Joint Strategic Needs Assessment for Bermuda

Mr Speaker, and Honourable Members, last month I set out the steps the Government of Bermuda is taking to deliver on its promise to implement universal health coverage for all residents. In particular, the work currently occurring to deliver three priority projects to build the foundations of our vision, namely:

  1. The National Digital Health Strategy
  2. Merging Government Insurance Funds
  3. Agreeing Our Starting Points

Mr Speaker, I am pleased to update you today on the progress we are making on the "Agree Our Starting Points" project through the development of the Joint Strategic Needs Assessment by the Ministry of Health and partners across the government, the health sector and the community.

Mr Speaker, Honourable Members will also recall that last month I explained the sheer complexity involved in our journey towards universal health coverage and improved population health outcomes. We have a high level roadmap to achieve this, but we must firstly know our current starting point. In order to manage, given the island’s financial constraints, we need to understand what our priority health needs are, including both physical and mental health. It is only through understanding these needs that we can align our efforts to improve the health of the people of Bermuda. The Joint Strategic Needs Assessment aims to achieve this.


Mr Speaker, at the beginning of this month and as previously reported, the Chief Medical Officer launched the process of developing Bermuda's Joint Strategic Needs Assessment at an event hosted by the Bermuda Health Council.




The event brought together professionals from health and social care with representatives from the government, the private sector, non- profit sector and patient groups to start the process of developing a systematic, data-driven and evidence-informed understanding of our population's health needs.

Mr Speaker, the Joint Strategic Needs Assessment uses an established methodology to assess the current and future health and social care needs of our local community to inform local decision-making. The Joint Strategic Needs Assessment builds upon previous work to understand better the needs of our population, such as the 2016 Census and 2017 Health in Review report. However, this is the first assessment to systematically capture all the relevant information to give a complete picture of our health.

Mr Speaker, I want to emphasise the Joint nature of the Joint Strategic Needs Assessment. We aim for the process to be locally owned and collaborative, involving all relevant stakeholders and produced openly and transparently.

The Ministry will, of course, provide the personnel with the technical expertise to coordinate the production of the report. But I believe that the Joint Strategic Needs Assessment will be a product that reaches beyond government and can be a valuable tool for the private and non- profit sectors as well.

Mr Speaker, many Honourable Members will be aware that it is not just medical care that influences our health. Social and economic conditions, including our work, housing, education and local community networks, are important factors that define our health. These factors are known by public health professionals as the social determinants of health. The Joint Strategic Needs Assessment will investigate the social determinants of health in the context of Bermuda and make recommendations that go beyond the healthcare sector.

This presents an opportunity for the whole of government and civil society to use the Joint Strategic Needs Assessment to develop actions to protect and promote health using the concept of the social determinants of health, whether in the classroom, the workplace or the local environment.

I urge all Honourable Members to read the final Joint Strategic Needs Assessment report and consider ways they can contribute to improving health and reducing health inequalities in their local communities.

Mr Speaker, the Joint Strategic Needs Assessment will be vital in determining our baseline population health needs in order to establish the necessary metrics to monitor the impact of the introduction of universal health coverage on population health outcomes. The Joint Strategic Needs Assessment will do this through the consideration of the following areas:

  1. Bermuda’s population profile and the social determinants of health,
  2. health behaviour and risk factors,
  3. causes of ill-health and death,
  4. vulnerable groups (including children, the elderly and people with disabilities), and,
  5. healthcare services.

Mr Speaker, our approach to developing the Joint Strategic Needs Assessment will be through the following process:

  1. mapping data sources,
  2. extracting data from these sources, and,
  3. analysing and interpreting these data in our local context.

This will culminate in a Joint Strategic Needs Assessment report being published by April 2023, outlining a statement of needs and making recommendations. Honourable Members may have noticed that the process relies heavily on data, but this will be supplemented by gaining insight from healthcare professionals, patients and the public on Bermuda's current state of health.

Mr Speaker, we are fortunate to have the professional expertise of the Chief Medical Officer in crafting the Joint Strategic Needs Assessment. He is chairing the Joint Strategic Needs Assessment Working Group, a skilled multi-disciplinary team charged with the production, publication and presentation of the Joint Strategic Needs Assessment.

The working group’s members include representatives from the Ministry of Health, public health professionals, epidemiologists, health promotion professionals and, also, representatives from the Bermuda Health Council.

This working group is supported by the Epidemiology and Surveillance Unit, joined by a Public Health Registrar seconded from the UK’s Public Health Training Programme. The UK Overseas Territories Team at the Department of Health and Social Care in London will provide additional technical support. This team has a wealth of experience in supporting communities in understanding their health needs.

Mr Speaker, Honourable Members will recall my desire last month to ensure that our work towards universal health coverage remains clear, coherent and coordinated whilst discouraging siloes. The Joint Strategic Needs Assessment project will be managed in line with these principles, involving regular touchpoint meetings with strategic partners and the other universal health coverage projects to identify areas of overlap and opportunities for mutual support.

In line with this commitment and as part of the Ministry’s quarterly Q&A sessions, on Tuesday, November 15, 2022, universal health coverage stakeholders from across our health system and the wider community were updated on the progress of the Joint Strategic Needs Assessment and were able to ask detailed questions about the project's development.

Mr Speaker, the core vision at the heart of this Government’s Health Strategy is for Bermuda to provide an environment for “healthy people in healthy communities". The Strategy is based on eight strategic principles, of which "understanding our population's health needs” is an important one. The Joint Strategic Needs Assessment will play a crucial role in understanding our population's health needs. The Joint Strategic Needs Assessment takes a pragmatic approach in emphasizing our communities' assets as well as our needs. We need to accurately know our start state, including gaps in our knowledge, to inform our future.

In fact, understanding gaps in our knowledge will help us refine the development of the National Digital Health Strategy and identify future data collection and health surveillance requirements to refine the metrics required for measuring future progress.

Mr Speaker, this is an exciting moment as we build momentum towards fulfilling the Government of Bermuda's commitment to implementing universal health coverage whilst seeking to improve Bermuda’s population health outcomes and reduce health inequalities.

We can only make progress if we have an accurate understanding of our start state. The Joint Strategic Needs Assessment will provide the data-driven and evidence-informed information to gain this understanding. I want to thank all those contributing to the development of the Joint Strategic Needs Assessment, particularly those outside government in the community, health sector and voluntary sectors.

I look forward to seeing the result of their hard work. Thank you, Mr Speaker.