JSNA

What is a Joint Strategic Needs Assessment (JSNA)?

A Joint Strategic Needs Assessment (JSNA) is a process that looks at the current and future health, care and wellbeing needs of St. Helens residents to inform and guide the planning and commissioning of health, wellbeing and social care services. The JSNA in St. Helens brings together information from many different sources and partners relating to the population of St. Helens.

The statutory responsibility for compiling a JSNA is shared between St.Helens Council and St. Helens Clinical Commissioning Group (CCG) via St. Helens People’s Board. The Department of Health has provided a statutory guidance document for JSNA’s.

The JSNA is intended to do the following:

  • Investigate wider social factors that have an impact on health and wellbeing, factors such as poverty, housing and employment
  • Look at the health of the population, what behaviours affect health and wellbeing such as smoking, diet and exercise
  • Provide a common overview of health and care needs for the local community
  • Identify health inequalities
  • Provide evidence of effectiveness of health and care interventions
  • Document current service provision
  • Identify gaps in health and social services and unmet needs.

The JSNA takes information and data relating to the population, e.g. population numbers, smoking levels, life expectancy, causes of mortality, etc., and collates, analyses and evaluates this population level data. This provides an overview of need in the Borough and helps to identify areas of concern and to highlight key achievements.

The JSNA is a continuous process and is updated as new information becomes available.

Who is the JSNA for?

The main audience for JSNA are health and social care commissioners. However, it is intended to be used by a wide variety of people and groups to prepare bids and business cases, to ensure voluntary and community groups can meet their community’s needs and represent their views, to assist in the future development of services and to access local health and wellbeing information, plans and commissioning recommendations.

As each chapter of the JSNA is revised and re-written the chapter report will be published on info4St.Helens. The following chapters are available, see below.

JSNA 2020 – Health Inequalities

In St.Helens there are wide differences between wards in both health and wellbeing measures and indicators of the wider determinants of health. The JSNA 2020 – Health inequalities chapter of the JSNA looks into the inequalities in health between wards across the Borough of St Helens and includes analysis of the drivers of inequality due to the Covid-19 pandemic.

JSNA 2020 – Mortality

Life expectancy and mortality may be considered as the key measures of public health. Life expectancy is a measure that indicates the overall health of a population and since 2011 has slowed in growth nationally. Increasing life expectancy brings its own challenge, as an older population means more people potentially living with long-term conditions, increasing pressure on health care and social care services. 

The mortality section provides insight into the trends, inequalities and causes of death in the Borough.

The data within this needs assessment is based on data published in 2019 and therefore does not measure the impact of Covid-19. Analysis of the effects of Covid-19 on mortality will follow in due course.

Key Findings
  • Life expectancy at birth for both men and women (2017-19) is significantly below the national average (78 years for men in St. Helens compared to 79.6 years across England; 81.4 years for women in St. Helens compared to 83.2 years across England).
  • There is significant inequality in life expectancy across different wards in St. Helens, with 10.4 years difference between the highest and lowest wards for men and 9.2 years difference for women.
  • Mortality rates in St. Helens for both men and women are slightly higher than the North West average but significantly higher than the national average.
  • Cancers account for the highest rate of deaths in St. Helens, approximately 26% of all deaths in 2019, with deaths due to circulatory diseases accounting for 24% of deaths in St. Helens.

For a more detailed analysis if the key areas in relation to life expectancy and mortality please refer to the St Helens Joint Strategic Needs Assessment 2020 – Mortality.

JSNA 2019 – Maternity and Early Years

Giving every child the best start in life is a key recommendation from ‘Fair Society, Healthy Lives’ (2010). The report from Marmot highlights the need to reduce inequalities by ensuring children during the early years of life are provided with the physical, intellectual and social skills necessary to develop into healthy and resilient children and adults.

This chapter of the strategic assessment explores maternal and early years’ health in St. Helens. It will provide an overview of need in the Borough and highlight both areas of improvement and of concern.

Key Findings
  • Smoking in pregnancy increases the risks of miscarriage, premature birth, still birth and low birth-weight. The rate of smoking during pregnancy has decreased in recent years from 22% in 2010 to 15% in 2018.
  • It is estimated that by 2029, the 0-25 year olds population will be relatively static. 
  • Breastfeeding rates are improving slowly. However, they still remain significantly below the England and regional averages.
  • Infant mortality in St Helens is the lowest in the North West and the national average. For the majority of vaccination programmes, St Helens performs better than the England rate.

For a more detailed analysis of the key areas of maternal and early years health, please refer to the JSNA 2019 – Maternity and Early Years report.

JSNA 2019 – Children and Young People

Giving every child the best start in life is a key recommendation from ‘Fair Society, Healthy Lives’ (2010). The report from Marmot highlights the need to reduce inequalities by ensuring children during the early years of life are provided with the physical, intellectual and social skills necessary to develop into healthy and resilient children and adults.

This chapter of the strategic assessment explores the health and wellbeing of children and young people in St. Helens from educational attainment to lifestyle factors and hospital admissions. It will provide an overview of need in the Borough and highlight both areas of improvement and of concern.

Key findings
  • At the end of the 2017/18 academic year, 69% of children educated and completing the EYFS in St Helens achieved a good level of development; similar to the regional average (68.9%) but below the national average (71.5%).
  • Students educated in St Helens and completing their KS4 studies in 2018 made significantly less progress than other pupils nationally.
  • Overall, since 2008 the number of teenage conceptions has reduced in St Helens by 70% (216 conceptions in 2008 and 65 conceptions in 2016) but 2017 has seen an increase.
  • The rate of alcohol–specific hospital admissions of under-18s in St Helens is the 2nd highest in England at a rate of 99 admissions per 100,000 population.
  • In comparison to England, St Helens children are more likely to be obese.
  • In St Helens, the proportion of children with who had experienced dental caries was 38% in 2017.
  • The rate of hospital admissions due to unintentional and deliberate injuries in 0-14 year olds has decreased three years in a row in 2017/18.
  • At 180 admissions per 100,000 population aged 0-17 years, St Helens has the highest rate of admissions due to mental health problems in Merseyside and is the 3rd highest in England.
  • At a rate of 135 children per 10,000 of the under-18 population (2019/20), St Helens has a considerably higher rate of children looked after by the authority than comparable regional and national averages. The rate of children in need in St Helens at the end of 2019/20 is 478 per 10,000 children; a higher rate than the North West and England.

For a more detailed analysis of the key areas affecting children and young people, please refer to the JSNA 2019 – JSNA 2019 – Children and Young People Report.

JSNA 2018 – Older People and Vulnerable Adults

The JSNA 2018 – Older People and Vulnerable Adults report considers key health and social care issues for older people such as falls and dementia, which may affect people of any age, but whose likelihood increases in later life. These conditions are major causes of death in St Helens and have a major impact on health and social care services. The report considers issues in end of life care, which could also be needed for a patient of any age but is more likely at older ages. The needs of those individuals who may be have a specific care requirement, such as people with learning disabilities or physical disabilities are also included.

Please note that this chapter of the JSNA was produced in 2018 and it is likely that some of the data will have been updated. 

JSNA 2018 – Adults’ Lifestyles

A wide range of factors can impact on an individual’s health and wellbeing. Lifestyle factors such as alcohol, smoking, substance misuse and obesity also have a large impact on health. The JSNA 2018 – Adults Lifestyles chapter explores adult lifestyle factors to determine the level of need and to gain a better understanding of adult health and wellbeing in St. Helens. Many of the health harms from these issues are proportionally greater in St. Helens than found nationally and long-term trends are of increasing concern in some areas, such as obesity.

Please note that this chapter of the JSNA was produced in 2018 and it is likely that some of the data will have been updated. 

JSNA 2017 – Demographics and Wider Determinants of Health

The health of local people is affected by a wide range of factors, some of which include:

  • Socio-economic aspects (e.g. economy, employment)
  • environmental conditions, (e.g. air quality)
  • living and working conditions (e.g. housing)
  • social connectedness and support
  • crime and community safety
  • access to healthcare
  • individual lifestyles choices (e.g. smoking, physical activity)
  • factors intrinsic to the individual, such as age, sex and genetics

The JSNA 2017 – Demographics and Wider Determinants of Health chapter considers the wider influences on people’s health and wellbeing. Please note that this chapter was produced in 2017, therefore much of the socio-economic data has since been updated.  Refer to NOMIS for updated economic data for St. Helens.