Clinical commissioning groups (CCGs) and upper-tier local authorities are required to prepare an assessment of the relevant health and social care needs of the area through the Health and Wellbeing Board (HWB).
These Joint Strategic Needs Assessments (JSNAs) are key evidence base documents for planners to be aware of.
The main rationale for the establishment of HWBs is recognition that health and wellbeing outcomes relate to factors beyond the health service. These are linked to wider determinants, such as education, work and the environment, which are the responsibility of local authorities and other agencies outside the healthcare system; hence joint strategic needs assessments, as local authorities are required to engage in their preparation with the CCGs.
The Health and Social Care Act 2012 requires that the development of JSNAs involve district councils and anyone who lives and works in the area. The key focus of the JSNA is to understand current and future health and well-being needs, and existing provision over the short (3-5 years) and long term (5-10 years), and inform commissioning decisions to address these needs.
There are separate JSNAs for Kent and Medway:
Each JSNA is made up of an overview summary report (refreshed every three years) and multiple needs assessments (based on programme area/ risk group) and other evidence.
The Kent and Medway Public Health Observatory includes health and social care maps for each of Kent’s twelve districts as well as Medway. These provide an overview of healthcare needs and service gaps for the locality, such as population mix, deprivation and health performance data. Being aligned to the JSNA and refreshed on a quarterly basis, these maps provide a robust and up-to-date data set. Along with the JSNAs they are potentially very useful for informing the development of Local Plan documents, Supplementary Planning Documents and Neighbourhood Plans.
The NPPF requires planners to work with public health partners and take account of local health and wellbeing needs and strategies. In practice, this means collaboration on the JSNA and the Joint Health and Wellbeing Strategy (JHWS). The Town and Country Planning Association’s (TCPA) “Spatial Planning for Health” guide aims to “promote the positive application of the JSNA in the planning process so that the JSNA as a method of engagement and an evidence-based tool can be fully understood and appreciated by planners and policy-makers”. The guide identifies key areas where evidence used in JSNAs and JHWSs can be useful in planning:
- housing quality and design;
- economic regeneration, employment and skills
- access to and provision of local services;
- community safety and crime;
- access to fresh food; and
- risk and vulnerabilities to climate change impacts.
JSNAs and JHWSs are also potentially useful to communities engaged in neighbourhood planning.
Planners should consider where and how data collected and presented in the JSNA can help to health-proof development plan policies and development proposals.
The JSNA should become a method of engagement and an evidence base that can be fully understood and appreciated by planners (e.g. for policy making, the development of Infrastructure Delivery Plans, setting Community Infrastructure Levy tariffs and informing development management decisions) and other policy/decision makers. Ways to facilitate this should be considered by health and planning teams. This is likely to include:
- aligning health and planning evidence gathering processes as far as possible
- exploring how the JSNA can be tailored to meet the needs of planners (and other stakeholders) more effectively e.g. by systematically addressing the wider determinants of health and by presenting data spatially to address the impact of specific developments or areas of growth/regeneration on health needs and health inequalities. The health and social care maps provided as part of Kent’s JSNA may be a useful focus for discussion.
The value of developing a JSNA for new communities such as Ebbsfleet should also be considered, drawing on the experience of Cambridgeshire (see Cambridgeshire JSNA under further information below).
When planning for health services provision the London Healthy Urban Development Unit (HUDU) Planning Contributions Model and Strategic Health Asset Planning and Evaluation (SHAPE) tool may be useful to policy planners – these are introduced in the Joint Working section. When preparing a CIL Charging Schedule planners should engage with health professionals at an early stage to make them aware of the information on health infrastructure requirements they will require, and when they will need it.