Introduction
The Joint Strategic Needs Assessment (JSNA) has never had a more central role in English health and care. The policy changes of 2025 and 2026 have, for the first time, created a formal requirement for JSNA evidence to inform NHS commissioning decisions at the neighbourhood level. This represents a step change in the JSNA's statutory significance.
Understanding the 2026 system architecture is essential before you begin or refresh your JSNA. The organisations you are working with, and the frameworks they are operating under, have changed substantially since the original springboard was published.
The neighbourhood health framework
Published in March 2026, the neighbourhood health framework is the most significant structural commitment to place-based health delivery in England in a decade. It sets out how integrated care boards and local authorities, working through health and wellbeing boards, will build a neighbourhood health service across England.
The framework is explicit: neighbourhood health plans must be informed by the JSNA and must address local priorities and health inequalities identified through the JSNA process. Integrated Care Boards (ICB) must align their five-year commissioning plans with both the JSNA and the Ministry of Housing, Communities & Local Government (MHCLG) local outcomes framework.
In 2026/27, ICBs and local authorities are required to agree neighbourhood footprints and complete ten core steps. From 2027/28, they are expected to produce jointly owned neighbourhood health plans, developed through the health and wellbeing board. The JSNA is the evidence foundation for that process.
ICB restructuring and the abolition of NHS England
In March 2025 the Prime Minister announced that NHS England would be abolished and its functions transferred to the Department of Health and Social Care. This is the biggest restructuring of national NHS architecture in a decade. Legislation is expected to complete the transition by late 2026.
As part of this process, integrated care boards have been required to reduce their running costs by 50 per cent. From 1 April 2026, twelve existing ICBs were abolished and six new, larger ICBs established. A further round of mergers is expected in 2027, reducing the total from 42 to approximately 26.
This creates direct implications for JSNA governance. New ICBs are new legal entities with new data controllers and new leadership. Partnership arrangements built up over three years may need to be rebuilt. The analytical capacity on the NHS side for joint intelligence work is likely to have reduced significantly.
The Health and Wellbeing Board in 2026
Health and Wellbeing Boards retain their statutory basis under the Health and Social Care Act 2012. Their role has, if anything, grown in significance. The Neighbourhood Health Framework explicitly requires neighbourhood health plans to be designed under the collective leadership of the HWB. During 2026/27, HWBs are required to work with communities and partners to establish whole life course outcome measures for 2027/28.
The DPH retains the statutory lead for the JSNA and an independent reporting function. That independence matters in a period when the NHS is restructuring rapidly. The Director of Public Health is the professional guarantee of quality and objectivity in the JSNA process.
Integrated care partnerships, which sit alongside HWBs, are also in flux. Several ICPs have stepped down their meeting arrangements as ICBs restructure. In some areas, the ICP function is effectively transferring to the HWB. Councils should be alert to this shift and ensure the HWB retains a clear and visible governance role.
What this means for your JSNA
The JSNA is the only intelligence process that is owned by local government rather than the NHS. In a system where NHS organisations are under severe financial pressure and structural disruption, the JSNA is your independent basis for shaping priorities, holding the system to account, and protecting community interests in commissioning decisions.
The new demands on JSNA are real. They require a step change in how the process is resourced, governed, and connected to decision-making. This is not business as usual. But the architecture now exists to make JSNA genuinely central to the health of your place.
What is a JSNA?
Key message: Some of the basics of JSNA are easily defined and you might find it helpful to remind yourself of them. The seven quality themes will then help you work through the design questions for your local process in the 2026 context.
What does a good JSNA process do?
As a minimum, a good JSNA process will be the definitive local programme through which:
- local authorities, the community and voluntary sector, service users and NHS partners research and agree a comprehensive local picture of health and wellbeing needs via the Health and Wellbeing Board
- partners jointly undertake big-picture intelligence and analysis: what is working, what is not, and what could work better? What are the major health inequalities and what can we do about them? What does an analysis of unmet need, seldom-heard populations and vulnerable groups tell us?
- partners use needs assessment information to negotiate and agree overarching priorities on health and wellbeing, recognising that this is equally manifested in the Joint Health and Wellbeing Strategy
- commissioning and decision-making are influenced by needs assessment and strategic priorities, via whatever products, services or methods of engagement are most appropriate
- Neighbourhood Health Plans (from 2027/28) are explicitly grounded in JSNA evidence and address the health inequalities the JSNA identifies
- summary information on the strategic picture for health and wellbeing is made available to wider audiences: the public, ICBs, service providers, local media, voluntary and community sector.
What data should a JSNA include?
Key message: Data is only a means to an end. Gathering it in one place is just one part of the overall JSNA process. Analysing it to build intelligence, inform priorities and drive change will be another.
The JSNA process is expected to include the following data:
- Population-level: total, growth, migration, birth, gender, age, ethnicity, using 2021 Census and local updates.
- Social and place: housing quality, environment, employment, educational attainment, benefit uptake, vulnerable groups, crime and disorder, community cohesion.
- Lifestyle determinants of health: exercise, smoking, diet, alcohol, drug use.
- Epidemiology: morbidity, mortality, life expectancy, long-term conditions, disease prevalence, vaccination coverage.
- Service access and utilisation: emergency admissions, primary care data, discharge information, screening uptake, frailty profiles.
- Evidence of effectiveness: commentary on good practice, NICE guidelines and quality standards.
- Community perspectives: views, expectations, perceptions and experiences of service users and local communities.
- Neighbourhood-level health inequality analysis, Core20PLUS5 populations, and wider determinants data linked to the MHCLG Local Outcomes Framework.
Information from the voluntary sector, qualitative sources, service providers, the private sector and any partner who will add value is crucial to the ability of a JSNA to provide an objective assessment of needs and priorities. The primary national data platform is OHID Fingertips.
Why have a JSNA?
Key message: The duty to undertake JSNA was introduced in 2007 in recognition that strategic planning for health and wellbeing was best done in partnership and based on evidence. It is intended to provide a powerful model for joint working in every locality. That rationale is more important, not less, in 2026.
No need exists in isolation
The health and wellbeing of all citizens is shaped by social and environmental determinants experienced throughout their life. The challenge of persistent health inequalities and complex needs cannot be satisfactorily addressed by any single agency alone.
Partnership is the only workable solution to the big challenges that we face.
A single, agreed picture of true needs is essential for strategic planning
Without it, decision-makers cannot coordinate joint actions effectively, nor identify what the most important investments are for today or tomorrow. Without shared priorities based on JSNA, the same problems will come up again and again.
A clearer picture of needs means stronger partnerships
An agreed, comprehensive picture of needs and assets demands that public services overcome professional and organisational differences and take joint responsibility. Partners are better able to understand and value each other's contribution by recognising the interdependency of public services.
Demand is not the same as need
Data on use of services is helpful to a point. But building an objective picture of needs, not demand, is fundamental to ensuring that the right people get the right services, at the right time, in the right place. Know what you do not know.
Using this toolkit
Who is this JSNA toolkit for?
Key message: This is a design tool to help Health and Wellbeing Boards lead a new generation of JSNA in the context of neighbourhood health. It will help you to ask the right questions about your JSNA, understand the range of good practice, decide what you want it to be, and how it will inform your Neighbourhood Health Plan and Joint Health and Wellbeing Strategy.
This tool is intended for all the statutory members of Health and Wellbeing Boards:
- elected members
- ICB representatives
- directors of public health
- directors of adult social care
- directors of children's services
- healthwatch representatives.
It is also useful to other key decision-makers and wider audiences, such as district councils (particularly in areas undergoing reorganisation), local authority chief executives, directors of finance and commissioning, housing and planning, service providers, the community and voluntary sector, and users of JSNAs.
What is the format?
Key message: Whilst the potential value of a JSNA is clear, each process requires local design beyond the basic essentials. Take ownership and lead a review from first principles. The 2026 policy context makes this more important, not less.
Experience shows that the most effective JSNAs have considered a number of key issues that have to be resolved when designing their JSNA process. We have developed these issues into seven quality themes to assist Health and Wellbeing Boards in deciding on their JSNA approach.
Take stock
1) Learn from the past: review your existing JSNA process and strategic partnerships.
Ask big questions
2) Agree the scope and mandate for the JSNA process going forward.
3) Know your audience. Agree the users of your JSNA and what they need from the process.
4) Build trust and agree a shared process of strategic priority-setting through your JSNA and JHWS.
Go into further detail
5) Match form to function and specify your JSNA products.
6) Secure the capacity, skills, data and knowledge needed to deliver your JSNA.
Consolidate
7) Agree governance and consolidate your vision into a clear specification.
A discussion on each quality theme should inform the next in turn. Each theme starts with a key message, followed by key issues to debate, and thinking prompts. Each theme also includes updated 2026 context, good practice templates, case studies, and a nominal position for comparison.
Joint strategic needs assessments are still evolving. So are the strategic partnerships that oversee them. Recent policy developments in 2025 and 2026 represent a significant step change in the role and function of JSNAs and most areas will need to review their local process from first principles.
Quality JSNA processes are unlikely to spring up overnight and will need long-term engagement of the HWB, the JSNA team, and other audiences. New leaders, systems and processes take time to settle. Evaluate your JSNA at regular intervals as part of an ongoing learning process.
Trusting relationships between partners representing very different organisations and interests can take time to build. The quality of your JSNA process will be a reflection of the maturity of your relationships.
Quality theme 1: Review your JSNA and strategic partnerships to date
Key message: Before you recast your vision for the process, gather your thoughts on local experiences and lessons learnt. What was your JSNA like last time? Your new JSNA will only be as good as the strategic partnerships that underpin it. In 2026, how have those partnerships been affected by ICB restructuring and the new demands of the Neighbourhood Health Framework?
Key issues to debate:
- Was it clear what partners wanted from the JSNA process last time? Was a clear vision agreed?
- Did our JSNA impact on commissioning and decision-making? What worked and what did not?
- What is our local experience of strategic partnership working? How have ICB restructuring and ICP changes affected the landscape since our last JSNA cycle?
- Has our JSNA been visible to, and used by, the new ICB leadership?
| Some reported JSNA successes | Do you agree? Note your thoughts or further comments here |
|---|---|
| The JSNA process has encouraged challenging conversations | |
| It has strengthened partnerships | |
| It has brought all the data together in one place | |
| The process has exposed unmet need | |
| It has driven strategic commissioning | |
| Producing the JSNA has been a useful learning process in itself | |
| The JSNA has been the key strategic document across the whole locality | |
| It has led to new and innovative services or moved money around the system | |
| The JSNA highlighted inequalities and has driven a health inequalities approach | |
| The JSNA informed our local Neighbourhood Health Framework response |
| Some common JSNA problems | Do you agree? Note your thoughts or further comments here |
|---|---|
| Few commissioners and decision-makers have been aware of the JSNA process | |
| The JSNA has not changed anything – it has just told us things we already knew | |
| The JSNA process has been dominated by one professional group and has not been prepared in genuine partnership | |
| The JSNA has been service-led and has not adequately covered the wider determinants of health | |
| The views of service users and the community and voluntary sector have been absent | |
| The Equality Duty has not been clearly embedded in the JSNA process | |
| The JSNA has not been adequately resourced | |
| Elected members have had limited engagement in the JSNA process | |
| The deficits model was not balanced with an asset approach | |
| ICB restructuring has disrupted our JSNA partnership without a clear plan to rebuild it | |
| Our JSNA has not yet connected to neighbourhood health planning requirements |
| Strategic partnerships more generally | Do you agree? Note your thoughts or further comments here |
|---|---|
| The statutory partners trust and understand each other | |
| Partners have developed a high-level consensus where local needs and priorities demand it | |
| Partners have overcome different organisational cultures and systems to reach good working arrangements | |
| Partners have good experience of joint investments and budget transfers to address common problems | |
| The community and voluntary sector have been fully involved in the JSNA process from the outset | |
| Our JSNA partnership has survived the disruption of ICB restructuring with governance intact | |
| Data sharing agreements have been reviewed and updated following ICB mergers |
Good practice template: The JSNA review is led by the HWB and includes an honest assessment of what the last JSNA achieved and what it missed. The review explicitly addresses how the partnership has changed since the last cycle, including the impact of ICB restructuring, and sets out what needs to be rebuilt or renegotiated.
Advantages:
- Creates a shared starting point for the new JSNA cycle.
- Ensures the HWB takes ownership rather than delegating entirely to officers.
- Identifies governance gaps created by ICB changes before they affect the new JSNA.
Disadvantages:
- Requires time and honest conversation that partners under pressure.
Case study: Rebuilding JSNA governance after ICB merger
Following the merger of two local ICBs in April 2026, one upper-tier authority convened an extraordinary HWB session to audit all existing JSNA data-sharing arrangements and partnership agreements. The session identified three agreements that referenced the old ICB as a legal entity and would need to be renegotiated, and two analytical leads whose posts had been lost in the restructuring. The DPH used the session to propose a refreshed JSNA steering group composition that reflected the new system architecture, and to secure member-level endorsement for the JSNA as the foundation for the forthcoming neighbourhood health plan.
Quality theme 2: Agree the scope and mandate for the JSNA
Key message: JSNAs must be central to strategic leadership for health and wellbeing. How will you achieve this? The Neighbourhood Health Framework has raised the stakes significantly: for the first time, JSNA evidence is an explicit input to NHS commissioning strategy. A discussion about the detail will quickly flush out different perspectives and help partners agree the mandate and influence your JSNA will have in driving change.
Key issues to debate:
- To what extent do we want our JSNA to drive all health and wellbeing decisions? What influence and levers will it have to support this?
- How will the JSNA connect to our neighbourhood health plan, which must be informed by the JSNA under the Neighbourhood Health Framework?
- To what extent will a health and wellbeing rationale drive all strategies across our locality, including economic development, housing, spatial planning?
- Will the JSNA process drive our strategic collaboration with the non-statutory sector, including VCSE partners integral to neighbourhood health delivery?
| Thinking in more detail | Note your thoughts here |
|---|---|
| Question: How wide does JSNA influence go? This is a local decision, and possibly the biggest question to answer. The JSNA and JHWS could limit itself to informing statutory commissioning for health and wellbeing, but would this be a missed opportunity to connect the wider determinants of health? The Neighbourhood Health Framework explicitly requires neighbourhood health plans to address housing, employment, education and VCSE capacity. | |
| Question: How will JSNA best add value to existing commissioning strategies and planning processes? Most commissioning streams undertake needs assessment as part of their current planning cycles. There is a real risk of siloed or service-led thinking unless early planning stages come from the shared, strategic perspective that the JSNA can offer. | |
| Question: How does the JSNA connect to the Neighbourhood Health Plan? From 2027/28, ICBs and local authorities working through the HWB are required to produce Neighbourhood Health Plans that must show how objectives are informed by the JSNA. What governance arrangements will ensure this connection is real and not nominal? | |
| Question: What levers will the JSNA and JHWS have? Informing is quite different to driving decision-making. What mandate will you give your JSNA process to ensure it has influence over strategic decision-making, including ICB commissioning plans? |
Good practice template: The JSNA is the authoritative strategic process for all health and wellbeing decision-making. There is a default culture across all partners that the JSNA is a shared assessment of need to underpin health and wellbeing planning. The HWB formally agrees that the JSNA will be the evidence foundation for the neighbourhood health plan. In other words: if it is not in the JSNA, it is not a priority.
Advantages:
- JSNA and JHWS are better able to influence the wider determinants of health including housing, education, and employment.
- Creates clear connection between JSNA evidence and the neighbourhood health plan, as required by the Neighbourhood Health Framework.
- Gives the DPH and HWB real leverage in ICB commissioning conversations.
Disadvantages:
- May require re-organisation of analysis capacity.
- Investment may be required to build strategic links with wider partners, especially those not bound by the requirement to commission according to the JHWS.
Nominal position: The JSNA intelligence is targeted only at health, public health and social care commissioning. It does not explicitly connect to the neighbourhood health plan or the MHCLG Local Outcomes Framework.
Advantages:
- A clearly defined process is able to target the available capacity into a specialist product.
- JSNA can be produced by professionals alongside the day job.
Disadvantages:
- Wider services may make decisions unilaterally, oblivious to perverse outcomes across the system.
- The JSNA will fail to meet the Neighbourhood Health Framework requirement that neighbourhood plans be informed by the JSNA.
- You will not know what you do not know.
Quality theme 3: Know your audience
Key message: Experience shows strategic needs assessment can be difficult for decision-makers to translate into actions, and they may require further input tailored to their needs. In 2026, your audience has changed: ICB leadership is new and stretched, neighbourhood health is creating demand for highly localised evidence, and elected members are being asked to co-lead plans they may not fully understand. Effective JSNAs are clear about the primary users they intend to inform.
Key issues to debate:
- Who will our JSNA primarily speak to: elected members, ICB commissioners, neighbourhood teams, VCSE organisations, the public, or all of these?
- How do the needs of the JSNA differ across audiences? Are the needs of decision-makers on the HWB similar to the day-to-day needs of integrated neighbourhood team leads?
- To what extent is our JSNA expected to cater equally to these users? Are some more important than others?
- How will we produce neighbourhood-level products that can inform the footprint decisions and INT planning that the Neighbourhood Health Framework requires?
| Thinking in more detail | Note your thoughts here |
|---|---|
| Question: How important is it that a range of audiences can access and understand JSNA products? Are the needs of ICB commissioners and HWB decision-makers of greater or lesser importance than VCSE organisations, neighbourhood teams, or public audiences? | |
| Question: Which intelligence and JSNA product will elected members value most? Elected members are the only democratically elected members of the HWB. They will need to be confident that the JSNA is of sufficient quality to enable them to challenge services on behalf of the people they are elected to represent, and to lead the neighbourhood health plan process. | |
| Question: What do integrated neighbourhood team leads and primary care networks need? In 2026, a new audience is emerging: the clinicians, social care practitioners and VCSE workers who will staff integrated neighbourhood teams. They need population health intelligence at neighbourhood footprint level. Can your JSNA provide this? | |
| Question: What do VCSE sector partners need? In the Neighbourhood Health Framework, VCSE organisations are recognised as integral to delivering neighbourhood health. They need intelligence on unmet need, community assets, and service gaps that statutory data alone will not capture. Ask them. | |
| Question: What do the public want to know? The public may be considerably less bound than commissioners to service-led commentary. What do they consider important to know and how should it be presented? Community engagement is a requirement of neighbourhood health plan development, not a nice-to-have. |
Good practice template: The JSNA is designed to be widely accessible with intelligence presented in a range of formats and products to a variety of audiences, including a neighbourhood-level tier of analysis that can directly inform integrated neighbourhood team planning and the footprint decisions required by the Neighbourhood Health Framework.
Advantages:
- Enables all parties, including those not bound by the JHWS, to align with the strategic agenda.
- Creates the neighbourhood-level intelligence base that the Neighbourhood Health Framework requires.
- Health and wellbeing is seen as everyone's business.
Disadvantages:
- The broader the audience, the more varied products you will have to offer.
- It needs dedicated JSNA capacity to ensure quality control and coherence.
Case study: Neighbourhood-level JSNA profiles
One county council, working with its ICB, developed a suite of neighbourhood health profiles at the footprint level agreed with the ICB for the Neighbourhood Health Framework. Each profile included deprivation quintile analysis, frailty prevalence, Core20PLUS5 population estimates, and a summary of community asset mapping. These profiles formed the evidence base for neighbourhood health plan development and were shared with primary care networks, INT planning teams, and local VCSE organisations. The DPH presented the profiles to elected members as part of a structured HWB conversation about local priorities.
Quality theme 5: Match form to function and specify your JSNA products
Key message: Very few products are a given, leaving the Health and Wellbeing Board free to choose those which offer the most value. Use your aspiration for the JSNA process to guide your choice of products and services, not the other way around. In 2026, the Neighbourhood Health Framework creates new product requirements: neighbourhood-level evidence, whole life course outcome measure baselines, and frailty and Core20PLUS5 profiles are no longer optional.
Key issues to debate:
- What products will best meet our intentions for JSNA and satisfy the requirements of the Neighbourhood Health Framework?
- Is our JSNA there to simply facilitate access to quality data or is it also to provide intelligence and drive priority-setting?
- How will we produce neighbourhood-level products at the footprints agreed with the ICB?
- How responsive will our JSNA be to the needs of audiences, including integrated neighbourhood team leads and VCSE partners, as and when they arise?
| Thinking in more detail | Note your thoughts here |
|---|---|
| Question: How sophisticated and diverse should our range of JSNA products and commentary be? Experience shows that accessible, quality data is useful to a point but is unlikely to challenge commissioning and decision-making alone. What do the new audiences of 2026, including neighbourhood team leads and VCSE partners, really want to know? | |
| Question: Will JSNA provide bespoke analysis or datasets at different geographies, including neighbourhood footprints? The Neighbourhood Health Framework requires HWBs to set the geography for neighbourhood health delivery. Your JSNA must be able to provide intelligence at those footprints. | |
| Question: Will JSNA provide the frailty, Core20PLUS5 and whole life course evidence that the Neighbourhood Health Framework requires? ICBs must reduce non-elective admissions and bed days for people with frailty by 10per cent by March 2029. The JSNA should provide the population baseline. | |
| Question: Are reports the most useful JSNA products? JSNA users may want to speak to someone, or be able to request bespoke JSNA intelligence. This can be very powerful as the glue that binds JSNA into everyday working decisions. |
| JSNA products for 2026: which products have others found valuable? | Crucial, helpful, or not a priority? |
|---|---|
| Accessible data portal: a shared online intelligence resource spanning health and wellbeing data at ICB, local authority, and neighbourhood footprint level. OHID Fingertips provides a national foundation; local portals add the granularity that national tools cannot. | |
| Neighbourhood-level profiles: analytical summaries at the footprint level agreed with the ICB under the Neighbourhood Health Framework. Includes deprivation, frailty, Core20PLUS5 populations, vaccination coverage, service access, and community asset mapping. | |
| Frailty and care demand projections: population-level frailty profiling, care home demand, housebound patient estimates. The Neighbourhood Health Framework sets a target to reduce non-elective admissions for people with frailty by 10% by March 2029. The JSNA should provide the baseline. | |
| Whole life course outcome measure baselines: HWBs are required to establish whole life course outcome measures for 2027/28. The JSNA should provide the baseline data across children's, adult, older people, and public health domains. | |
| Deep-dive needs assessments for specific topics: focused intelligence on particular conditions, population groups or inequalities. These remain essential for commissioning decisions and should be produced in response to JSNA priority-setting. | |
| Community asset mapping: identification of VCSE capacity, community infrastructure, informal support networks. Essential for neighbourhood health plan development and increasingly required by ICBs as they build INT models. | |
| JSNA support across all early commissioning: bespoke analysis, advice and support for individual commissioning strategies. The glue that binds JSNA into everyday working decisions. | |
| Public-facing summaries: accessible summaries of key health challenges for residents, covering local priorities, what services exist, and how the public can shape decisions. Required for neighbourhood health plan community engagement. |
Quality theme 6: Secure the capacity, skills, data and knowledge needed
Key message: The data, knowledge and skills required for quality JSNAs will be found across the system. In 2026, ICB analytical capacity has reduced significantly following the 50 per cent running cost cuts. The councils with strong JSNA analytical infrastructure are better placed to fill the intelligence gap and have genuine system influence. Review and agree which capacities are critical for your JSNA.
Key issues to debate
- Where is data on health and wellbeing found? What is needed from outside of health, social care, public health and children's services, including schools, planning, economic regeneration, housing, the voluntary and private sector?
- Has the ICB maintained analytical capacity following restructuring? What data flows and intelligence-sharing arrangements have been disrupted and need to be rebuilt?
- Are existing JSNA analytical skills sufficient for the 2026 requirements, including neighbourhood-level analysis, frailty profiling, and Core20PLUS5 population estimation?
- What is the capacity of wider partners, particularly the VCSE sector, to participate in the JSNA process?
| Thinking in more detail | Note your thoughts here |
|---|---|
| Question: How will our JSNA locate and manage increasingly diverse data? How will JSNA link with analysis and data contained within individual commissioning strategies? Data from wider sources will be invaluable but clear frameworks to manage the flow of information are needed. How will you access population health management data from the ICB now that analytical teams have been restructured? | |
| Question: Where is the capacity we need for our JSNA process? Ambitious JSNAs require people, time and skills. ICB analytical capacity has reduced. Could JSNA be mainstreamed into existing reporting, planning and commissioning arrangements? What can be done to enable wider partners, particularly the voluntary sector, to invest in JSNA? | |
| Question: What new skills do we need for 2026? In addition to the traditional JSNA skill set of epidemiology, statistics and community engagement, the 2026 context requires: neighbourhood-level geographic analysis, frailty stratification, population health management modelling, and the ability to connect JSNA findings to ICB commissioning cycle requirements. | |
| Question: How will we ensure data-sharing agreements are in place with the new ICB? New ICBs are new legal entities with new data controllers. Existing data-sharing agreements need to be reviewed and, in many cases, renegotiated. This is a legal and governance requirement, not just a practical one. |
Good practice template: Dedicated time and resources to analyse and produce the JSNA and to manage the whole process as a core programme of work across the local authority and NHS. Additional skills and capacity identified across public services and the VCSE sector and brought in where needed. Data-sharing agreements reviewed and updated following ICB restructuring. JSNA gathers qualitative and quantitative data from a wide range of partners.
Advantages:
- High confidence in quality of JSNA commentary across all sectors.
- Designated JSNA capacity fosters good working relationships and gives JSNA a high profile.
- Council analytical capacity fills the gap created by ICB cuts and creates real system influence.
Disadvantages:
- Risk that without investment in JSNA capacity, the demands created by the Neighbourhood Health Framework cannot be met.
- Rebuilding data-sharing agreements with new ICBs takes time and legal resource.
Case study: Filling the analytical gap after ICB restructuring
Following the halving of its ICB's analytical team, a metropolitan council's public health intelligence team negotiated a formal analytical partnership with the new ICB. The council's JSNA team agreed to produce population health profiles at neighbourhood footprint level, frailty stratification analysis, and Core20PLUS5 population mapping in exchange for access to ICB primary care activity data and GP risk stratification outputs. The arrangement was formalised in a data-sharing agreement, endorsed by both organisations' information governance leads, and reflected in the JSNA steering group terms of reference. The DPH described it as a shift from receiving data to co-producing intelligence.
Quality theme 7: Agree governance and consolidate your vision into a clear specification
Key message: Experience shows that good intentions for partnership working suffer at the hands of competing pressures. In 2026, this risk is heightened: ICB restructuring has disrupted established governance, new demands from the Neighbourhood Health Framework require formal connection between JSNA and NHS commissioning, and many partners are working under significant financial pressure. Bring all your discussions together and consolidate them into a clear specification of the JSNA including roles, responsibilities, and clear statements of intent.
Key issues for the Health and Wellbeing Board to debate
- Roles and responsibilities: who will need to do what, and when, to make this work? How have these changed following ICB restructuring?
- How will actions and priorities be set and recorded, and how will they connect to neighbourhood health plan development?
- How will we know if our JSNA and JHWS are working? Who will evaluate and review the process, and when?
- Has the HWB formally endorsed the JSNA as the evidence foundation for the neighbourhood health plan?
| Thinking in more detail | Note your thoughts here |
|---|---|
| Question: How formal should roles, contributions and working processes be? Who are the authors, contributors and users of JSNA? Who manages the process? Where does final editorial control lie? What constitutes meaningful involvement of the HWB members? How have ICB restructuring and ICP changes affected these roles? | |
| Question: How will JSNA influence be formalised? Informing is quite different to driving decision-making. Start from the principle that clear, agreed and binding processes will be more effective at driving real change. The Neighbourhood Health Framework creates a new formal connection between JSNA and NHS commissioning: how will your governance reflect this? | |
| Question: What governance structures are needed to connect the JSNA to the neighbourhood health plan? The Neighbourhood Health Framework requires that neighbourhood plans must show how objectives are informed by the JSNA. What governance mechanism will ensure this happens? Who is accountable for the connection? | |
| Question: How will we know if our JSNA is delivering what we want? Evaluation is essential. Agree some indicators of quality to guide the JSNA officers and authors in their work, as well as an evaluation of progress. Ask the board to state where it wants the JSNA process to be in one, three and five years time, including in relation to neighbourhood health plan outcomes. |
Good practice template: JSNA form and function is explicitly commissioned by the board following detailed and informed negotiations with partners. A clear statement of aspiration for JSNA impact is produced, both in terms of processes and outcomes, against which progress can be measured. Clear evaluation processes are established. The HWB formally endorses the JSNA as the evidence foundation for the neighbourhood health plan, and the DPH is mandated to report annually on whether JSNA evidence is changing decisions.
Advantages:
- HWB leadership of process much clearer: partners recognise the status of JSNA and adhere more closely to agreement.
- Clearer audit of decision-making for health overview and scrutiny, wider council membership, and members of the public.
- Reduced risk of partnerships disintegrating in the face of unpopular decisions.
- Creates the formal governance link between JSNA and neighbourhood health planning that the Neighbourhood Health Framework requires.
- JSNA officers able to target available resources around a clear quality framework.
Disadvantages:
- Risk that process becomes more bureaucratised and innovative ideas are harder to prioritise.
- Agreeing a specification requires significant upfront investment of partner time.
Nominal position: The board does not agree a specification for the JSNA in advance of its production or implementation. The connection between the JSNA and the neighbourhood health plan is left to officers to manage informally.
Advantages:
- Overall process is fluid and can be adapted quickly without need for in-depth review.
Disadvantages:
- Risk that JSNA team and other participants are unclear what they are aiming to achieve.
- Risk that competing pressures undermine the capacity and will of different actors to contribute to JSNA.
- The neighbourhood health plan will lack a genuine JSNA evidence base, failing the requirements of the Neighbourhood Health Framework.
- Evaluating JSNA process complicated by lack of original indicators of progress, quality, and working arrangements.
Case study: JSNA governance connecting to neighbourhood health planning
One shire county agreed a formal JSNA specification with its HWB that included an explicit clause: no neighbourhood health plan footprint would be agreed without the JSNA team first confirming that neighbourhood-level analytical profiles were available and had been shared with the relevant ICB leads and VCSE partners. The specification set out a twelve-month JSNA production cycle aligned to the ICB's commissioning calendar, a designated JSNA lead with a direct reporting line to the director of public health (DPH), and a biannual HWB quality review. The DPH annual report included a dedicated section on JSNA impact, addressing the question: where did JSNA evidence visibly change a decision this year?
Further information and resources
Key message: A range of good practice support and learning materials on key JSNA themes are available. The policy landscape has moved quickly. Always check the currency of any guidance against the most recent publications from DHSC, NHS England, OHID, and the LGA.
Glossary of terms updated for 2026
This glossary updates the original Springboard glossary to reflect the 2026 policy landscape. It is not definitive or academic, but is presented as a prompt for local JSNA discussions.
| Term | Definition |
|---|---|
| Asset-mapping | A process which identifies the capacity, skills, knowledge, connections, potential, and social capital in a community. Essential input for neighbourhood health plan development and for understanding what a community can do for itself. |
| Better Care Fund (BCF) | A pooled budget mechanism enabling integrated working between NHS and local authorities. BCF plans are expected to align with JSNA evidence and, from 2026/27, to confirm how pooled funding will support neighbourhood health. |
| Core20PLUS5 | NHS England's health inequalities improvement framework. Focuses on the most deprived 20% of the population (Core20), plus five clinical areas where action is needed. Local JSNAs should identify and profile Core20PLUS5 populations. |
| Director of Public Health (DPH) | The statutory lead for the JSNA, employed by the upper-tier local authority. The DPH has an independent reporting function and produces an annual report. In 2026, the DPH role is central to connecting JSNA evidence to neighbourhood health planning. |
| Health and Wellbeing Board (HWB) | The statutory body responsible for the JSNA and JHWS under the Health and Social Care Act 2012. Under the Neighbourhood Health Framework, HWBs are expected to co-lead neighbourhood health plan development with ICBs. |
| Integrated Care Board (ICB) | The NHS body responsible for commissioning most NHS services in a given area. From 1 April 2026, the number of ICBs reduced following mergers. ICBs are legally required to have regard to the JSNA and JHWS. |
| Integrated Neighbourhood Team (INT) | A multi-disciplinary team delivering neighbourhood health services across a defined neighbourhood footprint. INTs bring together primary care, community health, social care, and VCSE partners. JSNA intelligence should inform INT planning and proactive care management. |
| Joint Health and Wellbeing Strategy (JHWS) | The HWB's strategic response to the JSNA. Must be informed by the JSNA. In 2026, the JHWS should also be the bridge to the neighbourhood health plan. |
| Neighbourhood Health Framework | Published March 2026. Sets out how ICBs and local authorities will build a neighbourhood health service. Requires neighbourhood health plans to be informed by the JSNA and agreed through the HWB. |
| Neighbourhood Health Plan | A locally owned plan, agreed through the HWB from 2027/28, setting out how neighbourhood health services will be organised and delivered. Must show how objectives are informed by the JSNA. |
| OHID / Fingertips | Office for Health Inequalities and Disparities, and its data platform (Fingertips). The primary national data resource for JSNA analysis. Replaced Public Health England in 2021. |
| Upstream investment | Investment in prevention and early intervention to reduce demand for acute services. The Neighbourhood Health Framework's three shifts are an expression of upstream investment at scale. JSNAs should provide the evidence base for upstream investment decisions. |
| VCSE sector | Voluntary, community and social enterprise organisations. Integral to neighbourhood health delivery under the 2026 Framework. VCSE partners should be involved in JSNA as providers of community intelligence, not just recipients of findings. |
| Wider determinants of health | The social, economic, and environmental factors that shape health, including housing, employment, education, transport, and green space. JSNAs must cover the wider determinants; neighbourhood health plans must address them. |