To receive the 2012 summary Integrated Needs Assessment document “Understanding Herefordshire”, and note the programme of work towards a “Gold Standard” Integrated Needs Assessment.

The Board considered the 2012 summary Integrated Needs Assessment (INA) and the programme of work towards a “Gold Standard” Integrated Needs Assessment.

The Consultant in Public Health Medicine presented the report.  She highlighted that the document was integral to the commissioning cycle, providing an explicit evidence base that would enable strategic priorities, commissioning decisions and partnership working to be based upon a clear and comprehensive understanding of need.  She specifically invited comment on areas where the Board would like more in depth analysis over the coming year.

The Principal Research Officer gave a demonstration of how the information underpinning the high level summary document was made available on the Council’s website.

In discussion the following principal points were made:

·         The asset base as a whole required further analysis.  Carers were highlighted as a vital asset that needed to be protected. More analysis was needed on the needs of carers including their access to healthcare services.

·         It was suggested that there also needed to be more analysis of mental health and wellbeing needs.

·         Changes to the welfare system and growing poverty were highlighted as issues that would have an impact on the County.

·         The potential for facilitating self-help needed further consideration.

·         The locality analysis was welcomed and its potential benefit to all providers acknowledged.  It was emphasised that it was important that the analysis was considered in localities and the differences between localities and the need and scope for action to address these differences discussed.

·         The importance of ensuring that the Board’s priorities were firmly founded on the evidence and that the analysis was used to inform considerations across all organisations in the County was emphasised. When matters came before the Board for consideration evidence should be provided to demonstrate how proposals addressed the issues highlighted in the INA.

·         On behalf of the Clinical Commissioning Group (CCG) it was suggested that the scheduled bi-monthly meetings of practitioners could provide a useful forum for ensuring the analysis was more widely shared.

·         The potential to develop the website to make it interactive, generating user feedback and information on people’s experience of services was noted.

·         It would be of benefit to demonstrate in the INA summary how account had been taken of information gathered at stakeholder events.

·         A view was expressed on behalf of the CCG that whilst the INA was a vital part of the evidence base there were additional sources of information of which the CCG needed to take account in forming the commissioning strategy.  This included directives from the Department of Health, and qualitative issues including information gathered directly by clinicians and other frontline staff.  There may therefore be instances where the priorities agreed by the CCG did not correspond precisely with those in the INA.

The consensus was that it was important that the INA captured all the available sources of information and organisations highlighted any aspects of which account had not been taken. The engagement process was designed to achieve this objective.  It was recognised that having considered the available evidence organisations might reach different conclusions about priorities.  However, the Board had a responsibility to assess the extent to which strategic priorities and commissioning decisions to invest or disinvest were linked to the evidence base provided by the INA.

·         It was proposed that a further report be submitted to the Board in July 2012 on the rolling programme to develop the INA, taking account of issues raised during the discussion.

RESOLVED: 

That    (a)        the document “Understanding Herefordshire” appended to the report be approved as the summary of the 2012 Integrated Needs Assessment and it be recommended that its findings be embedded and used across all organisations in the County;

(b)          “Understanding Herefordshire” and the 2012 Integrated Needs Assessment be approved as the evidence base against which strategic priorities and commissioning decisions to invest or disinvest will be made and assessed in an open and transparent way; and

(c)          the following areas be proposed for more in depth analysis over the coming year: the asset base, the needs of carers; and mental health and wellbeing needs; and

(d)               a further report be submitted to the Board in July 2012 on the rolling programme to develop the Integrated Needs Assessment including enhanced analysis, capturing the additional sources of information and proposing the prioritisation of the areas of more in-depth analysis during 2012/13.