Health Needs Assessment Workshop

1
Health Needs Assessment Workshop

• Sue Cavanagh
• Keith Chadwick

2
Workshop aims
 

• To demonstrate the contribution that Health Needs
  Assessment can make to meeting national
  inequality targets, to addressing local
  priorities and to professional development
• 2. To provide participants with a clear
  understanding of the health needs assessment
  process
• 3. To provide the opportunity to consider the
  practical application of HNA for different types
  of populations

3
Workshop structure

• Part 1 Introduction
• Part 2 The HNA 5 step process
• Discussion
• Part 3 Case study presentation
• Part 4 Group activity

4
Introduction

• Health Needs Assessment is a systematic review of
  the health issues facing a population, leading to
  agreed priorities and resource allocation that
  will improve health and reduce inequalities.

5
Why is the HDA involved

• The HDA considers that the systematic process
  used by HNA provides ideal opportunities to
  reduce inequalities by gathering evidence from
  and about specific populations and for utilising
  an evidence based approach to affect service
  changes and improvements.
• The HDA supports HNA by
• Providing written guidance
• Providing a web site www.healthaction.nhs.uk
• Supporting regional HNA workshops, learning sets
  and networks

6
How does HNA support National Targets

• The Governments aim is to reduce health
  inequalities strategy by tackling the wider
  determinants of health, such as poverty, poor
  educational outcomes, worklessness, poor housing
  and the problems of disadvantaged neighbourhoods.
  This approach is supported by a national public
  service agreement (PSA)
• by 2010 to reduce inequalities in health outcomes
  by 10 as measured by infant mortality and life
  expectancy at birth.
• Tackling Health Inequalities A Programme for
  Action DH p7.
• HNA provides a vital tool by being able to target
  populations
• in most need of improved
• support and services.

7
HNA is compulsory

• HNA has been linked to health commissioning since
  1989, and in 2001Shifting the Balance gave
  specific responsibility for conducting HNAs to
  Primary Care Trusts.
• HNAs are recommended in various policy documents
  to inform
• Local Delivery Plans
• Community Strategies
• Specialised services commissioning
• Health and social care joint commissioning
• General Practice Strategic Development Plans

8
Benefits

•      strengthened community involvement in
  decision-
• making
•       improved team and partnership working
•        development of professional skills and
  experience.
•        improved communication with other
  agencies and
• the public
•        better targeted services and use of
  resources

9
Links to other assessment tools

• Health Impact Assessment (HIA)
• Integrated Impact Assessment (IIA)
• Health Equity Audit (HEqA)
• Population
  Policy/ Project/ Programme
• HNA
  HIA
• HEqA
  IIA
• 
  

10
The Five Steps of Health Needs Assessment

• Aim
• A systematic process focussed on a target
  population that
• sets priorities for improving health and tackling
  local health
• inequalities then plans effective change
• Result
• clear priorities for action
• implementation of effective local action plans

11
Target population

•  
• The four main population types
• 1.     Geographic at different levels eg
  regional/PCT/neighbourhood wide
• 2.     Settings for example schools, workplaces,
  prisons, hospitals.
• 3.     Shared social experience homelessness,
  refugee, ethnicity, culture,
• age, sexuality.
• 4.     Specific health experience diseases,
  mental health, disabilities. 
• Example older people living in a deprived
  neighbourhood
• Ensure you have
•         Clearly defined the population.
•         Clarity around sub groups
• Checked they match with National/local priorities
  on reducing health inequalities?

12
Setting Priorities

• Criteria For Setting Priorities
• Impact
• Which conditions / factors have the most
  significant impact on local health?
•   Severity
• Size
• Changeability
• What can effectively be done about the
  significant diseases / factors by those
  involved?

13
Setting Priorities

• Acceptability
• What are the most acceptable changes required
  for the maximum positive impact?
• Resource feasibility
• Are the resource implications of the proposed
  actions feasible?

14
Setting Priorities Sources of needs information

• data about population characteristics and the
  severity and size of the health issues i.e. who,
  when,where and what
• perceptions of the profiled population
• perceptions of people providing the services
• perceptions of managers of commissioning /
  provider organisations
• relevant national, local or regional priorities

15

• The 5 steps
• Step 1 Getting started
• who are the population to be assessed?
• why are we doing this assessment?
• who should be involved, when and how?
• what skills are required?
• Step 2 Identifying health priorities of the
  population
• what diseases or factors have a significant
  impact?
• which of these are changeable?
• who are most at risk from these?

16

• The 5 steps
• Step 3 Choosing priorities for change
• what significant diseases, conditions or
  factors affect this priority?
• what can be done to improve this priority?
• what are the acceptable, feasible changes?
• what resources are required?
• who will gain from these changes?
• Step 4 Action planning
• what are we aiming to do?
• who is going to do it?
• when is it going to be done?
• how are we going to monitor and evaluate the
  programme?
• what is our implementation and dissemination
  plan?
• what is our risk assessment strategy?

17
The 5 steps

• Step 5 Moving on
• what learning has emerged from the project?
• what needs to be done now/next?
• Selection of next population/priority revisit
  step 1

18
Health triangle

• Health Functioning

Health Functioning

• Levels of prevention
• occurring
• recurring
• consequences

Diseases / Conditions

• Factors
• biological
• personal behaviours
• social community networks
• living working conditions
• socio-economic, cultural and environmental
  conditions

19
Group Activity Step 1 Getting started

• Select a population
• How does this population relate to
  national,regional and local priorities?
• 3. What would you hope the HNA to achieve (aims
  and objectives)
• 4. Who would you want to be involved in the
  project (team, stakeholders, senior /policy
  mangers, skills)
• 5. What resources would you require?
• 6. What data might be available about this
  population and from where?
• 7. What challenges/ difficulties might you
  encounter setting up this project?
• 8. How would you overcome these
• problems?