Table of contents


Summary :: Executive summary :: Introduction

The current economic and social climate presents the people of Medway and their representatives with a number of challenges, but also opportunities. Nationally, and within Medway, life expectancy at birth has steadily increased over the past few decades. Recent evidence however, suggests that although people are living longer, their quality of life is reducing. There has been an increase in the number of people experiencing physical and mental disabilities, which impacts on their ability to undertake basic activities of daily living. Evidence suggests that the recent increase in population disability can be associated with the impact of preventable chronic long term health conditions, such as high blood pressure, diabetes and cardiovascular disease.

People living in the most disadvantaged areas often experience higher levels of premature mortality and disability than those living in more affluent areas. Within Medway there is a recognition that concerted action is required to address health inequalities. There is a commitment to an approach that improves the health of the whole population, whilst at the same time tackling issues that are impact on the wellbeing of the most vulnerable, such as children.

Making sure every child is given the best start in life is a priority for Medway Council and its strategic partners. Of particular concern is the need to improve outcomes for children looked after, children identified as at risk from neglect, or exposure to domestic abuse, child sexual exploitation or abuse. Understanding the needs of children with physical, mental health or sensory disabilities is also a key focus.

In line with the requirements of the Health and Social Care Act 2012, Health and Wellbeing Boards are responsible for produced and publishing Joint Strategic Needs Assessments (JSNAs). The Medway JSNA is an objective assessment of local needs. It aims to provide an overview of all current and future health and social care needs within Medway. It is an extensive document that takes into account emerging evidence.

The JSNA is divided into three broad parts: 1) a narrative 'picture of place'; 2) over 30 topic-specific chapters; and 3) health and social care profiles, which together provide detailed information on the health and wellbeing needs of the local residents and Medway context. It is regularly updated as new evidence and intelligence on the needs of local people emerge.

The Medway Health and Wellbeing Board has produced this JSNA to assist individuals and organisations working to improve the health of the population of Medway. It aims to improve their ability to better understand the needs of local residents and make more informed judgements when commissioning or prioritising resource allocation. JSNA's can also help residents and other interested parties to measure and challenge the progress being made to protect and improve the public health.

Readers should note the current transformation of the health and social care system in England may impact on future iterations of the Medway JSNA. This is because the manner in which the strategic organisations currently tasked with commissioning (buying) and providing NHS care and support locally, is under review.

The development of Sustainability and Transformation Partnerships (STPs) have significant implications for public services. Local authorities, the NHS and other stakeholders, such as the voluntary and private sector, are being brought closer together to improve the way in which care and support is provided to communities.

The key factors to note regarding potential impact of STP's in Kent and Medway are:

• The creation of a single strategic NHS commissioning body for Kent and Medway. This body will take on delegated responsibility for delivering some of the statutory functions of the 8 Clinical Commissioning Groups in Kent and Medway, in addition to some of the functions of other NHS organisations, such as NHS England and NHS Improvement.
• The development of a model of Accountable Care Partnerships, aligning NHS commissioning structures with that of local authorities. The purpose is to deliver better outcomes for residents and improve the efficiency of service provision through a local care model.
• Improving access to high quality services. This will be achieved through building workforce capacity and capability, transforming the NHS estate and the way in which people access certain services. Using technology to facilitate quality improvement and focusing on prevention to address the risk factors that lead to health inequalities and poor outcomes for our communities.