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Planning and Evaluating PH interventions (MPH) > Health Needs Assessment (HNA) > Flashcards

Health Needs Assessment (HNA) Flashcards

1
Q

What is a need? Who defines needs?

A

Need = gap between ideal and real conditions

Who defines need?

  • individual
  • family
  • community
  • professionals
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2
Q

Draw out the hierachy of need (Maslow, 1954)

A
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3
Q

What is the need, supply and demand for health?

A

Need = ability to benefit from an intervention

Demand = what people ask for

Supply = what is provided

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4
Q

What are the 4 types of needs?

A
  • Expressed* = equates to want - what people say they want or what they think are the problems that need addressing
  • Felt* = equates to demand - the health needs of a population by observation of use of their services
  • Normative* = what expert opinion define as need & covers a great deal of health planning
  • Comparative* = gap between recipient & other groups - need derived from examining the services in one area & using this as a basis to determine the services needed in other populations
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5
Q

How does “health need” differ to “health care need”?

A

Health need

  • need for health
  • much more generic
    e. g. measured using socio-demographic measures, morbidity, mortality

Healthcare need

  • need for healthcare
  • much more specific
  • depends on the potential of prevention, treatment & care services to remedy health problems
  • NOTE:* In practice HNA is used to cover both health needs and healthcare needs assessments
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6
Q

For the purposes of HNA what is need assumed to be?

A

Need is assumed to exist when there is an effective and acceptable intervention, or the potential of health gain

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7
Q

What type of factors can influence the ability to benefit from healthcare?

A

Epidemiology of the disease

Effectiveness of interventions

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8
Q

Define HNA

A

A systematic method for reviewing the health issues facing a population, leading to agreed priorities and resource allocation that will improve health and reduce inequalites

(NICE 2005)

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9
Q

Compare “health inequality” vs “health inequity”

A

Health inequalities : differences between individuals or groups due to biological, social, geographical and other factors.

Some difference, e.g. due to genetics, may be fixed

Others causes by social of geographical factors - known as health inequities - can be avoided/mitigated

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10
Q

TRUE OR FALSE

A health service that is provided may not always be effective or needed by the population

A

TRUE

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11
Q

What are the 3 approaches to a HNA?

A

Epidemiological

Corporate

Comparative

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12
Q

Describe the epidemiological approach to a HNA?

A

Considers

  • epidemiology of the population (e.g. morbidity, incidence/prevalence, mortality)
  • current service provision and use (e.g. prevention, treatment, care)
  • effectiveness & cost-effectiveness of interventions
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13
Q

What kind of data would you consider in an epidemiological approach?

A

Depends on the focus of your work - health care, social care, education e.t.c

  • census
  • surveys
  • registrations of life events (e.g. births/deaths)
  • disease registries
  • communicable diseases notifications
  • primary care & hospital activity data
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14
Q

What are the drawbacks of the epidemiological approach?

A
  • does not consider the felt need of the people affected
  • data may not be available/be of poor quality (CART - how Complete, Accurate, Relevant & Timely? are the data)
  • evidence-base may be inadequate
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15
Q

Describe the corporate approach of a HNA

A

Takes into account the views of stakeholders

HNAs can be an excellent opportunity to involve stakeholders in the service planning & increase ownership & sustainability

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16
Q

List possible stakeholders in a HNA

A
  • politicians
  • opinion leaders
  • commissioners
  • providers
  • professionals
  • patients/service users
  • press
  • local authorities
17
Q

What are the disadvantages of a corporate approach?

A
  • may be difficult to distinguish need from demand
  • groups may have vested interests
  • may be influenced by political agendas/dominant personalities
18
Q

Describe the comparative approach of a HNA

A

Compares different populations (or subgroups)

  • spatial
  • social (e.g. age, gender, class, ethnicity)

May examine

  • health status / outcomes (e.g. morbidity, mortality, QoL, patient satisfaction)
  • service provision / utilisation

Variations in these may be influenced by a number of factors and not just differing needs

19
Q

What are the disadvantages of a comparative approach?

A
  • may be difficult to find a comparable population
  • data may not be available / may be of poor quality
20
Q

What are the key steps in a HNA?

A

Step 1 : Getting started

Step 2 : Identify health priorities

Step 3 : Identify priorities for change

Step 4 & 5 : implement the changes and develop a monitoring & evaluation stategy & measure the impact of these changes

21
Q

What are the potential stumbling blocks in a HNA?

A
  • language - not having a shared understanding of words & ideas
  • believing we know all the priorities and see HNA as pointless
  • over-emphasis on either local politics & community views or professionally defined needs
22
Q

What are the benefits of a HNA?

A
  • better understanding of the population
  • improved care & better use of resources
  • meaningful patient/community involvement in decision making
  • development of relationships and skills
23
Q

What are the drawbacks of a HNA?

A
  • commitment is needed at a senior level
  • data & information
  • accessing the population of interest
  • skills
  • cross-organisational working
24
Q

What is a Joint Strategic Needs Assessment (JSNA)?

A

Assessments of the current and future health and social care needs of the local community

These are needs that could be met by the local authority or by the NHS

It is unique to each area and produced by the Health & Wellbeing Board

25
Q

What is a Health & Wellbeing board? Who must they include?

A

It brings leaders together from across health and care to improve the health of the population.

These were established following the 2012 Health & Social Care Act

They need to include:

  • at least 1 councillor from the relevant council
  • the director of adult social services
  • the director of children’s services
  • the director of public health
  • a representative of the local Healthwatch organisation
  • a representative of each relevant Clinical Commissioning group (CCG)
  • any other members considered appropriate by the council
26
Q

What does the JSNA include?

A
  • gives a view of the health of the population
  • details current service provision
  • identifies gaps in services
  • identifies health inequalities
  • looks at the wider determinant of health
  • includes evidence of what works

example of a JSNA : https://www.nottinghaminsight.org.uk/themes/health-and-wellbeing/joint-strategic-needs-assessment/

27
Q

Desribe step 1 (Getting started) of a HNA?

A

who (e.g. population, stakeholders)?

where (e.g. geographical location, setting (e.g. hospital, prison, school, workplace))?

illness or social experience (e.g. homeless, asylum seekers)

what resources are available?

28
Q

Desribe step 2 (Identify health priorities) of a HNA?

A
  • qualitative & quantitative data to describe the population of interest and give a detailed picture of health needs
  • data on similar localities to allow comparisons of health needs
  • review of current level of service provision/utilisation, which may include information of infrastructure & workforce/skills
  • assess evidence of effectiveness (clinical & cost) of interventions
29
Q

Desribe step 3 (Identify priorities for change) of a HNA?

A
  • many needs but scarce resources
  • prioritising some health care interventions over others & some individuals over others are difficults choices faced by most healthcare systems
  • identify which of the issues identified are most important, leading to priorities for action
  • priorities may be decided on the basis of : 1. no. of people affected by the problem (size), its impact in terms of severity (morbidity & mortality) & cost 2. local commissioning priorities and partnership arrangements
30
Q

Desribe steps 4 & 5 of a HNA?

A
  • implement the changes and develop a monitoring & evaluation stategy
  • measure the impact of these changes
31
Q
A
32
Q
A

Planning and Evaluating PH interventions (MPH) (4 decks)

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