Jersey’s performance framework

20.11.30

1 Deputy R.J. Ward of St. Helier of the Minister for Health and Social Services

regarding Jersey's performance framework (OQ.350/2020):

Given that Jersey's performance framework shows that, since 2008, the percentage of Islanders with physical or mental health conditions lasting (or expected to last) for 12 months or more has remained unchanged, despite the Island's population increasing by more than 12,000, will the Minister advise what measures are being undertaken to improve the long-term mental and physical health needs of Islanders?

Deputy R.J. Renouf of St. Ouen (The Minister for Health and Social Services):

The data the Deputy is referring to tracks a proportion of Jersey's population with self-reported long- term health conditions. It uses data from the Jersey Opinions and Lifestyle Survey, which survey is a representative sample of adults in Jersey. Participants are asked: "Do you have any physical or mental health conditions or illnesses lasting or expected to last for 12 months or more?" In 2020, 29 per cent of adults reported having a longstanding physical or mental health condition expected to last for 12 months or more. As the Deputy notes, while this proportion has remained largely unchanged for more than a decade, Jersey's population has increased by over 12,000 people during that time. So a greater number of people are living with long-term conditions. It may be thought that a decade ago their lives may have been curtailed by that long-term condition, they are now managing and living with it to a greater age. This is in line with population demands modelling conducted for the Jersey Care Model, details are provided in the proposition relating to the Care Model and the issue of addressing and assisting people to live with longer-term conditions is one of the fundamentals of the Care Model and will be addressed as we develop the Care Model.

Deputy R.J. Ward :

Apologies, but I do not believe that was an answer to the question I asked, which was: "... advise what measures are being undertaken to improve the long-term mental and physical health of Islanders." It seemed to me to be a description of how the information was gathered but there was no answer there, Sir. Forgive me if I am speaking out of turn.

The Deputy Bailiff :

You are entitled to a supplementary in any event, what do you want to say to the Minister. What do you want to ask?

1. Deputy R.J. Ward :

I would like to ask what measures are being taken to reduce the number of Islanders - and let us talk specifically about mental health then - with long-term conditions, to reduce that number and to improve it, given that the population has increased and those numbers are increasing accordingly.

The Deputy of St. Ouen :

As I did say, long-term measures will be worked through with all stakeholders involved in the Jersey Care Model. We recognise the need to change. We need to move away from the institutionalised base model into a more modern community-based model of the patients at the centre of care and, as an example of that perhaps, the Mental Health Services have recently established a community team, which is going out to address issues of patients while in their home, trying to make sure that those patients do not become acute patients.

[14:45]

That is one example of the sort of community-based work that needs to happen within all the planning for the Jersey Care Model.

2. Deputy G.P. Southern of St. Helier :

There is absolutely no breakdown of what will be spent, when it will be spent and on what services in association with improvement in our mental health. Will the Minister undertake to give this Assembly a full breakdown of what would be spent and when it will be spent as we introduce the Jersey Care Plan?

The Deputy of St. Ouen :

I cannot predict the future; I cannot say at the moment what the plans will be developed with stakeholders. The Care Model has only been approved in recent weeks. Within the Government Plan, the Assembly will be asked to vote sums of money. So it is dependent on approval of the Government Plan. Then with the Scrutiny Panel and all stakeholders we will develop the detailed models for delivery of the plan.

3. Deputy G.P. Southern :

Is the Minister suggesting that we vote for the money without any planning and breakdown of the planning whatsoever? Surely he must know what he intends to do in 2021 and how much he plans to spend on particular services or are we acting blind?

The Deputy of St. Ouen :

All this information was in the Jersey Care Model proposition, including the implementation planning within 3 tranches. Tranche one of 2021 was detailed there and I would refer the Deputy to that. It is at page 174 of the proposition, which talks about the work needed for detailed planning, assessment and modelling of need; establishing supports for workforce to be successful; driving efficiencies in acute services; focus on community and intermediate care; providing new pathways through an enhanced single point of access; creation of an Island-wide workforce plan; and communications. It is all in there in the proposition.

4. Deputy C.S. Alves of St. Helier :

The Minister mentioned that the data that Deputy Ward was referring to in his question was based on data that was collected from the lifestyle questionnaire survey. How is the Minister collecting other data, other than the survey, to see whether in fact these numbers are increasing or not?

The Deputy of St. Ouen :

There is a section within Strategic Policy, Performance and Population that deals with health informatics and collects data on health, so we have the waiting list data within the General Hospital and we have all the data that the Island collects. Because health is not just about health services but it is about quality of housing, it is about environmental aspects, all of which tend to be reported in such things as the Jersey Opinions and Lifestyle Survey.

5. Deputy C.S. Alves :

Is the Minister able to state whether in fact these areas of physical and mental health are increasing? Because originally the Minister mentioned that the percentage was the same in proportion to the whole population. So, by looking at this other data that he has just mentioned, can he specify whether there has been an increase there or is it still the same, looking at that specific data as well?

The Deputy of St. Ouen :

I am not sure what the Deputy means by "increasing". Does she mean the number of patients being seen or anything else?

Deputy C.S. Alves :

In the original question, Deputy Ward referred to the percentage of Islanders with physical or mental health conditions, lasting or expected to last for 12 months, or more has remained unchanged. But I believe the Minister said that Deputy Ward was only referring to the data that had been collected from the lifestyle questionnaire survey.

The Deputy of St. Ouen :

I am still not sure of the question. Yes, so I did agree with Deputy Ward that the data from that survey did show little change. In interpretation of that, I pointed out that the population has increased in the time. That was my answer because that was the question asked of me, referencing Jersey's performance framework and the unchanged nature of that particular statistic. I do not have to hand any other statistics.

6. Deputy R.J. Ward :

Beyond the good work of the Listening and Talking Therapies that will deal initially with people's mental health problems, does the Minister agree that there is a crisis over long-term mental health conditions? This data reflects that crisis and simply emergency action needs to be taken rather than just waiting for something to be done in the long term with the Care Model?

The Deputy of St. Ouen :

No, I would not call current pressures, which are regular pressures, a crisis. In Mental Health, our teams have been enhanced by additional recruitment recently. We are in a better place with Mental Health Services than we were some years ago. There is always room for improvement and our team is seeking out that improvement and is step by step delivering that improvement.