PCTs and local authorities are now working even more closely on understanding the needs of local people in a leap forward in partnership working. By Renu Bindra
The move towards stronger partnerships between communities, local government and the NHS is reinforced by the introduction of the duty of joint strategic needs assessment. As of 1 April this year, primary care trusts and local authorities are under a duty to work together even more closely to understand better the needs of the communities they serve, informing priorities and making a real difference to health and well-being outcomes.
With the move towards less central control and local people taking more control of their lives and the services that support them, the joint assessment provides a framework for health and local government to work in partnership with their communities to deliver choice, personalisation and empowerment and to reduce inequalities.
The duty builds on recent national policies highlighting the significance of working in partnership and determining local needs. In 2006, Our Health, Our Care, Our Say described the importance of designing services around the needs of local communities. This initiative was part of wider reforms focused on improving health, prevention and early intervention, and the reduction of health inequalities.
Likewise, the local government white paper Strong and Prosperous Communities stressed the need for local authorities, the NHS and other partners to work together to improve service delivery, underpinned by joined-up reporting systems and performance management for public health and social care.
The current NHS operating framework also emphasises the importance of partnership working, and the competencies for PCT world class commissioning require evidence of the skills and knowledge that will underpin and develop the use of data and information through joint assessment.
The statutory nature of joint assessment ensures that the findings will inform priorities and help improve commissioning, by giving a more transparent basis for the consideration of priorities and expenditure.
Section 116 of the Local Government and Public Involvement in Health Act 2007 places the duty of this assessment on upper-tier local authorities and PCTs. Directors of adult social services, children's services and public health are required to work together to lead the process, with close involvement of directors of commissioning. Involvement of the wider local authority, including areas such as planning and regeneration, will be an opportunity to address the range of factors that impact on health and well-being.
Joint assessment will be the main tool for determining local health and well-being priorities. Local authorities and their partners will take the findings of the assessment into account when determining the priorities and targets set in the local area agreement. The act places a duty on local authorities and their named statutory partners (including NHS organisations) to co-operate in determining local area agreement targets and to have regard to those targets in their activities.
Partners will need strategies to translate the findings into improved outcomes. For PCTs, the world class commissioning programme is driven by a thorough understanding of the health and well-being needs of the local community. There is a clear emphasis on improving health and well-being outcomes. A number of the described competencies to achieve effective commissioning are directly related to joint assessment.
Clinicians will have to understand population needs and demands, and the findings of the assessment should be shared across the health and care economy. Competency five - "manage knowledge and assess needs" - describes the importance of basing commissioning decisions on sound evidence, which will contribute to local prioritisation of investment.
This new phase in partnership working may pose a challenge for some organisations, but many will welcome this step to breaking down organisational barriers and improving relationships with local communities. It should help in the delivery of seamless services, and should also increase local accountability and empower local people to improve their health and well-being.
Aims of the joint strategic needs assessment
Understand the current and future health and well-being needs of the local population.
Enable communities, patients, service users, carers and providers to articulate their needs, resulting in appropriate sustainable services that are designed around users.
Inform the sustainable communities strategy, underpinning the health and well-being priorities and targets set by the local area agreement.
Provide the evidence base for world class commissioning, leading to services that promote health and well-being, improve health and social care outcomes, and reduce inequalities.
A second article on 5 June will focus on elements of successful joint assessment.