the information lead you to? What are the information gaps?

  46. Long Term Conditions and Disabilities Melanie Carr Community Information & Research Manager Adult & Community Services

  47. Context • Nationally: • 1 in 3 people have a long term condition (3 in 5 aged 60+) • Estimated that treatment and care of those with long term conditions accounts for 69% of the primary and acute care budget • People with long term illness and disabilities are more likely to be economically disadvantaged and experience social inequalities • Four times as many people with learning disabilities die of preventable causes than the general population

  48. Ageing Population

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