About the JSNA

What is the JSNA?

This refreshed Joint Strategic Needs Assessment (JSNA) is the evidence base for understanding population-level need in Barnet. It has been designed to inform joined up decision making and commissioning by the Barnet Health and Wellbeing Board, Barnet CCG, social care, public health, the wider public and voluntary sectors, and private sector service providers.

The intention is that by having a shared understanding of the size and nature of Barnet’s residents in one place that focuses on 1) the needs of the population, irrespective of organisational or service boundaries, 2) areas of common interest and 3) reducing demand for public resources, the JSNA will act as a tool to help partners come together to share expertise and resources to improve the prospects of people living here. It will also ensure that every penny of public money is used as efficiently as possible and with maximum positive impact.

This balance between engagement at a senior level and analysis has been a critical part of developing a successful JSNA because it has:

1. allowed the JSNA team to tailor the content to reflect what local partners want, value, and consider important
2. resulted in a JSNA that has credibility locally as an impartial, high quality, and up-to date evidence base for effective and joined up decision making across all sectors.

Purpose of the JSNA

The purpose of a JSNA is to allow local partners to improve the health and wellbeing of the population and to reduce inequalities for all groups, leading to reduced demand for public services and better lives for people who live in Barnet. It does this by acting as a common, shared evidence base across partners in the Health and Well Being Board and wider public services, enabling alignment of activity and resources around common issues and needs.

There is an opportunity in the JSNA to use it to ensure that public services more broadly are supporting the wellbeing of the population in a more joined up way. For example, to ensure that sports centres, parks and open spaces, employability and apprenticeship schemes, and use of community assets are explicitly targeting their services at those groups in the population who stand to benefit most from using them.

Figure 1: How to use the JSNA

Principles

It is important that the JSNA does more than just describe statistics and information relating to the Borough’s population. To add real value it is important that it aligns with and informs the big strategy decisions that need to be made across the public sector, including health and social care, over the next five years. With this in mind the following principles have been developed to guide the development of the JSNA.

This Barnet JSNA will:

• Focus on prevention, early intervention and demand management: Delivering better outcomes for individuals and communities whilst also meeting the challenges of scarce public resources means that it is more important than ever to encourage and support all residents to live longer, healthier, happier lives that are free of long-term conditions and illness. With that in mind, every section of this JSNA is based around understanding the root drivers of need for different services and providing commissioners across the public sector with the intelligence and insight they need to address them and to reduce long term demand for things like hospital beds, social care, and mental health services.

• Identify shared agendas across public services: The nature of JSNA as a joint evidence base means that the issues it focuses on should be cross-cutting “shared” agendas by definition. For example, mental health, carers, and long-term conditions. Crucially though, it also includes any early intervention opportunities that evidence shows can reduce the probability of an individual developing higher needs later on in life such as child immunisations and promoting good dental health in children, good parenting classes, quality housing, improving the effectiveness of smoking cessation activity, and promoting healthy lifestyles. The JSNA supports different agencies to identify the links between different service areas, keeping the person at the centre of care irrespective of who is providing it.

• Use existing data only: There has been no primary data collection associated with this JSNA, which only includes insight and analysis that already exists in the Public Sector. This reflects the fact that analyst time is increasingly valuable and scarce, but also the huge amount of information that already exists in the Barnet public sector and which could be used more effectively to inform decision making than has always been the case in the past.

• Support and align with existing service-level needs assessments: The JSNA draws on the significant amount of high quality needs assessment that has already been undertaken by the Council and the CCG, for example relating to mental health, special educational needs (SEN) and parks and green spaces. What the JSNA does is contextualise these and draw connections between them at a more strategic level, as well as makes their findings available to a wider audience of commissioners, members, and strategic decision makers.

• Be a way of working, not a document or product: The JSNA will be updated as required over the coming years. In particular, the new Barnet JSNA micro-site will be updated with current analysis as soon as it is available and interpreted for commissioning purposes. This will reduce the risk of the JSNA losing its usefulness as the data within it becomes increasingly out of date.

Theoretical underpinnings

The focus on prevention, early intervention and demand management embedded across the JSNA requires a broad view of health and wellbeing that accounts for the wider socio-economic factors affecting the health and happiness of individuals and communities now and in the future.

This JSNA uses Dahlgren and Whitehead’s Model of Health and Well Being as its theoretical basis, and incorporates not only the important lifestyle and health behaviours of the population, but also wider issues such as employment, volunteering, crime, and housing because all the evidence tells us that these issues are important to engage with if we want to improve health and wellbeing for the population and reduce demand for scarce public resources:

Figure 2: Dahlgren and Whitehead’s model of the wider determinants of health

Structure of the JSNA

The JSNA consists of a written document and an interactive, constantly updated website that has been designed to be accessible and useful to residents, elected members, commissioners, and providers. The written JSNA consists of the following sections, with connections made between them in the analysis where relevant:

1. Demography
2. Socio-economic and environmental context
3. Barnet Customer Segments
4. Health of the population
5. Lifestyle
6. Primary and Secondary Care
7. Children and Young People
8. Adult Social Care
9. Community Safety
10. Community Assets
11. Resident voice
12. Public Sector Finance

Who should use the JSNA?

The JSNA is a public, published document and is available to anyone who wants to understand the local population and its associated needs and trends. There are a number of specific groups who will either need or want to use the JSNA to inform priority setting and strategic commissioning, or to shape the targeting and delivery of front-line services at the areas of highest population need:

• Barnet Health and Well Being Board members

• Elected members

• NHS Clinical Cabinet Board members

• Senior officers

• Commissioners

• Providers who want to develop services to be commissioned by the Barnet public sector

• Strategic planners who want to understand and plan for future demand pressures

• Voluntary and Community Sector organisations.