Intended for healthcare professionals

Education And Debate Health needs assessment

Development and importance of health needs assessment

BMJ 1998; 316 doi: (Published 25 April 1998) Cite this as: BMJ 1998;316:1310
  1. John Wright (, consultant in epidemiology and public health medicinea,
  2. Rhys Williams, professor of epidemiology and public healthb,
  3. John R Wilkinson, deputy director of public healthc
  1. a Bradford Hospitals NHS Trust, Bradford Royal Infirmary, Bradford BD9 6RJ
  2. b Nuffield Institute for Health, Leeds LS2 9PL
  3. c North Yorkshire Health Authority, York YO1 1PE
  1. Correspondence to: Dr Wright

    Most doctors are used to assessing the health needs of their individual patients. Through professional training and clinical experience we have developed a systematic approach to this assessment and we use it before we start a treatment that we believe to be effective. Such a systematic approach has often been missing when it comes to assessing the health needs of a local or practice population.

    The health needs of individual patients coming through the consulting room door may not reflect the wider health needs of the community. If people have a health problem that they believe cannot be helped by the health service, then they will not attend. For example, many people with angina or multiple sclerosis are not known to either their local general practitioner or to a hospital specialist. 1 2 Other groups of patients who may need health care but do not demand it include homeless people and people with chronic mental illness.

    Distinguishing between individual needs and the wider needs of the community is important in the planning and provision of local health services. If these needs are ignored then there is a danger of a top-down approach to providing health services, which relies too heavily on what a few people perceive to be the needs of the population rather than what they actually are.

    Summary points

    Health needs assessment is the systematic approach to ensuring that the health service uses its resources to improve the health of the population in the most efficient way

    It involves epidemiological, qualitative, and comparative methods to describe health problems of a population; identify inequalities in health and access to services; and determine priorities for the most effective use of resources

    Health needs are those that can benefit from health care or from wider social and environmental changes

    Successful health needs assessments …

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