JSNA Readiness Tool
What is JSNA-RT?
The JSNA Readiness Tool is a tool to assist those in Health and Social Care responsible for ensuring a Joint Strategic Needs Assessment of the population is completed.
The Purpose of JSNA-RT?
The purpose of this JSNA Readiness Tool is to provide a relatively simple and cost-effective way of assessing the readiness of local systems to ensure a Joint Strategic Needs Assessment of their population is undertaken and completed. It enables a rapid appraisal of a system’s readiness and progress in delivering a JSNA and identifies areas of difficulty, thereby enabling a focus upon remedial action commensurate with the significance of the problems.
The tool is sequential, and it may well be that localities just beginning their JSNA planning will want to concentrate upon the first two or three principles in the sequence at the outset. As planning turns into action, then it will be appropriate to include the final two principles as part of a comprehensive self-assessment. However, even for localities in the first stages of activity, it will be useful to consider how far local partners anticipate their likely achievements on the final two principles.
The JSNA Readiness Tool can do three main things:
- provide material to conduct an assessment on the current readiness of local health and social care systems to produce a JSNA;
- prompt a dialogue amongst partners and an examination of the key process required to deliver a JSNA;
- provide a common framework and vocabulary for JSNA partners to develop a jointly owned approach to tackling some of the barriers to effective delivery.
The Four Stages of JSNA-RT?
Stage 1: Preparation
It is important at the start of the process that partners agree the reasons for using the tool. Is the process to be mainly developmental, more of a routine audit or part of a more extensive remedial programme? Opening up this initial debate is often an important step in individual partners becoming more honest in their views about the readiness of the local system to deliver a good JSNA.
Stage 2: Gathering Data
At the heart of JSNART is the process of gathering data about the health and social care JSNA systems through answers to a questionnaire. Key organizations stakeholders are asked to respond to 30 statements by reflecting on their perspectives and selecting from a range of possible responses.
Stage 3: Analysis and Interpretation of Data
The individual scores of key stakeholders are brought together to provide a picture of how the whole system is working, and to compare the responses of the different stakeholders.
Stage 4: Action Planning for Alternative Findings
Finally, an assessment has to be made about what the scores mean about the local systems readiness, and what action to take in the light of this exercise. This will involve determination of priorities and drawing up action plans to ensure change happens.
Stage 1: Preparation
For the tool to work properly there needs to be clear agreement about the reasons for using it. There are several possibilities:
- a prospective exercise undertaken by partners just embarking on JSNA with a view to identification of ‘success’ factors
- to undertake a series of regular 'health checks' as part of a wider programme of service monitoring and review
- to explore and expose problems or to confirm apparent success
- a retrospective exercise by partners renewing or revising their JSNA arrangements.
In the early stages of JSNA implementation it is likely that the use of JSNART will be prospective, focusing upon robust preparatory work and anticipated achievements. Whatever the purpose, it is important that everyone affected has the chance to discuss the reasons for using the tool and what is expected to be achieved. Facilitation of the process is important at two stages in particular:
- in introducing partners to the wider JSNA national policy and legislative context and the assessment process, and in helping them become familiar with the tool
- in analysis of findings across the partners, examination of issues arising and action planning
Often someone from one of the key agencies will conduct this facilitation internally. Where this is the case, then it should be made clear to participants that this activity has the strong support of all key stakeholders from all involved agencies at executive level. Sometimes, and especially where it is expected to be difficult or sensitive, it may be better facilitated externally by agencies or individuals with experience in this area. Another important preliminary step is to be clear about - and to communicate - what will conclude the process in terms of feedback and action planning. Those participating need to be assured not only that taking the trouble to undertake the assessment is worthwhile but that they can be, and should be, frank and honest in their responses.
Stage 2: Collecting Data
This is the main part of the exercise. In this section you will find 30 statements about the steps and systems required to deliver a JSNA working grouped around five principles. In relation to each statement you are being asked to do three things:
- answer the question realistically: make a judgement about how well prepared you think the system actually is, not how you would like it to be;
- give your opinion as an individual: this is about what you think, rather than trying to reflect what your organisation thinks;
- make your comments: there is room for comment in an expanding box, and the more you use this box the better JSNART will be an accurate tool
Principle 1 - Clear Purpose & Initial Preparation
Score 4 |
Score 3 |
Score 2 |
Score 1 |
There is widespread agreement in the locality on the nature of a JSNA |
|
|
|
|
The reasons for doing the JSNA are widely understood and appreciated |
|
|
|
|
There is strong support among the key stakeholders for the JSNA mission |
|
|
|
|
JSNA partners are working towards clear and agreed aims and objectives |
|
|
|
|
A robust infrastructure is in place to develop and prepare the JSNA |
|
|
|
|
Good quality data has been located and is being used to develop the JSNA |
|
|
|
|
Please briefly suggest ways in which you think performance on this principle could be improved:
|
Total Score
|
|
Principle 2 - Effective Partnering & Community Engagement
Score 4 |
Score 3 |
Score 2 |
Score 1 |
All relevant stakeholders are engaged in the JSNA process in appropriate ways |
|
|
|
|
All key JSNA parties demonstrate a commitment to working in partnership |
|
|
|
|
The way in which JSNA business is conducted is open, fair and values each partner’s contribution |
|
|
|
|
There are clear lines of accountability for the performance of the JSNA partners |
|
|
|
|
Accessible arrangements are in place to encourage engagement with the JSNA from all interested parties |
|
|
|
|
Community engagement is ongoing at all stages of the JSNA process |
|
|
|
|
Please briefly suggest ways in which you think performance on this principle could be improved:
|
Total Score
|
|
Principle 3 - Effective Collation & Clear Content
Score 4 |
Score 3 |
Score 2 |
Score 1 |
JSNA data provides a detailed picture of the diverse health and wellbeing needs of the community |
|
|
|
|
The JSNA covers both the short-term and long-term needs and aspirations of the local population |
|
|
|
|
Both quantitative and qualitative data are collected to inform the JSNA |
|
|
|
|
The JSNA is available in a range of accessible formats |
|
|
|
|
The JSNA clearly identifies groups whose needs are not being met and who are experiencing poor outcomes |
|
|
|
|
Clear and agreed priorities for local action are derived from analysis of JSNA data |
|
|
|
|
Please briefly suggest ways in which you think performance on this principle could be improved:
|
Total Score
|
|
Principle 4 - Commissioning Impact & Improved Outcomes
Score 4 |
Score 3 |
Score 2 |
Score 1 |
It is possible to see a clear link between JSNA content and local commissioning decisions |
|
|
|
|
There is clear evidence that the JSNA has been used to significantly shape the LAA and the Sustainable Community Strategy |
|
|
|
|
The JSNA and the CYPP are closely aligned, and this has led to improved planning and commissioning of services for children, families and communities |
|
|
|
|
There is clear evidence that the JSNA has been used to shape PCT Local Delivery Plans and Practice-Based Commissioning plans |
|
|
|
|
The JSNA is underpinned by evidence of effectiveness on how local health and wellbeing needs can best be met |
|
|
|
|
Health and wellbeing outcomes with clear measures of success are contained in the JSNA |
|
|
|
|
Please briefly suggest ways in which you think performance on this principle could be improved:
|
Total Score
|
|
Principle 5 - Monitor, Measure & Learn
Score 4 |
Score 3 |
Score 2 |
Score 1 |
It is understood and accepted that the key measure of success is the effect of the JSNA on the lives of people in the community |
|
|
|
|
Baseline performance has been completed, and robust arrangements for monitoring and evaluation are in place |
|
|
|
|
Stakeholders receive accessible feedback on the findings and decisions contained in the JSNA |
|
|
|
|
Clear arrangements are in place to demonstrate that feedback continuously informs and shapes the ongoing JSNA process |
|
|
|
|
Key JSNA messages and achievements are well communicated amongst the partners and the wider community |
|
|
|
|
JSNA partners have clear ideas on how their performance can be further improved |
|
|
|
|
Please briefly suggest ways in which you think performance on this principle could be improved:
|
Total Score
|
|
Stage 3: Analysis & Interpretation of Data
Having filled in the scores for each section of JSNA-RT Readiness Tool, you now need to interpret the meaning of the scores for each section, as well as the aggregate score. This is detailed in the boxes below.
Principle 1: Clear Purpose & Initial Preparation
A: 21-24 |
There is widespread agreement in the locality on the nature of a JSNA |
B: 16-20 |
The reasons for doing the JSNA are widely understood and appreciated |
C: 11-15 |
There is strong support among the key stakeholders for the JSNA mission |
D: 10 or less |
JSNA partners are working towards clear and agreed aims and objectives |
Principle 2: Effective Partnering & Community Engagement
SCORE |
INTERPRETATION |
A: 21-24 |
All relevant stakeholders are engaged in the JSNA process in appropriate ways |
B: 16-20 |
All key JSNA parties demonstrate a commitment to working in partnership |
C: 11-15 |
The way in which JSNA business is conducted is open, fair and values each partner’s contribution |
D: 10 or less |
There are clear lines of accountability for the performance of the JSNA partners |
Principle 3: Effective Collation & Clear Content
SCORE |
INTERPRETATION |
A: 21-24 |
JSNA data provides a detailed picture of the diverse health and wellbeing needs of the community |
B: 16-20 |
The JSNA covers both the short-term and long-term needs and aspirations of the local population |
C: 11-15 |
Both quantitative and qualitative data are collected to inform the JSNA |
D: 10 or less |
The JSNA is available in a range of accessible formats |
Principle 4: Commissioning Impact & Improved Outcomes
SCORE |
INTERPRETATION |
A: 21-24 |
It is possible to see a clear link between JSNA content and local commissioning decisions |
B: 16-20 |
There is clear evidence that the JSNA has been used to significantly shape the LAA and the Sustainable Community Strategy |
C: 11-15 |
The JSNA and the CYPP are closely aligned, and this has led to improved planning and commissioning of services for children, families and communities |
D: 10 or less |
There is clear evidence that the JSNA has been used to shape PCT Local Delivery Plans and Practice-Based Commissioning plans |
Principle 5: Monitor, Measure & Learn
SCORE |
INTERPRETATION |
A: 21-24 |
It is understood and accepted that the key measure of success is the effect of the JSNA on the lives of people in the community |
B: 16-20 |
Baseline performance has been completed, and robust arrangements for monitoring and evaluation are in place |
C: 11-15 |
Stakeholders receive accessible feedback on the findings and decisions contained in the JSNA |
D: 10 or less |
Clear arrangements are in place to demonstrate that feedback continuously informs and shapes the ongoing JSNA process |
Aggregation of Data
A final step in data interpretation is to form an overall view on the significance of the aggregate JSNA-RT scores in order to decide what further steps – if any – to take. The first step here is to complete the aggregate scoring box below, and compare these with the following table on how these scores should be interpreted.
JSNA-RT PRINCIPLE |
MAXIMUM SCORE |
ACTUAL SCORE |
Principle 1: Clear Purpose & Initial Preparation |
24 |
|
Principle 2: Effective Partnering & Community Engagement |
24 |
|
Principle 3: Effective Collation & Clear Content |
24 |
|
Principle 4: Commissioning Impact & Improved Outcomes |
24 |
|
Principle 5: Monitor, Measure & Learn |
24 |
|
TOTAL SCORE |
Maximum = 120 |
Actual = |
Interpretation of Aggregate JSNA-RT Score
SCORE |
INTERPRETATION |
105 + |
A highly prepared local social care and health system which has in place all of the ingredients to produce a good JSNA and successfully deliver on its key outcomes. |
80-104 |
The local social care and health system has in place many of the ingredients to produce a good JSNA and successfully deliver on its key outcomes, but remains in need of some further development. |
55-79 |
The local social care and health system has in place some of the ingredients to produce a good JSNA and successfully deliver on its key outcomes but needs significant improvement in several respects. |
54 or less |
The local social care and health system has in place few of the ingredients to produce a good JSNA and successfully deliver on its key outcomes and needs urgent remedial work to improve its position. |
The Dartboard Presentation
The final scores and their interpretation can be accessed pictorially on an integration dartboard, along with a summary analysis of team functioning.
Put the total score for each principle in the appropriate segment below and shade that segment
The profile shows overall performance across all five principles. The nearer the shading is to the centre of the diagram then the healthier is the assessment of team performance. It is possible for a team to be doing relatively well on some aspects and less well on others.
Stage 4: Action Planing for Alternative Findings
The principal aim of the JSNA -RT is to enable generic assessment of a system’s readiness to produce a JSNA and deliver the required outcomes. It cannot, on its own, offer detailed prescriptions for addressing any problems identified as a result of the exercise. How system weaknesses or barriers are tackled must depend upon local circumstances and is likely to require specialist organisational development expertise. What is clear generally, however, is that whatever the findings, the assessment process must be seen to conclude with a plan for action. Three broad alternative scenarios are outlined below.
ACTION PLANNING FOR ALTERNATIVE FINDINGS
4a | 4b | 4c |
Assessment suggests the system is in a good position to produce a JSNA and deliver the outcomes required; agencies only need to consider how often to build in a regular review. | Assessment suggests that many of the key ingredients for success are in place, but there are concerns about others. Agencies need to decide how to jointly address these areas of concern. | Assessment highlights significant areas of concern that require urgent attention and a detailed plan of action. |
Taking the first case (4a) if the findings show a broad consensus about the system being in a good position, the action planning may need to consist of little more than agreeing how and when to undertake the next assessment. This could be a repeat exercise with the same individuals, or it could also entail assessments at different levels in the partner organisations. There might also be an agreement that no further formal assessment takes place unless there are important changes within the system or the context within which it operates. Whatever the apparent success of the current JSNA position, it will be worthwhile acknowledging that even the healthiest system should have regular health checks.
In the case of the second broad scenario (4b) where some problems or weaknesses are identified, the action planning will focus on these areas. Where there is little sensitivity about the issues raised – whether individual or organisational – more detailed analysis of what underlies the assessment findings may well be conducted internally and informally. Where there is greater sensitivity, external facilitation may be preferable. Such exercises should help to provide:
- structured information about people's perceptions throughout the key stakeholders and the contributing partners;
- opportunities to compare and contrast the views of different stakeholders, thereby providing an opportunity to plan remedial action;
- a process which in itself opens up a debate that introduces more openness and transparency about partners' views on fitness to deliver on the requirements of JSNA.
In the case of the third scenario (4c) action planning will need to embrace extensive and possibly urgent remedial action. This may involve a thorough re–examination of the system. Indeed, if the problems are serious enough it may require that the system be radically reformed. Whatever the outcome, it is strongly recommended that skilled and trusted external facilitators are used for scenarios 4b and 4c.
Getting Further Help
In those cases where further help is needed, it will usually be best to bring in external support and facilitation. It is not appropriate in this tool to recommend any specific consultancies, though the original Readiness Tool framework has been devised by Professor Bob Hudson (bob@bobhudsonconsulting.com.) and built upon by Seamus Breen (seamus.breen@dh.gsi.gov.uk) and Janet Crampton (janet.crampton@dh.gsi.gov.uk) . Other sources of general support and information are:
The design task for JSNA-RT has been undertaken by Densen Digital Experiences: www.densen.co.uk.