JSNA Prioritisation Process

This sets out the prioritisation process for the JSNA Review priorities.

The Review Launch Workshop (29th April)

On 29th April, the Warwickshire Health and Wellbeing Board hosted the ‘Health and Wellbeing Strategy and Joint Strategic Needs Assessment Review Launch’.

This session was an opportunity to have a starting discussion on what the priorities for Warwickshire’s next full JSNA Review should be, which would then contribute to the development of Warwickshire’s Health & Wellbeing Strategy.

For Dr John Linnane’s presentation on the Health and Wellbeing Strategy, please click here.

For Chris Lewington’s presentation on the JSNA please click here.

For Rachel Robinson and Nicola Wright’s presentation on the review process, please click here.

To view the JSNA and Health and Wellbeing Strategy review timeline, please click here.

The following priorities and themes emerged from the day:

Priorities:

Economic wellbeing/development, safety, social isolation, premature mortality, diabetes, cancer, maternal health, obesity, physical activity, screening/immunisation, long term conditions, substance misuse, mental health, dementia, transitions from childhood/adolescence to adult, carers, special educational needs, education, smoking, smoking in pregnancy, alcohol

Themes:

Housing, deprivation, inequalities, prevention, children and young people, older people, communities.

The Prioritisation Process

As part of the 3-year review of Warwickshire’s JSNA, a tool has been developed to support the evaluation of the strength of evidence behind local health and wellbeing needs in order help prioritise those needs. The tool will be used to objectively assess and rank these suggested priority topics and the findings from this process will be presented and discussed at a Health and Wellbeing Board workshop on 23rd June 2014.

There is no single ‘best’ way of prioritising inherently complex and varied health and wellbeing issues and any such process involves a certain degree of subjectivity.  However, this tool aims to introduce an element of objectivity, robustness and transparency into the process so that stakeholders can hold a more informed discussion on what should be the key focus of Warwickshire’s JSNA.

The outcomes from this prioritisation process will be used to inform the next iteration of the JSNA and will provide the underlying evidence base for the development of Warwickshire’s Joint Health and Wellbeing Strategy.

Key Prioritisation Criteria

The following key criteria are each being considered as part of the JSNA Review prioritisation process:

  • Estimated level of need (in terms of volume, severity, trend, benchmarks, ability to benefit)
  • Is it any emerging issue likely to benefit from early intervention?
  • Strength of views from the public and stakeholders
  • Scale of inequality
  • Wider impact on the local population
  • Potential economic cost implications

Weighting of Prioritisation Criteria

Additional emphasis has been placed on the level of need (severity and volume) and economic cost prioritisation criteria and therefore these have been given greater weighting when the overall scores for each proposed priority area are calculated.

Click here to see the Prioritisation Tool.

Priorities and Evidence

The following documents contain brief summaries of the high level evidence which was used to assess each topic.

A ‘high’, ‘medium’ or ‘low’ score for each criteria of the prioritisation tool was recorded based upon the most robust available evidence.

Each of these scores was then totalled and moderated by a group of analysts before the overall scores and rankings were given.

Collation of Evidence

For each identified topic, a summary of the latest available evidence was collated and analysed by colleagues from Public Health and Strategic Commissioning.

Prioritisation process – A prioritisation scoring matrix was used as the template for the evidence collated.  It contained information on: Level of need – Volume, Severity, Trend and Benchmarks, potential health benefits, early intervention implications, qualitative information, scale of inequality, wider impact on local population and estimated economic cost.

Moderation Process

Colleagues from Public Health, Strategic Commissioning and the Warwickshire Observatory attended a single all day moderation session, which reviewed the evidence for all submitted topics.  All prioritisation matrices were scored using the same scoring method by the same people to ensure uniformity of scoring.

23rd June JSNA Prioritisation workshop

On the 23rd June a second Health and Wellbeing Board workshop, the JSNA Prioritisation Workshop, was held to present the prioritisation matrix scoring of the proposed priorities.  The main objective of the workshop was to agree on a manageable list of Warwickshire’s priority health and wellbeing needs, to be addressed through the Joint Health and Wellbeing Strategy. 12 topics were taken forward to this workshop based on the scores they achieved at the moderation day, and in discussions with the Strategic Group.  Attendees received short Dragon’s Den-style evidence based presentations from the topic ‘champions’ around why their topic should be considered as a priority in Warwickshire.

Feedback from Attendees

Attendees were asked whether they thought there were the ‘right’ number of priorities or whether the number should be reduced, whether the topics should be more specific rather than broad as some were and how the topics should be ranked in order of priority.

Ranking Exercise

Following the ‘Dragon’s Den-style’ presentations, each attendee at the workshop was given the opportunity to rank the priorities in order of importance.  These individual rankings were then collated to produce a final, overall, ordered list of priorities.

Final List

It was agreed by attendees that the 12 priority topics submitted for consideration be taken forward to the final list.  The consensus was that the 12 topics could be clustered into logical groups which would enable greater focus on the group as a whole.

Looked After Children

Vulnerable Young People

Educational Performance of Disadvantaged Children

Mental Health Adults & Children

Dementia

Carers

(Maintaining Independence – Strategic Group’s decision to include in strategy instead)

Weight management

Substance Misuse & Alcohol

Smoking in Pregnancy/ Smoking

Cancer

Cardiovascular Disease

Groupings

These groupings were as follows:

Vulnerable young people – Looked after children, educational attainment of disadvantaged children and vulnerable young people,

Mental wellbeing – Mental health Adults & Children and Dementia,

Long-term conditions – Cancer and Cardiovascular disease,

Physical wellbeing – Weight management, Smoking/Smoking in pregnancy and Substance misuse & alcohol

Carers– Young carers and adult carers.

The JSNA Strategic Group made the final decision to include Maintaining Independence within the Health and Wellbeing Strategy rather than a separate priority topic in its own right.  Therefore, the final agreed number of  priorities is 11.

The governance process included the JSNA Strategic Group’s decision of the order in which the priorities should be addressed and agreement from the JSNA Commissioning Group to use the priorities as the basis for the JSNA work programme for the next three years.

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