Joint Strategic Needs Assessment

North Tyneside Joint Strategic Needs Assessment Executive Summary

December 2009

This document summarises the ongoing JSNA work in North Tyneside and highlights the key messages and some of the implications for future commissioning and planning What is the JSNA? In April 2008 North Tyneside Council and North Tyneside Primary Care Trust (PCT) began a statutory duty to work together and with other partners to develop a JSNA for the local area.

The JSNA must pull together a wide range of information about the current and future health and well-being needs of the local population.

It provides an opportunity to look forward so that we can plan now to ensure that we are able to meet the needs of local communities in the future.

The JSNA will be one of the major influences in directing our commissioning priorities and planning service developments.

The Assessment describes the future health, social care and well-being needs of the population so that the Council and NHS can take co-ordinated action to make improvements.

How we undertook the JSNA The primary aim of JSNA is to describe the health and well-being needs of the population of North Tyneside.

We have focused on refining, improving and bringing together the information we have available that provides an insight into the overall needs of the population. This information is from national and local sources and includes extensive information we have collected directly from services across North Tyneside.

Initial work, carried out in 2008/09 has been used to take a longer-term view of population trends and the likely impact on demand for support over the next years and decades.

Alongside this quantitative information, we have looked at the commissioning knowledge we already have in order to identify what these figures and trends mean for services locally and to highlight priority areas for work. It should be noted that the quality of information sources varies and some population, condition and trend information are more robust and well-researched than others. Needs assessment, and in particular trend forecasting, is not an exact science, predictions tend to be more accurate at a general, larger population level and because of this we have aimed to keep key messages very strategic at this stage in this summary.

How we will use the JSNA The North Tyneside JSNA will underpin future revisions of the:

 Sustainable Community Strategy (SCS)  Local area agreement (LAA)  Annual operational/Local Delivery Plan  Council plan  Planning and commissioning for both children's and adult health and social care services

Involvement from people who use health and social care services as well as those providing services from the Council, NHS and community and voluntary sector will be essential for the ongoing success of the JSNA in North Tyneside, as will the use of social marketing to understand better what further steps we need to encourage people to live healthier lifestyles.

Information from the JSNA is already being used to direct the commissioning and planning of health and social care services in the borough. Overall Messages about Needs and Population

North Tyneside is an area of diverse The JSNA confirms that North character. Tyneside is an area where inequalities and health challenges are The geographical make-up of the comparatively high against national Borough ranges from the coastal areas figures and that faster progress is of Whitley Bay, Cullercoats and needed to reduce the inequalities gap. Tynemouth in the east, to the suburbs of Killingworth New Town in the west, In 2006-2008, life expectancy for and from the heavily industrialised women in North Tyneside is 80.6 years riverside towns of Wallsend and North compared to the England average of Shields in the south to the scattered 82.0 years. For males, the life former mining villages and isolated expectancy in our Borough is 76.6 agricultural areas in the north, such as years in comparison to the England Backworth and Earsdon. average of 77.9 years.

Between 2001 and 2008 the Borough At district level North Tyneside population has increased by 2.9%. appears to be “closing the gap”, in terms of reducing deprivation, against By 2018 North Tyneside’s population is the national picture. projected to have a rise of 7.3% from a baseline of 197,331 in 2008 to 211,700 North Tyneside ranks as the 102nd in 2018. By 2031 the projected rise is most deprived of the 354 local 14.3% to 225,500. authorities in England.

Projected birth rates for North Tyneside are expected to rise a little following the national trend for birth rates to decrease over the last few years. Tackling inequalities and closing the gap – between the Borough and England and within the Borough - has been the core part of our agenda in North Tyneside. The Council, NHS services and key partners have formed effective and robust partnerships to ensure overall commitment to the reduction of inequalities.

Our Local Strategic Partnership brings together the key stakeholders for improving health and well-being across the borough and aims to improve the quality of life and opportunities for the residents of our North Tyneside.

The Local Strategic Partnership is committed to reducing the inequality gap as highlighted in the Borough’s Local Area Agreement (LAA) and Sustainable Community Strategy that highlights our vision for 2030. Emerging Themes from the JSNA

Early Intervention Support for young carers remains an Key Priorities In line with national trends, North ongoing priority.  Ensure a more joined up approach Tyneside has a growing ageing to services for children and young population; increasing numbers of Long Term Conditions people with disabilities. people with long term conditions or Long-term conditions (LTCs) are those disabilities will need health and social that cannot, at present, be cured, but  Provide timely advice and care support into the future. can be controlled by medication and information for all members of the other therapies. community as part of a Health and social care systems must preventative approach using a focus more effectively on promoting People with LTCs in North Tyneside Contact Centre approach. good health and independence, and use disproportionately more primary on responding with preventative and secondary care services, and this  Develop preventive programmes models of support. pattern will increase over time due to which seek to reduce illness and factors such as an ageing population disability arising from chronic Carers and lifestyle choices. health conditions e.g., by North Tyneside has 21,002 people implementing health checks which (11% of the population) who provide For example, the number of men aged aim to reduce the risk of heart unpaid care. 65 years and over with dementia in the attack or stroke, and by reviewing Borough is predicted to increase by the provision of diabetes services. We must help carers to continue to 60.7% between 2008 and 2025. care and acknowledge them as  Use a co-ordinated approach to individuals with support needs in their In February 2008, there were 332 support carers in their caring role. own right. We need to improve our children and young people receiving a ability to assist carers to access service from the Children’s Disability  Co-ordinate health and social care benefits, support them into training, Team. These disabilities are likely to services for people with long term education and employment where be enduring and require long lasting conditions including those with required, and offer advice and training support. physical disabilities, learning on health issues. disabilities and mental health problems. Substance Misuse in life expectancy between the most Key Priorities Alcohol-related hospital admissions, and least affluent groups is associated  Reduce the number of alcohol- chronic liver disease and alcohol- with smoking. related hospital admissions through related deaths are all higher in North integrated alcohol treatment Tyneside than the average for both the North Tyneside has high rates of pathways, a programme of North East and England. smoking, which are associated with identification and brief advice statistically significantly higher delivered through general practices North Tyneside is the eighth highest mortality rates than the rest of and in multi-agency settings (e.g., “binge drinking” area in England. England. It is estimated that 87% of Police, probation, health and social Hospital admissions for alcohol-related deaths from lung cancer, 73% of care), and targeted work through harm are well above national deaths from upper respiratory cancer, A&E departments which aims to averages. Tackling rising levels of and 86% of deaths from chronic prevent alcohol harm related hospital admissions and binge drinking obstructive lung disease are hospital admissions. in young people is a priority. attributable to smoking.  Increase in the number of people Opiate use remains the most Smoking during pregnancy remains a accessing stop smoking services problematic drug in terms of treatment serious issue. In North Tyneside in by including tobacco/smoking in all need, associated crime levels and 2008/09, 21.3% of pregnant women contracting arrangements and impact on harm reduction services. were smokers at the time of delivery. undertaking a review of the NHS Poly drug use (the use of two or more Additional services are required to stop smoking service delivery psychoactive drugs in combination to support mothers, partners and families model. Target smoking cessation achieve a particular effect) is common who smoke. services to support mothers, amongst both adults and young partners and families who smoke, people. Despite considerable effort and and people in routine and manual activity, smoking among young people occupations. Tobacco Control has remained relatively stable since 1998. However, there are no local Smoking remains the greatest Identified Gaps contributor to premature death and data to monitor prevalence. disease across North Tyneside. It is  There are no local data to monitor estimated that up to half the difference prevalence.

Obesity The Mental Health Needs Index, MINI Key Priorities Nationally, obesity is the second most 2000, provides a relative measure of  Further invest in integrated care common cause of preventable death severe mental illness in the population. pathways for obesity to scale up after smoking; it has a major impact on North Tyneside has a ratio of 1.3 prevention and early intervention mortality, morbidity and quality of life. (compared to 1.0 for England). Based work, increase capacity in targeted The rise in obesity over the last 30 on this measure, North Tyneside has a intervention programmes and years is multifactorial and changes in predicted rate of psychiatric increase treatment of obesity using lifestyles and nutritional habits have admissions of 449 per 100,000 drug therapies, prior to had a significant influence on the persons aged 16-59 compared to 340 consideration for surgery. increased prevalence. per 100,000 persons aged 16-59 for England.  Work in partnership to increase Providing a healthy start in life is capacity across the statutory, third important for all children. Increasing Older people in North Tyneside will and commercial sectors to deal breastfeeding rates is important since become a larger proportion of the with increased demand in obesity low breastfeeding rates are associated population in the near future. This is services. with high levels of obesity in children. likely to result in increasing demand for In North Tyneside, breastfeeding services for those with dementia.  Co-ordinate health and social care initiation and rates of sustained services for people with long term breastfeeding at 6-8 weeks in North Hospital admissions for suicide and conditions, for example, by Tyneside are among the lowest in the injury of undetermined intent for those undertaking a joint review of country. aged 19 years or less has increased dementia services to ensure that from 88 attempts in 2001 to 104 services can be delivered now and Mental Health attempts in 2005. Contributory factors into the future that are in accord The overall average predicted rate in are thought to include alcohol, a range with the recently published National North Tyneside for common mental of emotional factors and mental health Dementia Strategy. health problems is 185.9 per 1,000 problems; these factors need to be persons aged 16-74 with higher rates further assessed.  Focus on the emotional well being in more deprived areas. This equates of children by implementing joined to approximately 26,400 cases in the This indicates that we need to address up work identified within the adult working age population. the emotional well being of children Borough’s Children & Young and young people. People’s Plan. Sexual Health and Pregnancy are unlikely to reach or maintain a Key Priorities North Tyneside exceeded its target to satisfactory level of health and  Reducing teenage conception rates screen 17% of 15-24 year olds in development, or their health and by improving access to and uptake 2008/09, but targets to further increase development will be significantly of all methods of contraception as screening coverage are challenging. impaired without the provision of part of a broader strategy that Positivity rates are low and it is services. includes well planned and effective important to ensure that screening sex and relationships education in reaches those identified as being at North Tyneside Council received a schools, colleges and other increased risk of Chlamydia to improve total of 1,573 referrals of children and relevant settings. Promote and earlier detection of the disease and young people to Children and Families provide long acting reversible reduce the likelihood of onward Services during the year 2008-09. contraception (LARC) to girls transmission. There has been a slight reduction in identified as being at increased risk the percentage of repeat referrals. The of early unintended pregnancy. Teenage Pregnancy continues to be a focus is to continue to ensure children challenge and is one of the key are safe.  Review arrangements for the National Indicators (NI 112) that is safeguarding of vulnerable children under-performing in North Tyneside. The number of Looked After Children and young people to ensure they In order to achieve the ambitious target (LAC) remains stable and is lower than remain effective. a more proactive approach to our statistical neighbours but in line performance monitoring and managing with the England average. The majority  Strengthen arrangements for the implementation of action plans, of LAC are placed in the South East monitoring and preventing bullying including a scaled up and systematic locality. Placement Stability has been in schools and the local community approach to the promotion and relatively with around 15% of children and ensure that it continues to provision of Long Acting Reversible having 3 or more placements 2008/09. address the needs that are directly Contraception (LARC), will be Long term stability has seen a related to children and young necessary. significant increase with the inclusion people themselves. of those placed for adoption. Safeguarding Children  Work together to eradicate child Children who are defined as in need It is estimated that 11% of children and poverty. under the Children Act 1989 are those young people are living in poverty in whose vulnerability is such that they the borough. Housing and campaigns resulting in a safer sound use of public money and are Young people who have access to North Tyneside. convenient to access. secure and sustainable housing are Key Priorities more likely to be healthy, safe and Preventing Ill Health and  Provide more housing that is involved in training or employment. In Promoting Well being affordable and meets the diverse 2008/09, from 907 applicants 648 North Tyneside is part of a group of needs of a wide range of local households were accepted by North areas where inequalities and people by working in partnership Tyneside Council as being homeless health challenges are the with North Tyneside Homes, and in priority need; of these 648 highest and faster progress is developers and Registered Social households, 258 were aged 16-24 needed to reduce the Landlords. Develop homeless years and 299 were aged 25-44 years. inequalities gap. Challenges prevention approaches such as include the need to support financial assistance, mediation and There is a shortage of affordable people to change their priority banding for domestic housing since house prices are lifestyles and health-related violence, care leavers and asylum relatively high compared to average behaviours by effective cases. earnings. Housing provision needs to engagement and education. meet a wide range of needs for local  Reduce the levels of safeguarding people. The JSNA has identified New Models of Care and concerns by developing high housing related support for drug Support quality adult services which have treatment users as a service provision The continued personalisation of NHS safeguarding at their core. gap. There is a general lack of and social care services will require emergency housing options in North whole system transformation to deliver  Reduce health inequalities by Tyneside and focus on linking with better advice and information, self- targeting action on the major housing providers and the Supporting directed support and personal budgets. causes of the life expectancy gap. People programme is a priority. Increase the focus on preventing ill Our residents want more from their health and promoting well being by Safeguarding Adults public services to match the choice, supporting people to change their All partners need to unite to implement customer service and personalisation lifestyles and behaviours. fundamental changes aimed at they get elsewhere. They ask for strengthening preventative initiatives services that are of good quality, make  Increase choice and control across health and social care services by personalising adult social services and introducing personal budgets.

Further Information For further information about the JSNA and to read the full report go to the North Tyneside Strategic Partnership Website www.northtyneside.gov.uk/ntsp/jsna.shtml

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