Intended for healthcare professionals

Education And Debate Health needs assessment

Assessment in primary care: practical issues and possible approaches

BMJ 1998; 316 doi: (Published 16 May 1998) Cite this as: BMJ 1998;316:1524
  1. John R Wilkinson, deputy director of public health (,
  2. Scott A Murray, senior lecturerb
  1. a North Yorkshire Health Authority, York YO3 4XF
  2. b Department of General Practice, University of Edinburgh, Edinburgh EH8 9DX
  1. Correspondence to: Dr Wilkinson

    This is the fourth in a series of six articles describing approaches to and topics for health needs assessment, and how the results can be used effectively. Series editor: John Wright

    This article is a practical guide to help primary care groups (as set out in the NHS white papers 1 2) and also individual practice teams assess the health needs of their respective populations before providing or commissioning services to meet these needs. Historically, much service provision has been service led rather than needs led, provided as before and at the convenience of providers rather than patients. The needs of patients are now accepted as being central to the NHS. An explicit framework is needed to help assess needs more systematically, to demystify the process, and to help prioritise and action changes.3 This paper outlines an approach that is feasible for individual practices, groups of practices, and populations of around 100 000 people (typically the size of the new primary care groups described in the white paper).

    Summary points

    • A practical strategy for assessing local health needs is required

    • This approach uses practice held data, routinely available local statistics, a patient/public consultation exercise, and (possibly) a postal survey to gain various perspectives on need

    • Unless specific, useful summary data are obtained, details will obscure the larger picture

    • Stages in this strategy are to collate the information, assess priorities, and plan and evaluate changes

    • Time and resources must be available at practice and locality level, but many important health needs cannot be met by health services alone

    Do we get involved with wider health needs or just health service needs?

    Health professionals understandably tend to think of health needs in terms of services they can provide. Patients may have different ideas about what affects their health. This might include getting a job, having a roof over their head, or having a bus route which …

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