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Introduction to the JSNA

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What is the Joint Strategic Needs Assessment?

JSNA stands for Joint Strategic Needs Assessment and is the responsibility of NHS Blackpool CCG and Blackpool Council. JSNA is a programme, specified nationally but delivered at a local level by all NHS and upper tier local authorities. The duty to undertake the JSNA is set out in Section 116 of the Local Government and Public Involvement in Health Act (2007).

The statutory guidance emphasises that the JSNA should be taken into account by the Health and Wellbeing Board and will identify the future health, care and wellbeing needs of the people of Blackpool and will guide how services are planned and developed. The issues identified in the JSNA will inform the priorities in the Blackpool Joint Health and Wellbeing Strategy.

The purpose of the JSNA is to pull together in a single, on-going process all the information that is available on the health and wellbeing of the people of Blackpool, the quality and accessibility of services, evidence about what works and the views and experience of the public. This information will then be used to make decisions about how services are provided in the future.

The JSNA is a key element of the commissioning process. The commissioning model below highlights that the JSNA is important to the 'analyse' section of the commissioning cycle.

Figure 1 - The Commissioning and Procurement Cycle

Figure1
Source: Institute of Public Care, Oxford

What are Health Inequalities?

A clear understanding of health inequalities is paramount for the development of policies and interventions that support all sections of society, as well as directing services, treatment and care in proportion to need. Two pivotal independent UK health inquiries, the Acheson1 and Black2 reports, helped generate extensive debate on inequalities in health, informing policy and action.

Determinants of Health

Socio-economic models of health and inequalities are widely used by Public Health practitioners3 . For example, Dahlgren and Whitehead4 developed a framework that identifies how a range of different factors can impact on personal and community health (Figure 2). Whilst an individual has no control over his or her age, sex and genetics, wider determinants of health can affect the likelihood of a person developing a disease, or in dying prematurely. Such determinants of health include:

    • Individual lifestyle factors: e.g. diet, physical activity, smoking, alcohol, drugs, behavior
    • Social and community factors: e.g. crime, unemployment, social exclusion, local cultures
    • Living and working conditions: e.g. housing and air or water quality
    • General socio-economic factors impacting on health: e.g. poverty and income, economic issues, and educational attainment.

Figure 2 - Consolidated concept of determinants of health

Figure2
Source: Dahlgren and Whitehead (1991)

Other inequalities are related to sub groups of the population, for example people from ethnic minority communities, the lesbian, gay, bisexual and transgender (LGBT) community, people with a disability, offenders and sex workers. For example, it is estimated that 7% of the Blackpool population are LGBT. The LGBT community, particularly men who have sex with men, are at higher risk of sexually transmitted infections.

JSNA awareness raising - Short film

The Health and Wellbeing Board, in partnership with Blackpool Clinical Commissioning Group and Healthwatch Blackpool have produced a short film to raise public awareness of the Joint Strategic Needs Assessment (JSNA). 


[1] Acheson D (1998). Independent Inquiry into Inequalities in Health Report. London: The Stationery Office.

[2] Black D, Townsend P, Davidson N, Whitehead M, and Great Britain Working Group on Inequalities in Health (1992). Inequalities in health: the Black Report: the health divide. Penguin Books. 0140172653.

[3] Drever F and Whitehead M (eds) (1997). Health Inequalities - Decennial supplement [Online]. Available at: www.statistics. gov.uk/downloads/theme_health/DS15_HlthInequals_v2. pdf [Accessed 11th August 2005].

[4] Dahlgren G and Whitehead M (1991). Policies and strategies to promote social equity in health. Stockholm: Institute of Futures Studies.