Section 116 of the Local Government and Public involvement in Health Act introduced the statutory requirement for a Joint Strategic Needs Assessment (JSNA) to be produced by each Local Authority and Primary Care Trust (PCT). The JSNA is expected to “describe the future health, care and well-being needs of local populations and the strategic direction of service delivery to help meet those needs”. Directors of Public Health, Adult Social Services and Children & Young People’s Services are jointly responsible for the development of the JSNA. Its key features are: 

• Joint: a key element of the JSNA is that it should involve all the stakeholders in identifying needs and acting upon them. Crucially the JSNA provides a new framework for health and social care to work in partnership to identify the needs of the population they serve and to work together in commissioning services to meet those needs.
  
• Strategic: the JSNA should identify those needs and service requirements that are most relevant and important to its population. The needs assessment process should provide health and social care organisations with an evidence based identification of the key needs of its population and should therefore define the strategic direction in its commissioning of services. This strategic direction should consider both today’s and future health and social care needs.
  
• Needs assessment: there are many definitions of needs assessment. In order to identify health and well-being needs the assessment process should make use of existing information, identify information gaps and should include the views of service users, patients and the population. Importantly the needs assessment must include outputs that can be translated into actions for the commissioning and delivery of health and social care services, health improvement and well-being programmes and other interventions. The process should consider social inclusion and should identify inequities and inequalities in health and well-being and in current service delivery.

The JSNA is being prepared by a project board consisting of senior representatives from the Joint Commissioning and Programme Delivery Division (Children and Young People), Adult and Community Services, Joint Policy Unit and the PCT. It is supported by Research Sandwell.

It is envisaged that the JSNA will develop into an ongoing process of joint review of the health and social care status and needs of the population. It is intended that there will be a series of outputs from this process.   

A workshop was held in September 2007 kicked off the JSNA in Sandwell and established the process and the project team.   The recommendations of the workshop were:

1. 1. To start the data collection and analysis in particular looking at the population projections.
2. 2. To establish a process for agreeing priorities and use the LSP themes.
3. 3. To engage widely

A five stage approach is being adopted locally that incorporates these recommendations that will:

1. 1. Summarise the current knowledge on the health, care and well-being needs of the local population to include the results of consultations where available
2. 2. Review existing strategies and plans for action where necessary
3. 3. Present our findings to those people with responsibility for making key decisions on expenditure priorities
4. 4. Engage local communities and stakeholders to ensure that our priorities are the right ones and people are taking responsibility for their health improvement
5. 5. Re-prioritise our programmes of action in light of the evidence of need and of the effectiveness of interventions available to address this, and the aspirations of local people

The approach is based the need to triangulate our analysis of the data against the plans already in place and the needs of our population.  If we miss out one of these elements then the priorities identified might be those that are not needed and not demanded rather than those that are needed and demanded.

Figure 0:1 The triangle of Data:Intention:Voice