Health and Social Care Bill

I shall speak in support of Amendments 210 and 217 which, as the noble Baroness, Lady Hollins, has just said, concern the quality and use of joint strategic needs assessments. These assessments are potentially vital to the work of CCGs and, more importantly, for the benefit of the populations they serve. The joint assessment is designed to lead to stronger partnership between communities, local government and the health service by providing a firm foundation for commissioning. This not only leads to improvements in health and social care provision, but also reduces health inequalities. It is an essential tool in the development of a truly integrated service across health and social care, which is why it is so important that the CCGs have adequate guidance on how to ensure that high-quality needs assessment is undertaken and used. The benefits are clear—helping commissioners, especially CCGs, to specify the outcomes that they want to see, including those that encourage local innovation and, in so doing, helping providers to better shape services that address needs fully. However, the experience of joint assessments has not been uniform across the country and there are challenges in making these assessments as effective as they can be. A joint assessment inevitably involves complex sets of information and data from a wide range of sources, and this brings challenges in analysis and presentation which allow data to be intelligible and used for the intended purposes. Joint needs assessments are a lot more than a technical exercise in data management. The most effective assessments involve local communities and use direct feedback and knowledge from those communities. I saw the power of this kind of assessment at first hand when I was fortunate enough to lead the Department of Health’s black and minority-ethnic needs assessment programme on drug use across England. The strength and success of the approach undertaken in this programme was that local people were integral to its work. When it comes to identifying needs, there can be no greater source of information than that which comes directly from the people who are most affected by the issue. For example, in the case of drug use, it was important to recognise the experiences of a wide range of people who were affected, including women, young people, older people, people with disabilities, families, carers, and particularly drug users. The Department of Health programme demonstrated, however, that it is not an easy or simple process. It does not just happen, and it is vital to distinguish real engagement from mere consultative involvement. Here in London, I have recently seen further evidence of the significance and impact of such effective community engagement in identifying and addressing needs. The Well London project, which is funded through the Big Lottery Fund, is an exciting £9.6 million programme that has been working with local people in 20 of the most deprived boroughs across the capital. Speaking about Well London, following a recent award for the project from the Royal Society of Public Health, Professor Sir Michael Marmot, director of the UCL Institute of Health Equity, said: "““If we are to reduce health inequities it is essential to take action on the social determinants of health—the 'causes of the causes' of ill health. That means working in partnership at local level to improve the social conditions in which we are born, live, grow, work and age. The Well London Alliance Partnership does just that. Empowering individuals and communities, and giving people a voice is integral to addressing health inequalities. I am delighted the Partnership has achieved well-deserved recognition for its work””." Running over the past three years, Well London has transformed health through promoting health and well-being, improving healthy eating choices, promoting access to open spaces and increasing physical activity. The University of East London, which is a lead partner in the research phase of the project, is revealing some absolutely fascinating results and I will share a few of its findings with the House. Results show that from a total of 10,843 participants, 8,400 reported an increase in healthy eating, 7,800 reported increased access to healthy food, 9,400 reported an increase in physical activity, 8,900 reported feeling more positive and 8,500 reported an increase in the understanding of mental well-being. The real key to success is having community engagement at heart. Professor Adrian Renton, the director of the Institute for Health and Human Development at UEL, said of this work: "““When we designed the project, we took account of the evidence that local social economic and physical environments provide strong barriers which prevent people from adopting healthier lifestyles and leading happier lives””." This is an excellent example of how to undertake a strategic needs assessment across health and social care that is driven by local communities and brings together commissioners, providers and the university sector to work alongside those communities in making a real difference to health and well-being. This is why it is essential to have adequate guidance on how to conduct such assessments, and that clinical commissioning groups should be required to demonstrate how they use such guidance. I hope that the noble Earl will see the benefit of these amendments and lend his support to making joint strategic needs assessments a truly effective tool in health improvement and service planning.