Agenda item
Joint Strategic Needs Assessment (JSNA)
Presentation on the Joint Strategic Needs Assessment (JSNA).
Joe Prince
Board Members to consider how the JSNA impacts on their work area.
(40 minutes)
Minutes:
Joseph Prince, Team Manager – Insight gave a presentation to the Board regarding this item. A copy of the presentation will be attached as an online appendix to these minutes and a summary is set out below.
Strategic Evidence Base – Update and Key Findings
Themes
Broadly, five themes have emerged.
• B&NES in summary
In 2020, the population of B&NES was estimated to be 196,953. ?(ONS)
The population has grown steadily over time:
This growth has come from a combination of increasing student numbers at the two Universities and an increasing number of new housing developments.
?
The shape of the population is largely driven by the high number of university students.
?
This data will be superseded by release of data collected during the 2021 Census in early summer 2022.
Overall population outcomes remain good.
o Life Expectancy is 80.8 for men and 84.7 for women, both significantly higher than national average. (OHID).
o 84% of residents satisfied with area as a place to live compared to 75% nationally. (Voicebox & LGIU)
o 84% of residents satisfied with area as a place to live compared to 75% nationally. (Voicebox & LGIU)
• Inequalities
2019 - As a whole, B&NES remains one of the least deprived local authorities in the country (ONS). However, within some areas, inequality is widening and deprivation remains significant.
Two small areas within the most deprived 10% nationally – Twerton West and Whiteway.
Premature mortality:
Between 2019 and 2021 the average number of B&NES residents that died each year was 1,748. Over this same period, the average number of premature deaths per year was 444. (OHID)
B&NES has a lower premature mortality rate than England, but there are wards within B&NES where the mortality rate for the under 75s is substantially higher.
Education and Lifestyle outcomes:
· Education outcomes (DFE)
The attainment gap between children eligible for free school meals is significant and has not changed over time. For early years, this is one of the highest gaps in the country. This trend continues in 20/21 Key Stage 4 attainment.
There remains an attainment gap for children with Special Educational needs and Disability, although this has reduced across all key stages.
Children eligible for free school meals and those of a mixed ethnic background see higher rates of fixed term exclusions than for England and similar authorities
· Lifestyle
Smoking - Tobacco remains the greatest risk factor for mortality in B&NES, particularly for those in their 50s and 60s, but also for those aged 70+. (OHID)
In B&NES, 1 in 4 workers in routine and manual occupations smoke.
Drugs - England level data shows that the most deprived areas have a higher prevalence of opiate and/or crack cocaine use than the least deprived deciles. (OHID)
Alcohol - In the over 40s, men are significantly more likely to be admitted to hospital due to an alcohol related injury or illness than women.? (OHID)
• Demand and Growth
Requests for adult social care support rose by 8% between 18/19 and 20/21, although provisional data for 21/22 suggests a 17% reduction. (In-house data)
There were 1,708 Education Health and Care Plans for children with Special Education Needs and Disability in 2021. 128% increase since 2016, reflecting both national and regional trends. (in-house data)
5,842 households are on the waiting list for social housing as of March 2022 a 12.5% increase since 2021 (in-house data)
83% of adults in the UK reported an increase in their cost of living in March 2022. (House of Commons Library)
Low-income households spend a larger proportion than average on energy and food so will be more affected by price increases. The Resolution Foundation estimates that an extra 1.3 million people will fall into absolute poverty in 2023, including 500,000 children.
Housing Growth - At least 14,800 more homes between 2022 and 2042 (Local Plan). 54% of additionality from regional demand may need adaptations for disability, (WECA)15% increase in 65+ population (ONS).
Employment Forecasts - Forecast to return to pre-pandemic levels by 2022 with modest growth thereafter. (Hardisty Jones Associates) Growth in administrative services, health and care, arts and entertainment.
• Ongoing pandemic impacts
B&NES had a lower overall rate of covid deaths than England. (ONS)
Cumulative excess deaths show that there were 289 excess deaths in B&NES between March 2020 and February 2022. The expected number of deaths over this period was 3,303 so there was an increase of 9%.
Exact local prevalence is unknown as self-reported long covid is not systematically recorded by GPs. Applying the national estimates to our local population, we would be expecting approximately 5,500 people in B&NES with long-COVID.? (ONS)
Children and Young people’s experience of lockdowns can be attributed to increased complexity and demand in services (Social Care, SEN)
Falls in 80+ resulting in hospitalisation rising and much higher than national rates. (OHID)
• Wellbeing and Mental health
Anxiety levels have generally been higher in B&NES than England since 2013/14 and have shown a greater increase than the national figure in 2020/21. (ONS)?
During the period of the Coronavirus pandemic though national rates of probable mental disorders increased more steeply – to 1 in 6 in 2021 (estimating 5,750 children and young people with a probable mental disorder in B&NES).
Social and Emotional Mental Health (SEMH) as the primary SEND need has more than doubled in recent years. (In-house data).
We also see high and increasing levels of (OHID):
• U18 hospital admissions for mental health conditions
• Eating disorders
• U18 hospital admissions for alcohol specific conditions
• Self harm hospital admissions
• Young women and girls have particularly high levels of admissions for self-harm and mental health conditions
Gaps
Data will be fed in when received regarding these subject areas.
• Health System Data:
• Population health analytics
• Service demand and pressures
• Digital Inclusion
• Active Travel
• Young Carers
• Child Exploitation
• Tourism and Visitor Economy
• Environmental Nuisance
• Regeneration
Future Approach
• Published June 2022
• Infographic headline document
• Summary document (~150 pages)
• Links to underlying content (e.g. more detailed reports) on Council website
• Iterative, what we know changes all the time.
• Refresh when new knowledge is generated.
• Aligned to core strategy/local plan refresh
• Ward Profiles (Post Census), including community asset information
Questions for strategy
• How might we build on our positive outcomes and use community assets to support everyone?
• How can we best respond to rapidly changing demands?
• How can we collaborate to produce better evidence/intelligence?
Paul Harris said that now the data had been gathered the focus should be on choosing the most important issues and tackling them. He added that from his point of view these would Inequalities and CYP and Adults Mental Health.
Rebecca Reynolds stated that a Sub-Group of the Board had been set up to decide on focus areas.
Councillor Romero said that what we do now with this information is so important.
Jayne Davis said that action must be taken to resolve the education gap as that can affect those from Early Years through to 19. She added that this can impact some disadvantaged learners throughout their whole lives.
Mary Kearney-Knowles commented that she felt that a whole system approach was needed and that a collective response was required to those issues that are deemed as a priority. She added that she recognised and acknowledged the pressures associated within Children’s Health and that the development of the ICS (Integrated Care System) should be seen as an opportunity to tackle these issues.
Councillor Romero said that they need to find ways to address the problems identified and that the specific wards identified in B&NES have been classed as areas of deprivation for some time.
Richard Smale said that he was keen to accept the challenge to try to tackle the issues raised and that it was key that a collective response is orchestrated. He added that he believed that we should not be afraid to target those areas in most need and that tangible next steps should be agreed by the Sub-Group.
Rebecca Reynolds commented that since the last meeting of the Board a development session had been held and that Sophie Broadfield, Director of Sustainable Communities had agreed for the need to work with specific communities to address issues raised.
Jayne Davis said that the Sub-Group was the right place to start to form ideas of how to resolve some of these matters. She added that she felt that the Board would benefit from inviting in people who are closer to the problems to gather further evidence and address them.
Rebecca Reynolds agreed and said that public engagement with the Board was very important.
Ruth Gawler asked if the Sub-Group would report back to the Board.
Councillor Romero replied that it would.
Councillor Rob Appleyard commented that he hoped this work would act as an opportunity for change. He added that in terms of attainment he was aware of the work that the St. John’s Foundation were doing with schools and asked the Board to consider hearing about the impact of their work.
Mary Kearney-Knowles said that a report could be provided if the Board decided that they would like further information.
Councillor Romero thanked Joseph Prince for his presentation on behalf of the Board and said she looked forward to seeing what developments could be made over the coming months.