LONG TERM CONDITIONS ACROSS THE LIFECOURSE

Stakeholder Key Findings Workshop19th May 2015

Welcome

Agenda for this morning

9.30 Welcome 9.40 Scene Setting10.00 Interpreting the Evidence11.00 Identifying Key Findings11.15 Refreshments break 11.30 Developing Next Steps12.30 Closing Remarks12.45 Finish

Scene setting

• The management and care of people with long term conditions - one of the most fundamental health and social care challenges

LTCs in Cambridgeshire• 31.7% in Cambridgeshire reported having at least one LTC (GP Survey)• 90,420 people reported a long-term activity-limiting illness defined as an

illness lasting at least 12 months, with any limitation (2011 Census)

0-15 16-24 25-34 35-49 50-64 65-74 75-84 85+ All ages0

10

20

30

40

50

60

70

80

90

100MalesFemales

Age group (years)

Perc

enta

ge o

f pop

ulati

on

Those reporting limiting LTC in Cambridgeshire, 2011 Census

Health & Wellbeing Strategy 2012-2017

• Priority 2 - Support older people to be independent, safe and well:

Promote preventative interventions which reduce unnecessary hospital admissions for people with LTCs, enable them to live independently at home or in a community setting where appropriate and improve their health and wellbeing outcomes, e.g. through falls prevention, stroke and cardiac rehabilitation, supporting voluntary agencies and informal carers.

Joint Strategic Needs Assessment (JSNA)

• Commissioners & LA jointly describe health, care & wellbeing needs & service delivery

• Focus on:• Outcomes• Partnership working• Consultation

• Drives commissioning process

• The Local Government and Public Involvement in Health Act (2007)

• Health & Social Care Act 2012

• Health & Wellbeing Boards statutory duty to prepare:

• Joint strategic needs assessment

• Joint health & wellbeing strategy

Statutory Background

Duties & powers relevant to JSNA & JHWSLOCAL DEMOCRATIC LEGITMACY – POWERS AND DUTIES

CCGs Local Authority NHS CB Local Healthwatch

Health and Wellbeing Board

Functions of health and wellbeing board

Duty to prepare assessment of needs (JSNA) in relation to LA area and have regard to guidance from Secretary of State

X* X* X (to participate)   X

Duty to prepare JHWSs for meeting needs included in JSNA in relation to LA area and to have regard to guidance from Secretary of State

X* X* X (to participate)   X

Duty to involve third parties in preparation of JSNAs: Local Healthwatch People living or working in the area For County Councils – each relevant DC

X* X*     X

Power to consult any persons it thinks appropriate in preparation of JSNAs

X* X*     X

Duty to have regard to the NHS Commissioning Board mandate in developing the JSNA and JHWS

X* X*     X

Duty to publish JSNAs X* X      

Impact of duties on other associated functions

Duty to have regard to relevant JSNAs and JHWSs in the exercise of relevant functions

X [in exercising any functions]

X [in exercising any functions]

X [in exercising any relevant commissioning functions

   

Specification

& agreement

• Establish parameters• Establish process

Data captur

e

• Identify & bring together relevant data• Identify best practice

Data review

• Identify relevant data

Analysis

• Appraise• Jointly agree alignment with strategic agendas

Advocacy &

implementat

ion

• Jointly generate key findings & recommendations• Jointly promote results/recommendations

Assessing

value

• Costs and benefits of JSNA

JSNA Impact

• Provide clearer idea of what is needed• Deliver what people want• Evidence decisions – enable stakeholders to buy

into change• Identify best interventions• Ensure range of interventions available &

accessible• Inform more effective & economic configuration

of services

Starting point: purpose of this work

• Describe patterns of long term conditions (LTCs) across lifecourse

• Raise awareness of health needs & inequalities • Understand complexity of LTCs • Understand impact & interaction of mental health across

LTCs• Review suitability & accessibility of current services • Recommendations to improve health, independence &

access to care with a focus on cost-effective solutions• Engage & empower people with LTCs

LTCs across the lifecourse

Primary Prevention JSNA LTC JSNA

Scope: LTCs across the lifecourse• Focus on care management for high risk people with adult-onset LTCs

– integrated management and care for adults with long term conditions, highlighting opportunities for prevention and avoiding escalation in health and care needs

– explore the principles of empowerment and self-care, and indicate findings on potential improvements to enable person-centred and high quality care.

– provide valuable information to the health and social care system, and to improve health outcomes of the population of people with LTCs across Cambridgeshire

• Characteristics of those at high risk of poor health outcomes:– Multiple conditions (multi-morbidity)– Limitation– Pain and Mental health conditions (anxiety and depression)

• Cross cutting themes– Inequalities – Risk factors across the life course – Models of care

• Short data supplements

• CVD • Hypertension• Diabetes• Chronic Kidney Disease• COPD

The story so far...Opportunities and challenges

• Defining the population…• Multiple conditions • Emerging evidence (i.e. not a lot there yet)

and more practice focussing on the most complex 1-2%

• Collaborative working on datasets to generate useful estimates

• Hearing and collating local views

JSNA Process and Engagement

Scoping paper to HWBJan 2015

Stakeholder Meeting: SCOPING

November 2014

Scoping

Final report to HWB July 2015

Development

Stakeholder Meeting:

LOCAL VIEWSApril 2015

Stakeholder Meeting:

KEY FINDINGSMay 2015

Aims of today’s workshop

• Increasing awareness and understanding of the evidence collated so far in this process

• Providing local interpretation of the evidence gathered, and adding further detail on existing assets and challenges to improve the accuracy and comprehensiveness of the JSNA

• Gaining a shared view on the gaps in information • Discussing the priorities among the population needs that

have been identified and exploring how this work can inform commissioning intentions and approaches

• Recognising the crucial necessity of co-production with local views at the heart of future work to improve outcomes for people with LTCs and considering how this can be embedded

INTERPRETING THE EVIDENCEGroup Discussions

• What is your reaction to this evidence and data?

• How would you interpret this evidence? • What are the gaps in knowledge that need to

be addressed? • What is this telling us so far?

IDENTIFYING KEY FINDINGSGROUP DISCUSSION

What findings that have been described today would you consider as ‘key findings’?

5-6 points per group

IDENTIFYING KEY FINDINGSPrioritisation

What findings that have been described today would you consider as ‘key findings’?

Please vote with your sticky spots on statements you feel are most important

You can put all your spots on one piece of information or spread them out

DEVELOPING NEXT STEPS

Panel discussion:

What are our current local assets and how can these key findings be taken forward within them?

Keeping in touch

• Contact:angelique.mavrodaris@cambridgeshire.gov.ukhelen.johnston2@cambridgeshire.gov.uk

Thank you very much for your attendance & participation today