Improving Children’s Health and
Wellbeing in the West Midlands
Feedback from survey
Present
To what extent did the JSNA really affect the
priorities of the Health and Wellbeing Strategy?
• Mixed response
• Where JSNA did affect the priorities
– Clarity of link
– Order of development
– Having consistency of Officer involvement
• Challenges
– Speed of development
– Work in progress
How to improve the development of JSNA/ Health
and Wellbeing strategy
• Wider consultation
• Linking key health risks to key Marmot themes
• Contract Monitoring to align service/team
impact to strategic priorities
• Dynamic relationship between JSNA and
Outcomes frameworks
Best features of JSNAs
Data
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Identifying the level of need in the population and Priority Neighborhood profiles
Level of Detail from overview to comprehensive data depending on their individual
requirements.
Comprehensive coverage of topics
Presentation
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Dynamic website,
The way the information is presented in layers on website- Overview to allowing
visitors to a greater level of detail, maps, data, etc, depending on their individual
requirements.
Process
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Collaborative process,
Senior manager buy in
Possible additional priorities for the H&WB
Strategy
• Qualitative indicators for child health
• Increase scope to incorporate deprivation in a
wider context.
• Focus on life course
• Some respondents requested a decrease in
the number of priorities
How will the H&WB Strategy really direct the
services commissioned?
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By governance through the HWBB
Focusing on the priorities
Having teeth and being part of the DNA of the LA
Encouraging joint commissioning
Assigning a Board member as "champion" for each of the
outcome areas.
• Agreeing the monitoring process
• Informing Public Health Priorities
Challenges
• Public Health Priorities smaller list
• Interface between professional and public/patient
Improving the Health and wellbeing
strategy
• Having a Strategy
• Wide spread consultation and engagement in
the Strategies development
• Communicating Strategy to stakeholders/ Staff
• Refreshing Strategy once Board members
established / board matures
• More detail
Best aspects of Health and Wellbeing
Strategies
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Clear Governance Structures in place
Identify work areas for priority
Consultation with key stakeholders
Links to other Strategies, Plans and priorities.
Evidenced based targeted on clear and validated
data
• Short, easy to read, comprehensive
• Whole system approach
Improving existing Governance
arrangements
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Awaiting the Governance Structures for CCGs.
Alignment of local structures/governance
Ensuring all stakeholders are fully represented
Improved communication between Boards
Managing relationships across the
complex system
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Health and Wellbeing Board critical role
Being Active rather than passive
Focus collaboration on specific themes/ Services
Ensuring strong collaborative relationships exist at all levels of
structure.
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Regular contact,
Mutual trust and respect,
Transparency,
Genuine desire to work differently
Commitment to new arrangements.
• Strong links in place based on existing working relationships
– relationship building between key individuals where these don’t exist
Strengths of current joint commissioning
• Health Visiting services working in Children's Centres
– Family and Child Centred
– Sharing skills and expertise
• Joint commissioning posts
– Enables all perspectives to be afforded equal importance
• School nursing service
– Regular meetings with commissioners from health & LA
Strengths of current joint commissioning
(Cont)
• Multi Agency Panels
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Multi-agency group
Single Focus. All three agencies fully committed.
Budget Holders
joint decision
Examples
• Joint Solutions Panel
– Pooled Budget to support children with complex needs
– Focus on sourcing better, cheaper, more local solutions to meet needs.
• Children and Young Person's Substance Misuse Group.
– Comprehensive needs assessment process.
• Women and Children's joint commissioning group
– Includes council's and NHS Provider services
Future Priority areas For joint
commissioning
• Social support in pregnancy and early years
• Children's integration with adult
commissioning
• CAMHS,
• School nursing,
• Health Visiting
• 0-19 Healthy Child Programme
Examples of joint delivery that are working
well
• JSNA
• Triaging arrangement involving children's
social care, health and police.
• Obesity
• Targeted Youth Support Panel
• Sexual Health Services
• CAF
Areas for further integration of
delivery
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Priorities within HWB strategy
Having an holistic approach to an individuals health and wellbeing.
5-19 healthy child programme
Front line and preventative services
• Specific areas
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School nursing,
Health visiting
CAMHS
Early years -Children’s centres,
Schools and colleges,
Youth services
Sharing best practice:
Warwickshire County Council JSNA Website
Sharing best practice:
Dudley’s Joint local protocol between adult drug and alcohol
treatment services and local safeguarding and family services. :
Link http://safeguardingchildren.dudley.gov.uk/information-for-professionals/safeguarding-children-procedures/children-in-specialcircumstances/?assetdet549=106104
Sharing best practice:
• CAMHS
West Midlands
– Warwickshire and Coventry Tier 2 Targeted Services for Mental
Health (TAMHS),
– Wolverhampton Tier 3+
– Worcestershire Service redesign
National
• SE Scotland redesigned Tier 4 across 3 NHS Board areas (Lothian, Fife,
Borders)
• Tendering of Tier 2, 3 and 4 services
Sharing best practice:
Public Health (0-5)
– Family Nurse Partnership Programme (FNP)
– Costs of the FNP are typically around £3200 per supported family per year
based on supporting a caseload of 100 families.
– Stoke, Staffordshire, Telford & Wrekin, Walsall, Birmingham, and Dudley.
YP Substance misuse
• National Treatment Agency Guidance and Best Practice
– http://www.nta.nhs.uk/young-people.aspx
• London CAMHS Substance Misuse Specialist Service –(3 Las)
• Stoke
– Outcomes Based Commissioning
• Worcestershire
– payment by results
– recovery based
– outcome focused contract.
Sharing best practice:
• Disabled Children’s Services and complex health needs
– Personalisation
– http://www.opm.co.uk/wp-content/uploads/2012/10/MIP-word-doc-of-pdf-finalOct-2012.pdf
• Teenage pregnancy (and sexual health)
– http://www.respectyourself.info/
Joint commissioning of sexual health services
• Solihull and Birmingham (4PCTS)
• London Sexual Health Programme
– http://www.londonsexualhealth.org/about-us.html
• Yorkshire and Humber
– http://www.yorksandhumber.nhs.uk/what_we_do/improving_the_health_of_the_popul
ation/sexual_health/
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Links to JSNA
Birmingham City Council
Coventry City Council
Dudley MBC
Herefordshire Council
http://bhwbb.net/wp-content/uploads/2012/09/New-One-JSNASUMMARY-2012-final.pdf
http://www.coventrypartnership.com/upload/documents/news/PIE%20
GROUP/JSNA%202012.pdf
http://www.dudleylsp.org/jsna/
http://www.herefordshire.gov.uk/factsandfigures/docs/Research/JSNA_
2011_Key_points_and_Recommendations_(V1.2).pdf
Sandwell MBC
Shropshire Council
Solihull MBC
Staffordshire Ccunty Council
Stoke-on Trent City Council
Telford and Wrekin Council
Walsall Council
Warwickshire County Council
http://shropshire.gov.uk/jsna.nsf/viewAttachments/JSHW8WLCEF/$file/Shropshire_JSNA_SummaryDocument_2012.pdf
http://www.solihull.gov.uk/akssolihull/images/att14595.pdf
http://www.staffordshire.gov.uk/health/PublicHealth/StaffordshireNeeds-Assessment-2012.pdf
http://www2002.stoke.gov.uk/planning_uploads/Joint%20Strategic%20
Needs%20Assessment%202011.pdf
http://www.telford.gov.uk/downloads/file/4286/discussion_1priorities_and_new_ways_of_working_to_improve_the_health_and_we
llbeing_in_telford_and_wrekin
http://cms.walsall.gov.uk/observatoryindex/wponeeds_assessments/wpo-jsna.htm
Wolverhampton City Council
http://jsna.warwickshire.gov.uk/
http://www.wtonpartnership.org.uk/UserFiles/File/JSNA%202009%20Update.pdf
Worcestershire County Council
http://www.worcestershire.gov.uk/cms/pdf/JSNA-Summary-2012.pdf