Experiences with “rapid appraisal” in primary care: involving the public in assessing health needs, orientating staff, and educating medical students

The incorporation of lay perspectives in research and development in the health service is not only politically mandated in recent white and green papers but also has the potential to improve the relevance and impact of research and the quality of subsequent services.1 There are many ways of identifying lay views and incorporating these into decisions, but the methods used to achieve this need further evaluation. Traditional methods to encourage public participation—such as public meetings, patient participation groups, and complaints procedures—have met with limited success.2

During the past decade the technique named “rapid appraisal” has begun to make important contributions in the assessment of local needs and planning in the developed and developing countries (see box on p441). Its use in the United Kingdom has been guided by the work of Chambers,3 Annett and Rifkin,4 and Ong,5 and Manderson and Aaby have described an “epidemic increase” in the use of this method.6 Rapid appraisal has now been used by community workers and primary healthcare teams to gain public involvement in the assessment of needs from the Isle of Skye to inner city London and from Belfast to Norway. Initially used for assessment of global needs it has also been used with specific groups of patients and to gain broad perspectives on accident and emergency services.7