1 Health Needs Assessment Workshop Sue Cavanagh Keith Chadwick

2 Workshop aims 1.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  Supporting regional HNA workshops, learning sets and networks

6 How does HNA support National Targets The Government’s 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 4Action 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 Factors biological personal behaviours social & community networks living & working conditions socio-economic, cultural and environmental conditions Diseases / Conditions Levels of prevention occurring recurring consequences Health Functioning

19 Group Activity Step 1: Getting started 1.Select a population 2.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?