Agenda item

Report CS18140

The Board considered a report outlining the Joint Strategic Needs Assessment (JSNA) Evaluation findings and recommendations, as well as the proposed methodology for identifying priorities for the Joint Health and Wellbeing Strategy.

Bromley’s first Health and Wellbeing Strategy was published in 2012 for the period 2012-15 with an overall strategic vision for Bromley residents to “live an independent, healthier, happier life for longer.”  Nine priority areas were identified within the first strategy which were later refined to four areas considered to be the highest priority comprising Diabetes, Obesity, Dementia and Children and Young People’s Emotional Health.  At its meeting on 8^th February 2018, the Health and Wellbeing Board agreed that a comprehensive evaluation of the Bromley JSNA be undertaken to review the structure, process and outcomes of the report to ensure it was fit for purpose and capable of answering the complex commissioning questions of the future, and that the Joint Health and Wellbeing Strategy be reviewed concurrently to this evaluation to inform the publication of a refreshed strategy later in the year.  This work had now been completed, and Board Members were requested to consider the findings of both reviews as well as the proposed methodology for agreeing priority areas for the new Joint Health and Wellbeing Strategy and the Action Plan that would deliver them.

In considering the JSNA Evaluation findings, Board Members generally agreed the proposed recommendations. 

Recommendation 3 proposed a more strategic and proactive approach be taken to identifying existing and planned opportunities to engage specific groups in aspects of JSNA development.  Board Members discussed the scope to build on existing engagement mechanisms and offer new opportunities to enable Bromley residents to engage with the JSNA.  The Chairman noted that engagement undertaken at a recent Carers’ Conference had led to the development of the highly successful Connecting Bromley campaign which offered befriending services, volunteering opportunities and a searchable directory of activities to reduce social isolation.  With regard to Recommendation 4, it was agreed that it would be beneficial for key partners to share data and analytical capacity and expertise as a means of achieving the best possible outcomes from available intelligence and to avoid duplicating work.  There was an increasing amount of regional and national data from organisations such as Public Health England which would also be used more widely in future. 

In supporting Recommendation 5, Board Members requested that the Joint Strategic Needs Assessment production cycle be extended to three years which would allow additional capacity to produce in-depth needs assessments between updates to the core chapters.  The Chairman noted that this could also include the exploration of emerging issues such as sleep hygiene which had been identified as having a significant impact on health and wellbeing.  Members also agreed that the proposal at Recommendation 6 to combine the Joint Strategic Needs Assessments for children and adults would support the delivery of a more coordinated response.  In response to a query from a Member, the Director: Public Health reported that the level of childhood immunisation and uptake of screening services such as for cervical cancer remained variable.  Public Health England had responsibility for commissioning these services and the Health and Wellbeing Board might want to consider inviting Public Health England to a future meeting of the Board to explore how immunisation and screening services were being delivered across the Borough.

Recommendation 8 requested that Cardiovascular Disease, Cancer, Diabetes/Obesity, Dementia, and Accommodation for those with Learning Disabilities and Homelessness be agreed as the local priorities for the joint Health and Wellbeing Strategy.  The Director: Public Health confirmed that dementia remained a key concern for the Borough as the levels of dementia were expected to increase in relation to Bromley’s ageing population, despite a recent reduction in the incidence of vascular dementia.  Members were concerned to note the high proportion of adults with a learning disability identified as not living in stable and appropriate accommodation, and also flagged the increasing level of statutory homelessness as a factor for concern.  It was likely that a wider strategic approach was needed to support the health and wellbeing of people residing in inappropriate accommodation or who were homeless, such as in maintaining their access to community health and support services.  The Chairman suggested that consideration be given to adding a Health Implications section to the standard Local Authority committee report template to place concerns around health and wellbeing at the heart of policy development, scrutiny and decision making.  Board Members agreed that Suicide Prevention be added as an additional priority area within the new Joint Health and Wellbeing Strategy.

In response to a question from the Vice-Chairman about Recommendation 10, the Director: Public Health explained that the “Life Course” approach aimed to increase the effectiveness of interventions by targeting the needs of people at critical periods throughout their lifetime, such as by promoting breastfeeding, and addressing the causes rather than the consequences of ill health. A Board Member underlined the importance of empowering Bromley residents to make healthy choices.  Another Member was encouraged by how the JSNA had evolved to become a living document that reflected the varying health needs across the Borough and allowed provision to be better targeted at vulnerable groups.  A Member highlighted that the JSNA should be an accessible document which was understandable to Bromley residents.

RESOLVED that:

1)  The proposals for the revised methodology to identify priorities for the next Joint Health and Wellbeing Strategy be endorsed;

2)  The suitability of the proposed priority areas for inclusion in the next Joint Health and Wellbeing Strategy be agreed with the addition of Suicide Prevention; and,

3)  The proposal of using a “Life Course” approach as a way to help develop the Action Plan relating to priorities agreed for inclusion in the Joint Health and Wellbeing Strategy be agreed.