A changing JSNA, for a changing environment…
The JSNA baseline report was published in 2008 and making sure that this context is kept up-to-date is fundamental to the JSNA process. Since that time there have been many changes that have the potential to affect health, not least the economic recession, rising energy costs, climate change and emerging infectious diseases.
Evidence suggests that any financial crisis affects poor people the most and this will cause a widening of the health inequalities gap in Wakefield unless minitating actions are put in place. Recent studies in Leeds have shown that the recession is impacting on the spending pattern of all social groups (except the very wealthy). There is no reason to think this will be any different in Wakefield, having the potential to lead to increases in the use of alcohol and illicit drugs, mental health problems, greater consumption of cheap energy-dense foods and more individuals living in fuel poverty.
The changing political picture within England as a whole has also seen the potential for huge changes in the way we commission and deliver health and care services. The move to increase localism and encourage individuals and society to take greater responsibility in the planning and delivering of services, means that the JSNA now needs to be aimed at a wider audience and presented in a way which will allow all our partners to understand the needs of the district.
The Health and Social Care Bill currently moving through parliament will shift responsibility for commissioning for public health and health improvement from Primary Care Trust, to Local Authorities and Clinical Commissioning Groups – led by General Practitioners (GPs). These groups are tasked to work together as a Health and Wellbeing Board for the district, ensuring that there is a coordinated approach to our major health threats moving forward.
A changing population, with specific needs…
The population is aging and growing. This will continue to add additional burdens onto our care commissioners unless we are able to move toward effective prevention. This prevention needs to build on existing good practice and industrialise it. People need to be supported to make sensible lifestyle choices which will protect their long term health.
In 2009 Professor Michael Marmot delivered the results of a government funded research project looking at how we can best tackle raising inequalities in health. Within the document he identifies the need to give every child a good start, provide good education and meaningful employment opportunities, along with recommendations around the wider determinants of health – including tackling climate change, removing the obesogenic environment, improving poor housing, reducing crime rates, improving air quality, reducing road traffic and providing good quality green spaces. We have incorporated these areas into this year’s JSNA refresh process.
In 2010 Wakefield Together partners agreed to work together to try and tackle some of the challenging inequalities across the district by focussing on our 12 priority neighbourhoods, and by focussing service delivery across the whole district into 7 geographical areas. In this way we are committed to working more closely together and more closely with residents to help them to identify and co-deliver solutions which are appropriate, practical and sustainable at local levels.
We need to use the information contained within the JSNA to help plan for our future service provisions within the district. We need to ensure that – as far as possible – the customer journey is not impacted upon by transition through various agencies, and allowing pooling of resources where necessary to tackle the major health issues to the district. This pooling of resources has begun to occur with the pilot “Place Based Budgeting” projects on worklessness and alcohol issues within the district. Links to these reports can be found within this document.
It is important that the JSNA is widely owned and understood within the district. To facilitate this, there was a period of consultation between December 2011 and February 2012 to ensure this happens. The main themes are detailed in the next section.