The Wandsworth Joint Strategic Needs Assessment and Annual Report of the Director of Public Health 2017/18
Business Intelligence Team
Wandsworth JSNA 2017/18 PDF Version
Date of publication: Autumn 2017
- Executive Summary
- Addressing the need
- More information
- Appendix: Joint Health and Wellbeing Strategy Scorecard 2017/18
The Wandsworth Story is an annual snapshot of the priority local needs identified through the Joint Strategic Needs Assessment (JSNA) process, developed to inform the commissioning intentions of the Council and the Clinical Commissioning Group (CCG).
Wandsworth is a vibrant and well-connected borough, with many community assets, attractions and facilities that support and can be further utilised to improve healthy lives. The population is growing and diverse, provided for by good schools, accessible parks and green spaces and thriving businesses. The Council is working hard to ensure that its ambitious regeneration schemes create opportunities for residents to lead more prosperous, active and healthy lives.
Environment – In common with other inner-city areas, the population and motor vehicle traffic density leads to issues with air quality and noise pollution. There is a need for affordable housing as property to rent or buy in Wandsworth is in high demand, which will only increase with the growing population. At the same time, homelessness is on the increase and is an example of physical circumstances that can leave people particularly vulnerable to disease and ill health.
Inequalities in children – Although rates are lower than the rest of inner London boroughs, a fifth of children in Wandsworth aged under 16 live in low-income families, and whilst educational outcomes are good across the board, as elsewhere, there remains a gap in outcome between the more and less well-off children. Teenage experimentation with tobacco and cannabis is relatively high. Wandsworth is not an exception to issues that are experienced elsewhere, such as below-target immunisation rates and overweight and obesity prevalence nearly doubling during the primary school years.
Healthy living – Significant numbers of people in Wandsworth engage in one or more behaviours that can be detrimental to health, including smoking tobacco, physical inactivity, poor diet, excess alcohol intake and multiple sexual partners. Along with other factors, this leads to increasing levels of long-term conditions, with a complex interplay between physical and mental and emotional health.
Care for isolated elderly – Life expectancy for over 65s in Wandsworth is lower than the London average and the average resident can expect 15 years of deteriorating health in old age. Over a third of people aged over 65 are living alone, which increases the risk of social isolation and many of the unpaid carers in the borough are themselves part of the older population, and particularly vulnerable to ill health.
<h3″>Addressing the need
The Council and CCG exist to meet the relevant needs of the population and a wide range of activity is going on in this regard, including the following key programmes:
- Addressing the causes of air pollution and encouraging active travel through the Air Quality Action Plan, including the introduction of cleaner buses which has been followed by a major reduction in pollution episodes in Putney.
- Strong record of affordable housing provision – 1,307 new affordable homes delivered since 2014.
- Borough-wide improvement of housing, transport, leisure and business opportunities through regeneration and redevelopment.
- Targeted support for vulnerable children and their teachers through the Education Inclusion Service – for example, advising on special educational needs and pupil behaviour, and ensuring good attendance through the Education Welfare Service.
- Wandsworth Council’s Families First programme supports the Government’s Troubled Families approach to reduce crime and anti-social behaviour, non-attendance at schools and worklessness.
- The Council and CCG’s Joint Health and Wellbeing Strategy develops the principles of healthy places, targeted intervention and mental health.
- Development of the Prevention Framework to promote health and wellbeing of residents in everything the council and CCG do.
- A concerted approach with other South West London boroughs and CCGs to transform the health and social care system through the Sustainability and Transformation Partnership.
- The Older People’s Strategy implements a preventative approach to maintaining health and wellbeing and, when needed, provision of care and support with dignity into older age.
The joint strategic needs assessment (JSNA) draws together a wide range of data and research to provide a robust understanding of the borough population’s overall health and wellbeing. The intelligence it provides is essential to our joint health and wellbeing strategy and ensures that local services are shaped according to the changing needs of local communities. Our aim is to improve the wellbeing of Wandsworth residents and a strong and up-to-date evidence base is vital to achieving this shared objective with our NHS and community partners.
The assessment process involves an extensive review of local and national evidence, as well as engagement with key stakeholders to build up a shared and robust understanding of the borough’s needs. From here we continue to commission services and work in partnership with health and wellbeing board members to ensure those needs are understood and addressed. It’s important to note that the needs we identify within the JSNA are not necessarily unmet, and that there is already a coordinated multi-agency programme in place to address these recognised challenges. By regularly reassessing strategic needs in this way we ensure that our initiatives, intervention and physical assets remain closely aligned to the borough’s changing health and wellbeing needs and that we continue to use our resources to their best effect.
Houda Al Sharifi
Director of Public Health
The Wandsworth Story is an annual snapshot of the priority local needs identified through the Joint Strategic Needs Assessment process, developed to inform commissioning intentions.
Under the Local Government and Public Involvement in Health Act 2007, as amended by the Health and Social Care Act 2012, local authorities and Clinical Commissioning Groups (CCGs) have a joint duty to prepare and publish a joint strategic needs assessment (JSNA) for their area.
The purpose of the JSNA is to inform the Health and Wellbeing Board’s Joint Health and Wellbeing Strategy and to ensure that Wandsworth Council and Wandsworth CCG’s service development, commissioning plans and strategies are shaped according to the needs of the local population.
The statutory definition of a relevant need is very broad – it covers any need that is capable of being met through any of the functions of the Council or the CCG. So, the JSNA is a statement of wellbeing needs in the widest sense, with the “wellbeing” of residents not just restricted to good physical and mental health, but referring to a full, flourishing and good life. The needs of a population will be constantly changing, so must be monitored regularly and at a local level.
Needs are complex and have to be understood along a number of dimensions. To identify the local priorities, the following considerations were taken into account:
- Severity of the need (or the consequences of failing to meet a need)
- Absolute burden of need (number of people affected)
- Relative comparison (benchmarking) against similar boroughs and London and national averages
- Trend over time (increasing levels of need)
- Inequalities between different population groups
For brevity, in the Wandsworth Story, not all of these aspects are reported for every topic or indicator, although they are usually available from the original datasets. Rather, the salient aspects have been highlighted for attention, so the absence of comment on one of these aspects can usually be taken to mean that they do not indicate cause for particular concern (i.e. the trend will only be mentioned if it is getting worse or better – if it is fairly static, it will not be mentioned).
Using this approach, evidence pertinent to Wandsworth was reviewed, including previous and existing Council, CCG and voluntary sector needs assessments and reports, as well as publicly available datasets, profiles and literature from Public Health England, the Office for National Statistics, the Greater London Authority and many others. Initial findings and subsequent drafts were reviewed and refined with a wide range of internal and external stakeholders and groups. The process was overseen by the JSNA Steering Group, which includes membership from the Council, CCG and voluntary sector.
The needs that were identified have been ordered under the themes of ‘place’, ‘start well’, ‘live well’ and ‘age well’, to represent the needs that occur at each stage of the life course, as well as those that cut across it.
In order to set these needs into context, a similar process was conducted to identify local assets that contribute to health and wellbeing in the borough, or could be utilised to do so, as well as the suite of existing policies, programmes, strategies and services already in place to address local needs.
Wandsworth is a vibrant and well-connected borough, with many community assets, attractions and facilities that support and can be further utilised to improve healthy lives.
- Wandsworth is the largest inner London Borough and has a growing population, currently estimated at 314,544 residents. The population of Wandsworth is much younger than both the London and England average. Nearly half of all people living in Wandsworth are aged between 25-44 years old. It has the highest proportion of people aged 30-34 years creating a young population ‘bulge’ which is unique nationally.
- The population is diverse, with over a quarter of the population having a nationality other than British. Black and minority ethnic (BME) groups make up 29% of the overall population and account for more than half the population of Tooting (52.7%).
- Higher levels of education are associated with a wide range of positive outcomes including better health and wellbeing.
- Examination results regularly exceed local and regional averages. 43% of schools in the borough are outstanding, which is double the proportion found nationally, and all special schools are either good or outstanding. 
- The borough also supports young people to develop a sense of place and promote teamwork with initiatives such as the Wandsworth/GLL Heritage Awards for schools
- Two universities: University of Roehampton – which has the largest campus of the London universities – and St George’s University, the UK’s only university dedicated to medical and health sciences education, training and research.
- The borough has 47% of adults educated to degree level or above, which is the second highest percentage in the country.
- Wandsworth has the second highest employment rate in London (79%) and there are over 18,000 active businesses in the borough, providing 134,000 jobs.
- Wandsworth Council is working to improve existing areas of Wandsworth and approving plans for new developments aiming to better cultivate better housing, transport, leisure pursuits and business opportunities in the borough. This will be done through the creation of 20,000 new homes (of which 4,000 will be available through a range of low-cost housing schemes), 24,000 new jobs, employment and business opportunities (with major employers like Apple choosing to base themselves in the borough), as well as increasing community facilities including education, retail, recreation and health. The development is focused on Nine Elms, Winstanley and York Road and Alton estates.
- The borough is extremely well connected with a wide variety of transport links including five tube stations, Mayor’s Bike Hire scheme, riverbus service and future developments with the Northern line extension and Crossrail.
- Clapham Junction is the busiest railway station in the UK by trains passing through it and number of passengers making interchanges.
- 45% of Wandsworth residents of working age travel to work by public transport, which is the second highest proportion in country. Active travel (e.g. walking, jogging, cycling) can be a simple way to add physical activity into one’s daily routine and 11% of Wandsworth residents of working age travel to work by foot or bicycle, with the borough being the second highest for levels of regular cycling in London.
- Green space promotes active living and provides important physical, psychological and social health benefits for individuals and the community. Publicly accessible parks (regional, metropolitan, district, local, small and pocket parks) make up almost a quarter (23%) of the total area of Wandsworth.
- There are 32 public parks in the borough including Wandsworth Common, Tooting Bec Common, Wandle Valley and Battersea Park
- Biodiversity can increase the benefits that people enjoy from nature. There are 1,600 different species recorded within 27 different habitat types; several rare and endangered species can be found in Wandsworth including peregrine falcons, black redstarts and stag beetles 
- With the borough’s good transport links, Wandsworth has a balance of proximity to central London but with more accessibility to open space.
- Five bridges: Chelsea Bridge, Albert Bridge, Battersea Bridge, Wandsworth Bridge and Putney Bridge allow easy access between the south and north of the river as well as five miles of Thames river-frontage.
- Culture and leisure has a positive impact on health and wellbeing of local communities. Wandsworth benefits from a range of events such as Get Active Wandsworth Festival, Wandsworth Arts Fringe and the Feel Good festival.
- There are also many landmarks in the borough which can be enjoyed, including Battersea Power Station, London Heliport, Young’s Brewery and the Peace Pagoda.
- Numerous parks, leisure centres, gyms, and sports facilities provide opportunities for active leisure, including Tooting Bec Lido and Battersea Park, which is a green flag park. Over a quarter of adult residents are members of a sports club. Battersea Park is also a venue for many events including the Battersea Park Dog Show, Foodstock, Live at the Bandstand and the London Motor Show.
- Vibrant town centres: Balham, Clapham Junction, Putney, Tooting, Wandsworth
- Theatres: Battersea Arts Centre, Theatre 503, Putney Arts Theatre and Tara Arts Theatre
- Eleven Libraries in the borough with a range of facilities
- Wandsworth is the most popular borough for people moving to London from elsewhere in the UK.
- Wandsworth is the safest inner London borough, in terms of rate of notifiable crimes per head of the population. The borough also has the lowest rate of violence with injury and knife crime of the 12 inner London boroughs.
- There is a wide range of Healthcare Assets in Wandsworth:
- St George’s Hospital – large teaching trust which provides community services to residents of Wandsworth, local hospital services and specialist services.
- GP surgeries – Forty-two GP surgeries with a range of services including asthma care, contraceptive planning and advice, and management of long term conditions such as diabetes.
- Pharmacies – a service where you can get expert knowledge on medicines, how they work and how you should use them as well as advice on minor aliments coughs, colds, aches and pains and other health issues such as weight loss, giving up smoking and emergency contraception.
- Dentists – There are a number of dental services in the borough.
- Opticians – There are a number of opticians in the borough.
- Care homes – There are 33 residential and nursing care homes in the borough.
- Wandsworth has a thriving voluntary and community sector working in partnership with the Council and CCG to deliver key services, with 35% of adults volunteering. The Council and CCG promote grassroots development of the sector through programmes like the Voluntary Sector Forum and the Wandsworth Grant Fund.
Where we live, work and play has a big impact on our health and wellbeing, both through direct health impacts, such as exposure to toxins, and indirectly, such as encouraging positive or negative health behaviours or exposing us to other stresses and pressures.
- The borough has been declared an Air Quality Management Area (AQMA) because it has exceeded permissible levels of pollution. The predominant source of air pollution in the borough is road traffic with a smaller contribution coming from boilers, construction and wood burners.
- A sixth of Wandsworth primary schools (10 in total) are in areas that exceed the legal air pollution limits, of which three (in Fairfield and Queenstown wards) are among the worst 100 primary schools in London for levels of nitrogen dioxide (NO2).
- The annual mortality burden in London from long term exposure to fine particulate matter (PM2.5) and NO2 is estimated to be equivalent of up to 9,400 deaths and associated health impacts incurring an economic burden between £1.4 billion and £3.7 billion.
- It is estimated that over 40,000 residents are exposed to high levels of transport noise (road, rail and air) during the daytime, rising to 50,000 at night time, which equates to higher proportions than London and England averages. Noise pollution reduces quality of life, increase stress levels and increases the risk of heart problems.,
- Whilst regeneration should lead to improvements in housing, transport, leisure pursuits and business opportunities, the associated population growth is likely to increase demand for health and social care services.
- In 2016/17, Wandsworth Foodbank provided 4,712 emergency food supplies to people referred in crisis, of which one in three were children. Problems with benefits was the most common reason for crisis referral.
- Home ownership is associated with increased life satisfaction, however only 16% of Wandsworth residents own their home outright, which is similar to the London average (18%)., Wandsworth has the tenth highest housing affordability ratio (this is calculated by dividing house prices by annual earnings and is a measure of housing affordability) in the country. The median purchase price of a property in Wandsworth is £557,000 and, between 2010 and 2015, increased by 47% (compared to 39% in London and 14% in England) which, whilst benefitting existing owners, makes it increasingly difficult for first-time buyers to get on the property ladder.
- Almost a third (32%) of residents rent privately, which is higher than the inner London average (29%). The median monthly rent of around £1,650 is similar to other inner London boroughs (average £1,699), but higher than the London average (£1,495) and more than double the England average (£675). This is estimated to be approximately 40% of the median household income, which makes a lot of private sector housing unaffordable to people on lower incomes.
- Housing estates cover 10% of the area of the borough, and social housing accounts for 19% of property. , In 2015/16 there were 27,403 social housing properties, of which 16,750 were council tenanted properties and 10,653 were registered provider social rented properties.
- Although rates of hospital admission for drug misuse are lower than the England average, access to drugs is a theme underpinning many crime issues within Wandsworth.
What happens in pregnancy, childhood and adolescence, impacts on physical and emotional health all the way through to adulthood.
- In 2014, 10,385 children aged under 16 were living in low income families, which equates to 20% – lower than the inner London average (29%) and similar to the England average (20%). This is an increase of 9% (approximately 600 more children) from 2013.
- Although Wandsworth is 11th highest in the country for disadvantaged children achieving a good level of development at the end of reception (5 years old), there is a 14-percentage point difference between disadvantaged children and their peers (disadvantaged = 62% and non-disadvantaged = 76%) that achieved a good level of development at the end of reception (5 years old), which widens to 24 percentage points by Key Stage 2 (11 years old) (disadvantaged = 47% and non-disadvantaged 71%). ,
- It is estimated that there are between 250 and 600 children who act as carers, a group that is particularly vulnerable and in need of support.
- The number of young people being monitored by the Sexual Exploitation Multi-Agency Panel (SEMAP) increased from 50 in April 2016 to 62 in April 2017, in line with increases seen elsewhere. The majority of referrals are for female young people (94%).
- There has been a sharp increase in Children Looked After (CLA), with the rate in 2017 being highest of the last ten years. At March 2017 there were 289 Children Looked After. The majority (69%) of the CLA population continues to be black and minority ethnic (BME) and older children are coming into care than previously.33
Patterns of healthy behaviours are often established early in life through education and what is observed at home in the family, and childhood outcomes can function as indicators of later health problems.
- A significantly lower percentage of children (82%) have received 2 doses of measles, mumps and rubella (MMR) immunisation at or before the age of five compared with the England average (88%), both of which are below the 90% target required to control transmission of infectious disease. 
- In 2015/16, the proportion of children entering primary school aged 4-5 years who were overweight or obese was 19% (564 children, better than London average of 22%); with prevalence increasing to 33% of children aged 10-11 years leaving primary school (730 children, better than London average of 38%).
- Almost a quarter of five-year-olds have one or more decayed, filled or missing teeth and the hospital admission rate for dental caries in children aged under 5 years (287 per 100,000) is significantly higher than the England average (241 per 100,000), although both are showing signs of improvement over the last five years.
- Female genital mutilation (FGM) can have devastating long-term physical and psychological consequences for its victims. Each year, 100 out of 2,600 female babies in Wandsworth are estimated to be born to women with FGM, which puts them at higher risk of being subjected to FGM themselves. In 2016/17 there were around 60 Wandsworth women who attended hospital who had undergone FGM at some point in their lives (although there is no indication that FGM had occurred recently or in this country).
- Mental health problems affect about 1 in 10 children and young people. They include depression, anxiety and conduct disorder and often are a direct response to what is happening in their lives. An estimated 2,800 children aged 5-16 have mental health disorders in Wandsworth.
Younger adults can be more prone to risk-taking behaviour, with tobacco use and binge drinking generally being associated with this group.
- A survey of local people indicates that:
- The cumulative risk from multiple unhealthy behaviours is significant. It is estimated that 12% of 15-year-olds in Wandsworth partake in three or more risky behaviours (including smoking, drinking, cannabis, use of other drugs, poor diet and low physical activity). This is similar to the London average (10%) and lower than the England average (16%).
- Hospital admissions due to alcohol specific conditions in those aged under 18 are high, with 33 admissions per 100,000 in Wandsworth compared to 24 admissions per 100,000 in London.
Our social environment has an impact on what we do both directly, through our opportunities and the availability of resources, and indirectly, through associated stresses and pressures.
- Between 2011/12 and 2015/16, reports of domestic and sexual violence have soared by 80% and 100% respectively. A key contributor to this is a greater awareness and willingness for victims to engage but it remains an area that suffers from underreporting.
- There are over 19,000 carers in Wandsworth, with almost 3,000 caring for 20-50 hours per week and almost 4,000 caring for over 50 hours per week. 12% reported ill health as a result of their caring duties.
- The rate of family homelessness in Wandsworth has increased year on year from 4.7 per 1,000 households in 2011/12 to 6.3 per 1,000 in 2015/16. In common with most London authorities, homelessness is significantly higher than the England average of 2.5 per 1,000 households. The number of rough sleepers in Wandsworth is relatively low compared to other inner London boroughs, although it has increased from 62 in 2011/12 to 96 in 2015/16.
- Wandsworth Prison is the largest in the UK and currently holds 1877 prisoners. Offenders are more likely to smoke, misuse drugs and/or alcohol, suffer mental health problems, report having a disability, self-harm, attempt suicide and die prematurely compared to the general population. Offenders and ex-offenders are particularly vulnerable to mental ill health before, during and after contact with criminal justice system.
The causal chain leading to long-term conditions is complex. The impact of a person’s social and environmental surroundings, including employment and housing, and factors such as loneliness and isolation influence the uptake of unhealthy behaviours.
- 37,000 (15%) adults in Wandsworth are estimated to smoke. It is estimated smoking is responsible for over 500 hospital admissions and 250 deaths in Wandsworth per year.
- A survey of local people indicates that 44% of adults drink more than the limit of 14 units of alcohol per week recommended in order to keep to a low level of risk of alcohol-related harm, the highest proportion in London.
- Habitual drinkers can become alcohol dependent, which can be particularly costly in personal, social, and economic terms. An estimated 3,743 adults in Wandsworth are alcohol dependent with the highest rate in men aged between 25 and 34.
- In 2015/16, around one in five people starting treatment for drug use were homeless or had housing problems and the proportion who were unemployed (59%) was high compared to the national average (43%).
- More than 50% of over 16-year-olds are overweight or obese, with 19% of people in Wandsworth having said that they do not take part in any physical activity, but both are significantly lower than the England and London averages.
Unhealthy behaviours and exposures go on to account for a high proportion of disease. The subsequent impact of poor health and mental wellbeing results in huge costs to the individual, the economy, and the health and social care system.
- There are 15,000 residents in Wandsworth who are living with diabetes and another 25,000 who are on the verge of developing it. 80% of cases of Type 2 diabetes can be delayed or prevented by making simple changes like moving more, losing weight and eating healthily.
- An estimated 44,000 people aged between 16 and 74 have a common mental health disorder such as depression and anxiety.
- Ninety-three suicides were identified from 2009 to 2014, which is about 15 per year. The gender ratio was similar to the national picture, with three men to one woman. Almost a third (32%) of people had a recorded history of alcohol misuse and a quarter (26%) of the deceased had a history of drug use.
- The rates of physical and mental ill health and health risk behaviours are higher in LGBT+ population than the wider population.,,, In London, 2.2% of people identify as lesbian, gay, bisexual or other, which, if applied to the Wandsworth population, would equate to about 8,000 people.
- In 2015, there were 4,950 new sexually transmitted infection (STI) diagnoses excluding Chlamydia in under 25-year-olds (2,145 per 100,000). This is significantly higher than the London average (1,606 per 100,000) and the England average (815 per 100,000).
- In 2015, cancer overtook circulatory disease as the leading cause of death in the borough (as elsewhere), accounting for 28% of all deaths, compared to 27% of deaths due to circulatory disease and 14% due to respiratory disease.
- Around 180 people aged 18-64 are registered deaf or hard of hearing. Those with severe hearing loss who do not use hearing aids have unemployment rates nearly double those who do. People with hearing loss are significantly more likely to experience emotional distress and reduced social engagement.
- An estimated 10% of the Wandsworth population has a disability affecting day to day activities. One in three Citizens Advice Wandsworth clients are disabled or have a long-term condition. Citizens Advice found disability to be the single biggest cause of employment discrimination amongst clients.
- The population is ageing: the number of people aged 65 or over is projected to increase by 44% in the next 20 years (from 29,300 in 2015 to 42,200 in 2035).
- Over a fifth of older people in Wandsworth are on low incomes, which is about average for London, but in the highest 20% in the country. Just over 7,000 of over 60-year-olds are in receipt of pension credits.
- In Wandsworth, 9,000 people aged 50 years and older are unpaid carers.
- 39% of people aged 65 and over live alone in Wandsworth – over 10,000 people, projected to increase to 11,300 by 2020 – and are at greater risk of social isolation. ,, Social isolation is also a factor in increased alcohol use – nationally there has been a marked increase in alcohol-related hospital admissions across all age groups but the increase was greatest for older people.
- Approximately 1 in 4 victims of recorded fraud in Wandsworth are aged 65 and over. In comparison, the 65+ age group accounts for approximately 1 in 20 victims of crime overall, in Wandsworth, well below the fraud estimate.
The accumulated impact of behaviours and exposures earlier in life, combined with functional decline lead to increased levels of disease in older people.
- Falls by older people and the injuries resulting from them can lead to disability and a loss of independence. The rate of hospital admissions for injuries due to falls in those aged 65 and over is significantly higher than the national and regional averages. In 2015/16 there were 794 admissions due to falls. 
- In 2015 there were an estimated 3,420 people aged 65+ living with visual impairment. Furthermore, there are higher rates in those aged 65+ per 100,000 of age related macular degeneration (107.61 vs 84.86), glaucoma (17.43 vs 13.69), diabetic eye disease (4.12 vs 3.78) and sight loss certifications (38.44 vs 29.95) compared to London in 2014/15.
- The number of patients with dementia recorded on GP registers in Wandsworth is 1,387. There are almost two women to every man with dementia.43
- Although life expectancies continue to increase incrementally, healthy life expectancy is much shorter than overall life expectancy, so the average person in Wandsworth can expect 15 years of deteriorating health in old age.
- Life expectancy is 9.3 years lower for men and 4.5 years lower for women in the most deprived areas of Wandsworth than in the least deprived areas.
- Life expectancy at age 65 for both males and females in Wandsworth is significantly lower than in London.
Addressing the need
The Council and CCG exist to meet the needs of the population, and a wide programme of work is already in operation to address the needs identified by the JSNA. Although this is not an exhaustive review, some of the key programmes and services are included below.
These are some of the actions that are in place which help to promote an environment which enhances health and wellbeing.
- Air Quality action plan – contains measures to improve air quality across the borough helping to reduce the key pollutants of concern within the borough, for example through encouraging low emission vehicles and alternative methods of travel, especially active travel. Provisional data indicates a major reduction in NO2 exceedances in Putney High Street since February 2017, which coincides with the introduction of cleaner buses.
- Housing and Regeneration Department policies and strategies – Wandsworth Housing strategy 2015, Wandsworth Council Tenancy and Rent Strategy, Wandsworth Council Affordable Rent guidance, Wandsworth Council Tenancy Policy, Allocation Scheme and Anti-Social Behaviour: Housing policy statement 2015-2018.
- Building homes for older and more vulnerable people – new supported housing developments.
- The Council has a consistent record of affordable housing provision, delivering 1,307 affordable homes since 2014, with 601 being shared ownership.
- Private rented sector – The Council’s Housing Strategy includes measures to improve the availability and affordability of private rented sector housing to meet the demands of local residents, such as the “Wandsworth Rent Model” which is aimed at developing structured forms of intermediate and private rent housing and the development of new private build low cost rent homes as part of regeneration plans.
- Affordable housing solutions information event with 12 exhibitors including housing associations, legal firms and financial advisors who offer advice to local people looking to buy their first home.
- Regeneration – improving existing areas of Wandsworth and approving plans for new developments aim to cultivate better housing, transport, leisure pursuits and business opportunities in the borough. A few of the current regeneration projects affecting the borough are Nine Elms on the South Bank, Winstanley and York Road estates, Roehampton Alton Area regeneration and Ram Brewery development.
- Aspirations programme – ensuring that regeneration means more than the physical improvements by working to improve residents’ quality of life through employment and training opportunities; arts and culture; and healthy activities.
- Cycling strategy – Wandsworth Council’s cycling strategy to 2020 sets out the case for supporting more people to cycle more often in and through the borough, for which the context is set by the Council’s overall transport plan. The strategy actions are set under infrastructure, planning, help to cycle and awareness.
- Active Wandsworth Strategy – The Council recently consulted on a new strategy for 2017-22 to promote and develop sport and physical activity in the borough, which will help to provide a framework through which the Council, its contractors, and other key stakeholders work towards improving the health and wellbeing in the borough.
- Cultural Strategy – widening the opportunities in the wealth of arts, sports, heritage, libraries, parks, play and tourism.
- Arts and Culture – many arts programmes within the borough, some of which are held at the Pump House Gallery in the centre of Battersea Park. Many free, family-friendly events held such as the Tooting Blues and Folk festival.
- Parks and open spaces – the council aims to encourage more wildlife to the green spaces in Wandsworth. Some parks have exercise equipment and outdoor gyms provided free to use, as well as several games areas for basketball, netball and 5-a-side football. There are also allotment and fishing facilities available in the borough.
- Early Years Services – in Wandsworth these are made up of a range of partners, who are supported by the Early Years and Intervention Support Service, which include 12 Children’s centres, health visitors, Family Nurse Partnership, weight management for children 0-5 years and new mothers, family support services and therapy services.
- School aged services – School nursing, young carers, weight management for school aged children.
- The Wandsworth Child and Adolescent Mental Health Service (CAMHS) offers a range of treatments and assessments for children and young people experiencing moderate to severe mental health problems.
- CAMHS Plus – recently launched and works with young people aged 17-25.
- Risky behaviour services
- Condom distribution schemes and integrated sexual health services
- Catch 22 – Substance misuse services
- Youth Service – a service for all young people aged 11 to 19 and up to 25 if they have a learning difficulty or disability. Services are provided for young people who want to attend a youth club, gain an award outside of school, may be at risk of dropping out of school, may be at risk of getting crime or are in serious difficulty and require social work input and family work.
- Youth Voice – helps young people to be involved in decision making.
- Families First programme – Wandsworth Council supports the Government’s Troubled Families approach to reduce crime and anti-social behaviour, non-attendance at schools and worklessness.
- Families First – a consent-based multi-agency team who support families who are in need of specialist support to overcome problems. The service offers short-term, intensive support for families who meet two or more of the six criteria areas: worklessness and financial exclusion, not attending school regularly, child who needs help, crime and anti-social behaviour, domestic abuse and a range of health needs.
- Wandsworth Family Recovery Project – provides intensive family support, working on an agreed whole family plan, addressing difficulties faced by family members to improve outcomes for both children and adults.
- Child Health Inequalities Pilot Scheme (CHIPS) – aimed at improving health outcomes for families with children aged 0-5 years who are not engaging in services.
- Groupwork and Parenting service (GaPS) – coordinates parenting groups and programmes across the Borough. Groups are mainly for families needing additional support or are around specific issues, such as domestic violence.
- Education Inclusion Service – provides targeted support for vulnerable children and their teachers, for example, advising on special educational needs and pupil behaviour, and ensuring good attendance through the Education Welfare Service. The service includes three Pupil Referral Units (PRUs) and also undertakes strategic work in partnership with mainstream schools to plan and provide effective support for children with a range of additional needs, such as language, literacy, social, emotional or behavioural needs.
- Child Sexual Exploitation (CSE), Missing and Teenage Pregnancy workers – a group of targeted and specialist workers, led by CSE/Missing coordinator, who support some of the most vulnerable young people in the borough as well as raising awareness of these issues with practitioners, parents and young people through education, training and group work. The service includes:
- CSE & Gangs Youth Advocate
- CSE Consultant Social Worker
- Barnardo’s Missing Workers
- Vulnerable Young People’s workers (one for young women and one for young men)
- Sex and Relationships Education Outreach Worker
- Barnardo’s Stop it Before it Starts worker (CSE awareness raising with faith communities)
- Public Mental Health Strategy – good mental health is the foundation for living well and the strategy aims to build happy, thriving and resilient communities.
- Wandsworth Suicide Prevention Strategy – the strategy aims to contribute to a society where individuals, families and communities value their own life and the life of others, should never feel that suicide is the only option and are supported in times of need, by safe, integrated and compassionate services.
- Mental Wellbeing Services – there are a number of local services available including Mood Manager DVD, Wellbeing classes at South Thames College, Expert Patient Programme, Adult Care Information Service (ACIS), Community Mental Health Teams and specialist care.
- Talk Wandsworth – provide free confidential help for problems such as stress, worry and low mood.
- WorkMatch programme – offering Wandsworth residents a 10-week programme called New Routes to Work.
- Stop smoking services – offer a range of free services to help with the quitting of smoking, including tips on managing withdrawal symptoms, regular carbon monoxide checks and access to stop smoking medication including Nicotine Replacement Therapy (NRT).
- Alcohol interventions – there are a variety of local services for people with alcohol dependency or people concerned about their alcohol use as well as for carers and family members. Some of these include the Wandsworth Community Drug and Alcohol Service (which offers specialist advice and support in Wandsworth), two Fresh Start clinics and charities.
- Substance misuse interventions – a range of services including the Wandsworth Community Drug and Alcohol service (WCDAS), as well as helplines and charities.
- Adult Weight Management Programme – aims to encourage residents to take the first step in controlling their weight by offering a sustainable weight loss solution.
- Healthy workplace initiatives – provides a structured framework for organisations and businesses to improve and maintain health and wellbeing for employees, and is endorsed by the Mayor of London.
- Wandsworth Sexual and Reproductive Health Strategy – good sexual health is important throughout life and individual need, demand and requirements vary according to age, gender, lifestyle, faith and sexual orientation. It takes account of the National Strategy for Sexual Health and HIV (2010) and the Department of Health’s Framework for Sexual Health Improvement in England (2013). It is also informed by local health needs, information gathered from local services and evidence of best practice across the UK.
- Wandsworth Integrated Sexual Health Service (WISH) – Providing a range of services including testing and managing sexually transmitted infections, emergency and on-going contraception and rapid HIV testing.
- Integrated Offender Management – the overarching framework that brings together agencies across government to prioritise intervention with offenders who cause crime in their locality.
- Older People’s Strategy – a preventative approach to maintaining health and wellbeing and, when needed, provision of care and support with dignity into older age. It looks across several dimensions of ageing including health and healthy living, housing and the home, living in a supportive neighbourhood, keeping connected, getting out and about and income.
- Falls service – falls prevention, treatment and rehabilitation
- Flu vaccination for over 65s – improved to 70% take-up
- Carers’ Strategy – including Integrated Carers’ Service
- Adult social care services – including our enablement service, Keep Independent Through Enablement (KITE), help when leaving hospital, hubs for older people, Telecare (sensors and equipment to help you stay safe at home) and community equipment to help at home
- Social prescribing – a way of linking patients in primary care with sources of support within the community.
- Day care services – offer a vital social lifeline for otherwise socially isolated residents. Approximately 500 older people are in contact with five services across the borough; this includes a specific programme for Asian older people. Age UK provides a volunteer service with 150 older people receiving visits from volunteers.
- GoodGym – a national organisation that has implemented programmes in the Battersea area. The ‘Coach Runs’ programme pairs individuals who are DBS checked with older people at risk of loneliness and isolation – members run to the location of the elderly person and the pair gets to know each other and develop a social connection. GoodGym participants also take part in ‘Mission Runs’ where runners help socially isolated and elderly people with small jobs or tasks.
- Better Care Fund – a single pooled budget to support health and social care services working more closely together.
There are other actions which address needs over the whole life course including:
- Joint Health and Wellbeing Strategy 2015 to 2020 – developed and agreed by both Wandsworth Council and Wandsworth Clinical Commissioning Group. The principles and priorities are based on healthy places, targeted intervention and mental health.
- Prevention framework – promotes health and wellbeing of residents in everything the Council and CCG do as well as to guide the way in which the Council aims to commission voluntary services in the future.
- South West London Sustainability and Transformation Plan (STP) – The plan is the product of unique collaboration between all commissioners and providers in the local NHS, working with local authorities to transform the health and social care system with the following objectives: Making health and social care services more productive; Putting much more emphasis on prevention; Early intervention; Integration of primary, secondary and community care; Reviewing services provided in hospital.
This is only a snapshot of the detailed information available. Please see www.wandsworth.gov.uk/jsna for further information or contact firstname.lastname@example.org for help finding the referenced documents.
The JSNA incorporates a wide variety of quantitative and qualitative data about demography and the pattern of determinants of health, risk factors and diseases, service utilisation, effectiveness, patient and public voice and cost. To make sense of local information, data is compared over time (trends), with other comparable boroughs (benchmarking), where available with standards (expected pattern) and with what local people and health and social care professionals tell us (voice). A better understanding of local issues is gained by bringing together information from different sources.
 A notifiable crime is any confirmed criminal offence irrespective of severity (e.g. shoplifting, robbery, assault).
 ONS Mid-year population estimates 2015
 Management Information –schools – as at 31st July 2017, Ofsted
 Vauxhall, Nine Elms, Battersea Opportunity Area, Mayor of London, London Assembly
 Number of active businesses 2015, London borough profiles, GLA
 Census 2011.
 Walking and Cycling Statistics, Department for Transport, July 2016
 London Datastore: Access to Public Open space and nature by ward, published by GiGL.
 Enable Parks website, biodiversity
 Health Assets Profile, Public Health England 2015/16
 ONS internal migration within UK
 GLA Intelligence London Borough Profiles, 2016
 GLA Intelligence, London Borough profiles, % adults that volunteer in past 12 months (2010/11 to 2012/13).
 London Borough of Wandsworth website, Air pollution,
 Mayor of London, London Assembly; hundreds of London schools exceed legal air quality levels, July 2016.
 Understanding the Health Impacts of Air Pollution in London, Walton H et al (2015)
 Annual Public Health Report 2014/15.
 Public Health Outcome Framework 1.14ii and 1.14iii, 2011.
 Hunger and Poverty in Wandsworth, Wandsworth Food Bank 2016/17
 English Housing Survey, Headline report 2013-14, ONS.
 Annual Population Survey, tenure of population, 2015, GLA datastore.
 Health Assets Profile, Public Health England, 2016
 English Housing Survey, Headline report 2013-14, ONS; GLA London Borough profiles.
 GLA London DataStore; Average house prices, Borough.
 Valuation Office Agency, private rental market statistics, 1 April 2016 to 31 March 2017
 Total Median Annual Household Income estimate, GLA, 2012/13
 Local mapping by Business Intelligence Team
 Annual Population Survey, tenure of household, 2014, GLA datastore
 Statistical data return 2015/16
 Wandsworth PHOF update report 2017
 Public Outcomes Framework 1.03i, 2015/16
 Annual Quality and Standards Report (AQSR) 2016
 Wandsworth Young Carers Audit 2009
 Appendix 9 – Placement Sufficiency Strategy
 Public Health Outcomes Framework 3.03x, 2015/16
 Public Health England Child Health profiles, 2015/16
 JSNA newsflash – Child Health Profiles 2017
 Prevalence of Female Genital Mutilation in England and Wales: National and local estimates, City university.
 Mental Health Foundation; children and young people
 PHE Child Health Profiles; Estimated prevalence of mental health disorders in children and young people, 2014.
 What About YOUth? Survey 2014/15.
 Clustering of unhealthy behaviours over time: implications for policy and practice, Kings Fund 2012.
 JSNA Strategic assessment Newsletter.
 Market position statement definitive index, June 2015
 P1E returns 2015-16, Department for Communities and Local Government part of Homelessness statistics.
 CHAIN data.
 Wandsoworth Prison information, ministry of Justice
 How offender healthcare is managed in prisons and in the community, part of Prisons healthcare from National Offender Management Service and Her Magisty’s Prison and Probation Service, July 2014
 London Assembly Health Committee, Offender Mental Health, September 2017
 Public Health Outcomes Indicator 2.14, 2016.
 PHE Local Tobacco control profiles.
 PHE Local Alcohol Profiles for England, 2011-14.
 Wandsworth JSNA newsflash: Estimates of Alcohol dependence in England.
 Adults drugs JSNA Support pack 2017/18 Wandsworth
 PHE Physical activity profiles; Excess weight (2013-15), Percentage of adults achieving less than 30 minutes of physical activity per week (2015)
 Public Health Annual Report 2016 – Diabetes in Wandsworth.
 PHE Common Mental Health disorder profiles, 2014/15.
 Wandsworth Suicide Audit.
 Improving health equality for gay, bisexual and other MSM – why now and how?, Public Health Matters, Public Health England, 2015
 Looking at the health needs of LGBT women, Public Health Matters, Public Health England, 2017
 Healthwatch Wandsworth consultation on LGBT Mental Health
 London Assembly LGBT+ Mental Health report Feb 2017
 ONS Sexual identity, UK, 2015; ONS 2014-based sub national population projections for 2017.
 PHE Sexual and Reproductive Health profiles, 2015.
 PHE End of Life Care profiles, 2015
 Adult Social Care, Public Health England profiles, People aged 18-64 registered deaf or hard of hearing per 100,000, 2009/10
 NHS England: Action Plan on Hearing Loss, 2015
 Hearing Matters, Action on Hearing Loss
 Office of National Statistics, 2011 census
 Health and Wellbeing in Wandsworth 2017, Citizens Advice Wandsworth.
 GLA population projections, long term interim 2015 round
 Income Deprivation Affecting Older People Index, English Indices of Deprivation 2015, Department for Communities and Local Government
 London Datastore; Pension Credit Claimants, Borough, Aug 2016.
 Older Peoples Strategy, 2020
QS110UK – Adult lifestage (alternative adult definition), 2011 Census, Office for National Statistics
 Business intelligence data analysis of Metropolitan Police Service data, 2015/16
 PHE Public Health Outcomes Framework, 2.24i, 2015/16.
 Older Peoples Health in Wandsworth presentation, taken from PHOF 4.12i-iv, 2014/15.
 Quality Outcomes Framework (QOF), 2015/16
 Public Health Outcomes Framework 0.1i and 0.1ii, 2013-15.
 PHE Health profiles, 2016
 Provisional data suggests major fall in Putney pollution, Wandsworth Borough Council Website 8th August 2017
 Housing Department policies and strategies, London Borough of Wandsworth
 London Borough of Wandsworth, Building homes for older and more vulnerable people, April 2017
 Enable Website, Active Wandsworth Strategy 2017-2022; London Borough of Wandsworth website, Community Services Overview and Scrutiny Committee, 16th February 2017
Appendix: Joint Health and Wellbeing Strategy Scorecard 2017/18
This scorecard of performance measures is not meant to be comprehensive but rather aims to provide a high-level overview of the health and wellbeing of the borough.
Indicators from the NHS Outcomes Framework, the Public Health Outcomes Framework, the Adult Social Care Outcomes Framework (ASCOF) and the Child Health Profiles have been used, since these are national, benchmarked and validated.
Wandsworth performance is colour-coded according to the quartile in which it falls, when compared to other London boroughs (or compared to other boroughs in the same CIPFA [Chartered Institute of Public Finance and Accountancy] group, for the six ASCOF indicators).
Indicators were initially selected from the outcomes frameworks by considering the following factors to identify 10-11 indicators for each priority area:
- Marker indicators with wider relevance
- Robust indicator definitions
- Historical data available, allowing trends to be seen
- Performance issue or deteriorating range (e.g. children and adults, deprived and affluent)
- Range of indicators including short-term and long-term sensitivity
- Broken down by equality characteristics