Primary Care based assessments are usually targeted at one of three levels:
|Generic or Population: This examines the overall
health needs of either the whole practice population or a community served by the practice.
|Client Group specific: Used to examine the health needs of a specific group within the practice population.|
|Disease or intervention specific: Used to examine how well the needs of patients in a specific disease area are being met, either from the patients perspective or in terms of clinical effectiveness.|
However, these levels are not mutually exclusive. You may decide to begin with a broad assessment at community or practice population level and then move on to examine the needs of a specific client group in more detail. Alternatively an assessment which focuses on a specific intervention or disease area such as stroke, may raise wider questions.
In deciding which approach would suit your needs best it is helpful to consider the following:
- What interests and knowledge can be built upon?
- What previous work can be used?
- What is your reason for undertaking the needs assessment?
- What time and resources do you have available?
HNA should never be a solitary activity. Working in a small team with colleagues from different professions or even different organisations will almost certainly result in your HNA being more comprehensive and more relevant, and it will enable the workload to be shared.
The size and composition of your team will vary according to the size of your population and the type of HNA you are undertaking. There are no hard and fast rules, but teams of 3 to 6, including at least one GP, a nurse, a manager or information manager and a member of your administration or reception team often works well.
If you are thinking about a community based HNA you might want to involve a colleague from Community Services or colleagues from Social Care. If you are keen to look at a particular client group or disease area then it may be helpful to work with a practitioner knowledgeable in that area.
Whatever the size and composition of your team it is important to make sure that all the team members are keen to get involved and are committed to using the results of the assessment to improve services or practice.
Time and resources
HNAs can be time consuming, but it is a very cost-effective use of time, because it can not only produce demonstrable improvements in services to patients it can also enhance job satisfaction within the practice .
From the outset it is important to be realistic about the time and resources your team can commit to the work. If you know that most of the team can only give one or two hours each week to the assessment, it may be better to begin by focusing on one disease area or client group, or accept that it will take six months not three.
If the HNA is being undertaken as part of a wider project, it may be possible to set aside more time. Either way, it is helpful if you can create some protected time. It can also be helpful to set aside a small budget to purchase a few key books or papers or perhaps to cover the cost of a postal survey.
When thinking about the information you need, there are a few
important points to remember:
- Keep in mind why you are undertaking the HNA and how you hope to use the results. There is no point in collecting information simply because it is available or it might be generally interesting.
- Although it is the quality not the quantity of information that is important you may want to consider obtaining data on the same issue from different sources so that you can validate or cross check it.
- You may also want to think about the balance between quantitative information, for example how many patients were referred to the Community Mental Health Team in the last year or how many consultations there are each week for low back pain, and qualitative information, for example what do local people feel are the most pressing health issues in the community or how well do younger disabled people feel their needs are being met.
- Ensure that the information will actually tell you something about needs and is not misleading. For example, information about utilisation rates may tell you more about the availability of a service than the need for it.
How to collect the information
It is likely that much of the data you are interested in already exists but getting hold of it in a usable form may not always be easy.
There are three important sources of data for HNA:
- Practice and CCG based data;
- Routinely available local and national statistics which may be found on the internet e.g. NHS Information Centre, Health Observatory, Office for National Statistics etc.
- Information collected especially for the HNA e.g. via a survey
The information from a survey can be collected via a number of different methods. Click on the links below for more information:
For guidance on how to decide which survey method is best for you, and how to prepare your survey, click here.
If you need to collect data specifically for the HNA, then it is important to consider the most appropriate and practical approach to getting that information given the time and resources available to you. If a particular piece of information is likely to be difficult or time consuming to collect or extract, you may have to consider using a proxy or applying national estimates.