Agenda item

To receive the report of the Head of Policy, Leeds City Council, which outlines that the purpose of the Joint Strategic Assessment (JSA) is to assess current and future health and social care needs in Leeds to inform the Health and Wellbeing Strategy, specifically to shape priorities, inform commissioners and guide the use of resources as part of commissioning strategies and plans for the city.

The report of the Head of Policy, Leeds City Council outlined that the purpose of the Joint Strategic Assessment (JSA) was to assess current and future health and social care needs in Leeds to inform the Health and Wellbeing Strategy, specifically to shape priorities, inform commissioners and guide the use of resources as part of commissioning strategies and plans for the city.

In attendance for this item were:

·  Mike Eakins – Head of Policy, Leeds City Council

·  Rosie Armitage – Intelligence and Policy Manager, Leeds City Council

The Chair provided an introduction to the item, noting that the publication of the JSA was a key function of the Board and its production on a three year cycle was a joint statutory responsibility of the Council and the West Yorkshire ICB, which informed the Leeds Health and Wellbeing Strategy. The last iteration of the JSA was published in 2021 and this report detailed the findings of the latest data analysis.

The following information was highlighted to Board Members:

·  The scope of the 2024 JSA was vast, covering a broad approach to the social determinants of health and had drawn out data to identify inequalities and also linked to the Marmot City work.

·  The JSA sought to go further than baseline data provision and contained qualitative data to create a narrative driven approach and provide a summary of where the city was and where improvements were needed.

·  It was noted that the report was in its draft format and was overseen by a sounding board which including partners. All contributors to this stage were thanked.

·  The structure of the JSA was primarily around life course stages, linking to policy implications and bringing data to life through lived experience.

·  Section 1 covered Leeds population data analysis, which mirrored national trends. There was birth rate boom from 2008 to 2018, with birth rates falling since, which had implications on the education system and its capacity for post school (16+) college and sixth form capacity.

·  The pandemic had impacted child development and improvements were needed for provision of key stage (KS)1 and KS2 schooling.

·  Indices of multiple deprivation (IMD) decile data for age displayed that deprivation had increased most for young and elderly people. Child poverty was above national averages, with caution noted for this data when considering the geographical boundaries of the Council’s district covered inner city and outer, more rural settings. The scale of poverty in inner city areas was significant and work was ongoing for a more granular breakdown of data.

·  The IMD data for ethnicity outlined a disproportion for lower living standards and opportunities for diverse ethnic communities and individuals.

·  The student population within Leeds had significantly increased when census data from 2011 was compared with the 2021 census. The traditional student areas had expanded which posed questions to service provision and needs analysis, a response was required to address dynamic health care needs.

·  The geography of inequalities had been studied for a spatial understanding of health outcomes and social determinants in relation to amenities, services and transport options. The Health and Wellbeing Strategy offered positive influence on sustainable, connected communities, with transport framework being vital.

·  There was a wealth of greenspace within Leeds, with an estimated £600million relief on the wider health system pressure, with the positive benefits of using green space, however, a disparity of access was noted.

·  Qualitative data was used to represent community voice and understand lived experience, which was used to supplement quantitative data and inform the whole life course approach.

·  The Third Sector played a fundamental role in wider system support; however, staff retention and infrastructure issues were noted, particularly for smaller organisations.

·  Housing standards and location data had noted disparity in fuel poverty, employment and education opportunities. This had covered not only affordability but accessibility and adaptation requirements to provide better quality housing.

·  Leeds was performing well in regard to affordable housing provision but, the cost of living crisis had reduced real income level and the defined level of affordable required scrutiny as average rent costs exceeded £850 per month, which was higher than comparable data for other Local Authorities in the West Yorkshire region.

·  Data for energy efficiency covered fuel poverty, with figures exceeding national averages and also noting indoor air quality disparities. Social housing had low performing energy efficiency which had additional implications for people living in poverty incurring higher costs.

·  Inequalities were noted in the level of school performance for those accessing free school meals, with 36% of boys on free school meals not achieving Maths and English GCSEs at the end of their schooling.

·  The prevalence of mental health had increased for adults and young people, which had a cumulative impact across communities and services. Mental health related hospital admissions had grown for people under the age of 18 since the 2021 JSA, but Leeds was below the national average.

·  For data comparing productivity against employment, Leeds held a strong employment rate, although it had dropped when analysing the most recent data suite. Average pay in Leeds had decreased, with the gender pay gap being significant. Women earned on average £10,000 less per year than men and were more likely to hold jobs within education, health care and public services.

·  There had been shifts in industry with a decrease in positions for manufacturing, retail, hospitality and real estate. This had implications for people aged 50+ as they were less likely to have skills in emerging sectors. More work was required to improve adult education opportunities, with reference to the Inclusive Growth Strategy.

The Board discussed the following matters:

• With the Government’s pledges to tackle violence against women, it was agreed that the section regarding community safety would expand on this data which could be built upon to create a clearer strategic approach in addressing this sensitive issue.
• It was suggested that the JSA could have a greater focus on progress since the 2021 JSA to indicate what work was ongoing to improve social determinants. Strategically comparing previous data was essential.
• A full circle analysis on the trajectory of child poverty was proposed to understand contributing factors and link with the 2023 Public Health Annual Report. More reflection on outcomes was to be done through collating groups of issues and a dashboard was in development to set the narrative identified by the data, allowing the JSA to be dynamic and for future data and outcomes to be built into it.
• Further analysis for factors to inform plans and intervention was required to better understand impact and prevention methods to work within communities and add layers to services where required.
• In light of the gender pay gap data, the Board asked for further analysis to be undertaken to understand demographic information and whether the intersectionality factors meant that the pay gap was greater amongst certain communities.
• Less anticipated or surprising results were outlined as the huge increase in the student population and that improvements in education inequalities had been somewhat unyielding. Overall, the data had raised a number of questions and the JSA findings were to remain live and considered to inform the partnership approach in improving outcomes.
• As well as the study of gender pay gaps, it was noted that reporting of disability and ethnicity pay gaps were to become mandatory, and can we get ahead of the national requirements with data to be collated to compare and better understand compounding factors.
• The findings were considered a good basis for response and planning; the JSA was not to just describe and identify inequalities but to direct work to improve outcomes.
• Wider representation such as input from the Third Sector, was good practise for creating improved outcomes. Projects and existing structures enabled better governance practises and understand policy implications.
• The JSA document and its findings were to be shared across the health and care system to influence targeted action. Internal to the Council’s policy network, it was to be submitted to Scrutiny Boards and the Executive Board.
• Linking up with other sectors and departments was integral to improvements, such as the input required for green space provision. Notable improvements to green space within Lincoln Green had yielded positive results and health and wellbeing outcomes. Areas that needed more green space provision were to be mapped against strategic priorities.
• Whether post graduate students were choosing to stay in Leeds and how this was considered against the student population boom was queried. A response was agreed to be provided back upon further data analysis, considering affordability of accommodation in inner city areas and the implications this had on traditionally non-student areas. It was also noted that student populations can mask poverty demographic data at a Ward level.
• The experience of working age people living with disabilities and the associated data was queried. This was agreed to be studied and included, with signposting to support offers provided.
• The Third Sector and associated boards and meetings, including the Poverty Truth Commission, was a good arena for discussion and a vehicle for change. There was a vast scope of poverty considerations, including healthy life expectancy, employment and opportunity, with a system wide approach needed to ameliorate issues.
• Safer Leeds crime data was noted to be helpful to enrich the suite and inform the Public Health response, including statistics for domestic abuse and victims of crime by gender. Through the Domestic Abuse Act 2021, children and young people were now recognised as victims of domestic abuse in their own right. This was agreed to be followed up after the meeting.
• Actions to include within this JSA were to better articulate how data would be reflected upon and issues addressed and to include more headline data and analysis for women and children and compounded factors.
• The enthusiastic approach to respond to data was supported and the report format was commended. Contributors and presenting Officers were thanked for their work.

RESOLVED –

• That the JSA draft summary report attached as Annex A, specifically whether the policy implications highlighted fully reflect the headline findings and challenges or opportunities ahead, be considered.
• That the draft cross-cutting themes highlighted within the conclusion, and whether these are reflective of the contents of the JSA, and how these may shape future work priorities, be considered.
• That the best ways to respond to any strategic and commissioning implications of the analysis, in particular those relating the tackling health inequalities and the needs of various communities of interest, be considered.
• That the report, along with Member’s comments, be noted.

(Councillor S Arif joined the meeting during consideration of this item)