NATIONAL JSNA DATA SET PROJECT
PROJECT SITE SUMMARY REPORT
GENERAL INFORMATION
Field Site Name:
Manchester
Web address:
http://www.manchester.gov.uk/jsna
Type of Site:
Please give some context to your LSP including how the local authority is arranged, e.g.
unitary, two-tier etc. Please also comment on the alignment of health and local
authority boundaries, the local JSNA process and extent of partnership working with
wider partners.
Manchester is a Metropolitan District Council at the heart of the Greater Manchester City Region. The city is the 4 th
most deprived local authority district in England. Life expectancy among males is the 2nd lowest in the country and
that of females is the 4th lowest. The local authority is co-terminus with Manchester PCT (“NHS Manchester”), which
was formed in November 2006 following the merger of the former North, Central and South Manchester PCTs. Both
Manchester City Council and NHS Manchester form part of the Manchester Partnership. The Manchester Partnership
is led by the Manchester Public Service Board (PSB), currently Chaired by the Chief Exec of NHS Manchester, and is
made up of a number of Thematic Partnership Boards, including the Adults Health and Wellbeing Partnership Board
and the Children’s Board.
The first edition of the JSNA was formally sponsored by the Manchester PSB. This sponsorship was reaffirmed in
August 2009. The work to develop and produce the JSNA was led by the Manchester Joint Health Unit (JHU) with the
support of a multi-agency Working Group made up of representatives of NHS Manchester, Manchester City Council
Research and Intelligence Team, Adults Social Care, Children’s Services and the Manchester Local Involvement
Network (LINk). A range of other partners, including the Housing Information Unit, Drugs and Alcohol Team (DAAT),
Manchester Public Health Development Service, Cultural Strategy Team and the Health Protection Unit, were brought
in to write individual sections of the document and provide expert advice. The JSNA was published in November 2008.
A public summary document was also produced with the assistance of a freelance journalist. Both documents are
available to download electronically via the Manchester City Council website. A set of summary Health Factsheets for
each of the 32 wards in the city were also produced to provide some local context to the JSNA and are also available
via the City Council website.
Primary JSNA contact(s): Neil Bendel (Head of Health Intelligence)
Contact details:
Tel: (0161) 234 4089
Tel: (0161) 765 4409
Mobile: (0777) 5823149
Mobile:
Email: [email protected]
Email: [email protected]
PROJECT DETAILS
Project overview,
outcomes and output:
Please give a summary of the project you chose to undertake and why. Briefly explain
the methodology for the work you have carried out, detailing the outcomes and outputs
available to share nationally.
The focus of this project is on developing a robust and sustainable process for developing a series of Locality JSNAs.
The need to do this was highlighted in the first edition of the citywide JSNA and reflects the fact that the process of
commissioning health and social care services for adults and children is increasingly being devolved down to smaller
geographical localities (e.g. practice-based commissioning hubs, children’s services districts etc). The process of
developing Locality JSNA is intended to help commissioners working at a locality level to develop a common
understanding of the current and future needs of local residents and service users.
The methodology adopted for the project emerged from a series of Locality JSNSA workshops held in December 2008
and February 2009. These highlighted the fact that, although individual commissioners often have a good
understanding of the needs of their specific client group or locality, this knowledge is rarely shared at a strategic level
or across discipline. Furthermore, commissioners working at locality level rarely have the time or resources to develop
as systematic a picture of local needs as they would have liked. The workshops also highlighted the importance of
NATIONAL JSNA DATA SET PROJECT
PROJECT SITE SUMMARY REPORT
ensuring that the processes, and the resulting outputs, are owned by individual localities. It was felt that working
with, rather on behalf of, local commissioners would give local areas a greater stake in the outputs of the work and
increase the likelihood of the JSNAs becoming a central part of the commissioning cycle.
With this in mind, three multi-agency Locality JSNA Working Groups have been established (in North, Central and
South Manchester). Each group has agreed a common Terms of Reference but have adopted slightly different ways of
working and have different membership lists. The Joint Health Unit provides overarching project management
support and liaison between the groups. Current work is focused on bringing together available local data and
identifying gaps in their knowledge base, as well as establishing a list of existing local strategies and needs
assessments. The groups are working towards a common date of the middle of December 2009 for the production of
initial outputs from their work.
The outcomes and outputs that will be available to share nationally include:






A summary of locality commissioning arrangements across the NHS, Adults Social Care and Children’s Services
and how these currently operate
A review of existing data gathering and synthesis processes and how these overlap
A set of core governance documents (Terms of Reference, suggested membership lists etc)
A Locality JSNA Core Dataset and graphing tool
A set of three Locality JSNA documents (precise format to be determined)
An evaluation of the short and longer-term benefits of the Locality JSNA process.
It is anticipated that the first four of these outputs will be available (in full or in part) in time for the final National
JSNA Dataset Project workshop in November 2009. A final set of outputs will be available by the end of March 2010.
What worked well?
We have been particularly successful in gaining high-level buy-in to the Locality JSNA
Process at both strategic (via the PSB) and operational level (via the Associate Directors of
Commissioning in each PBC Hub and the Children’s Services District Managers).
We have also been successful in engaging local officers via the Locality JSNA Working
Groups. These have proved to be a useful forum for bringing together people working
within the different locality structures at an operational level. Although the key agencies
were Adult Social Care, Children’s Services and the PBC Hubs, it quickly became apparent
that other teams and organisations within the city, e.g. Housing, Regeneration, Ward
Coordinators and even the Manchester Crime & Disorder team, had information around
local needs and gaps in local provision and were keen to be involved in the project to some
degree or another. Regeneration teams have been particularly useful partners because they
already have links to the key agencies for planning purposes.
The involvement of the JHU in these Working Group has provided a crucial point of liaison
and has enabled cross-fertilisation of ideas between the groups (also see next section).
Although it took some time for officers at local groups to fully understand the project and
each others’ roles within that, some groups have started a dialogue around the fact that
this is the first time that local commissioners have tried to work together for the purposes
of a needs assessment and that they might like to make this project a starting point for
future local strategic and operational needs assessment/commissioning work.
The construction of an initial Locality JSNA Core Dataset has been a stimulus for further
work to identify further sources of local data and to identify gaps in the knowledge base.
Furthermore, the groups have become used to using “soft” data, based on local knowledge
and plans, to support commissioning decisions.
NATIONAL JSNA DATA SET PROJECT
PROJECT SITE SUMMARY REPORT
What didn’t work well?
The major gap in the JSNA process is, and continues to be, the lack of proper engagement
with local residents and service users in identifying local needs and agreeing local priorities.
At citywide level we have attempted to address this by including a representative of the
Local Involvement Network (LINk) on the Working Group and by producing a public
summary of the JSNA in easy to understand language with the assistance of a freelance
journalist. Despite establishing a dedicated phone line and Freepost address, we have, to
my knowledge, received no public feedback on the priorities highlighted in this document.
The Locality JSNAs are being produced partially in recognition of the fact that people
working within the locality commissioning structures are best placed to engage with local
residents and service users in order to gain an understanding of their perceived health and
social care needs. In order to facilitate this, one of the Engagement Managers from NHS
Manchester sits on each of the Locality JSNA Working Groups. There are currently no plans
to hold a dedicated engagement event with local residents and service users around the
JSNA and, instead, it is likely that the Working Groups will attempt to utilise existing
engagement mechanisms and opportunities to obtain some local feedback about the local
needs identified through the JSNA.
Some of the difficulties faced were in terms of project management:

Both a positive and negative issue was the fact that officers on working groups felt that
if we were to attempt to produce a locality JSNA, we should try to make this a
meaningful and usable product. That meant that this would be a complex piece of work
and therefore time consuming. Officers had anxieties around identifying adequate time
to do the work that we anticipated would be done between locality meetings (some of
these anxieties subsequently proved unfounded). Therefore, although the Joint Health
Unit had appointed a part time project manager, it did become necessary to support
the project by bringing in extra staff resources by way of an administrative support role
as well as someone to support the work of the Project Manager. The staff and time
resources required were therefore greater than originally expected.

As a pilot project effectively, it took some time initially to scope which professionals
should be involved in the project and who would do what. There were some issues
around the fact that the operational boundaries used by the agencies differed
geographically, so agencies had different views as to which “locality” the local JSNA
should refer to. This meant that there were some delays in production of a project plan
and timeline.

Ideally, we would have liked the locality groups to contain the same people (in terms of
roles within their localities). However, agencies in different areas chose to be
represented by different types of officers. In keeping with the principal that the
stakeholders and partners should decide how they wanted to their group to work, this
was accepted by the project management team. The various differences in the north,
central and south groups also resulted in some difficulties in ensuring consistency and
progress between working groups.
A further difficulty is arguably a lack of consistent leadership of the project at local level and
the time that senior officers can commit to the project. The Joint Health Unit therefore
coordinated and “project managed” to a greater extent than was originally anticipated,
although this approach is now working well.
To date, insufficient consideration has been given to the sustainability of the Locality JSNA
process beyond the immediate target of constructing a first iteration of the document by
December 2009
NATIONAL JSNA DATA SET PROJECT
PROJECT SITE SUMMARY REPORT
What would you do
differently?
As outlined above, it was not possible to establish some of the project management basics
at the outset, because some learning had to be done around who should be involved in the
process both in terms of roles and geography and who should do what in terms of driving
the project. If the project were to be repeated therefore we would set up and brief groups
more quickly and introduce the full project plan and timelines at an earlier stage.
In terms of the project management, our initial timescales proved to be too ambitious and
more time needs to be devoted to this task, particularly in Phase One of the project. There
are also ongoing difficulties in ensuring that resources are in place to sustain the Locality
JSNA process beyond the production of an initial document. Greater consideration should
have been given to the need for project management staff.
Consider from the outside the capacity to conduct a process and outcomes evaluation of
the JSNA and take steps to address gaps in capacity where necessary.
What barriers did you
have to overcome?
A key barrier was the lack of understanding at a local level regarding the purpose of the
JSNA and how it differed from existing profiling and needs assessment work. A number of
senior members of the working groups said that this was the first time that the
representatives from Adult Social Care, Children’s Services and PBC Hubs had met at a
locality level. They all regarded this as a huge step forward therefore and agreed that this
should continue, but in the early stages of the project, we had spend time allowing groups
to “gel” and to establish a common understanding.
In practical terms, the major barrier was the lack of analytical and intelligence capacity at
both a locality and corporate level. In particular, there was a widely held perception that
the JSNA would involve local agencies in a great deal of extra work that was not part of the
core business of their organisation. Differing geographies was also an issue and some work
was required to get the partners to agree the geographical footprint of each of the Locality
JSNAs.
Because of the professional background of some officers, they did admit to failing to
understand the core data set and how best to use it to identify need. We therefore had to
reverse the process to some degree, asking officers to tell us what they thought their
strategic priorities were and why and then assisting them interrogate the dataset to see
whether it supported their notions. In this regard, the outcome of the JSNA will help to
validate and ‘sense check’ existing strategic priorities rather than identify them afresh.
Most agencies had their own strategic documents which identified priorities. This was
useful, but integrating these documents and plans into a “joint” strategic needs assessment
can be a challenge.
Ensuring consistency across the groups, as alluded to above, was an issue. This included
how we would actually pool contributions of members working groups in order to produce
useable document. All groups agreed that they would like to use national monies to employ
a writer. Appointment of the latter remains outstanding.
Although we were allocated a grant of £20k in respect of this project, which was hugely
helpful and will enable us to employ the writer (above), in fact, the cost of the project
escalated because we had to identify staff resources from within the Joint Health Unit to
make progress in keeping with the project deadlines.
NATIONAL JSNA DATA SET PROJECT
PROJECT SITE SUMMARY REPORT
Looking ahead, how
has your JSNA work
helped to prepare you
for the new policy
landscape of "Total
Place", QIPP,
"Personalisation" and
"World Class
Commissioning"?
Total Place is a natural extension of the JSNA in that both approaches seek to facilitate the
development of a whole public sector view of issues facing an identified population. Where
Total Places takes the JSNA forward is in the more direct use of that analysis to make the
case for a redirection of resource. JSNA, with Total Place in mind, would naturally be seen
as a significant source of intelligence to identify specific transformation projects which
would address the significant Total Places questions.
What concerns do you
have about making
your JSNA useful for
this new context?
Making the JSNA useful is a challenge both in terms of the statutory citywide and locality
documents. There are also issues around keeping the data current and both types of
document need to constantly evolve.
The personalisation agenda is at the heart of the thinking around the development of the
JSNA and has been extensively referred to within the full Manchester JSNA. Similarly, the
JSNA is a key piece of evidence for demonstrating the NHS Manchester’s standing in terms
of World Class Commissioning competency 5.
There is also a tension between making the documents sufficiently sophisticated to reflect
the new context and at the same time being simple enough to be actually used by local
managers and commissioners. In general terms, there is a constant and ongoing challenge
to link high level strategic priorities to good commissioning and service design and this is no
less the case in respect of the JSNA.
One of the best ways to continue to make the documents useful, arguably, is to build upon
the structures and professional relationships that the locality JSNA project has established,
so that Adult Social Care, Children’s Services , PBC Hubs and other teams continue to meet
and work together effectively in a “new” way. However, sustaining such joint working can
be problematic at a time when teams face constant challenges from within their
organisations. Lack of time may also be sited as an issue. However, the people who have
participated in the Locality JSNA project do agree that in the long term, joint needs
assessment and commissioning at a local level represents best practice.
ADDITIONAL INFORMATION
Please provide any additional information you deem useful, and any other relevant comments and list attached
documents, presentations and web-links.
The Government is bringing forward new legislation (the Local Democracy, Economic Development and Construction
Bill) that would place a duty on all county councils and unitary authorities to assess the economic conditions of their
area via a Local Economic Assessment (LEA). There is a strong common purpose to both LEAs and JSNAs in that they
are designed to provide a robust evidence base to inform the community strategy and LAA etc. As well as sharing a
common knowledge base, there may be some process-type learning in terms of how to best develop different types
of local strategic assessments and link these into the development of policy and strategy. There are also clear links
between economic development and poor health outcomes (and vice versa) and tying together the Local Economic
Assessment and the JSNA might help address this
Please return completed forms to [email protected]
Many thanks for completing this form and for your engagement and enthusiasm for the project!