Health needs assessment
Health services have usually developed in response to a perceived need for them by either service users (i.e. the public) or providers (i.e. health professionals). Over time, populations and public expectations in different countries change; some diseases disappear, new diseases appear, and medical knowledge and technology develop; thus, prevention and treatment options also change. Services may or may not adapt to these changing patterns. As a result, existing health service provision may not be a good indicator of what healthcare is needed for a population. Health needs assessment provides a systematic way of assembling information to plan, negotiate and change health services for the better. The commissioning approach to health service planning (see Chapter 41) should be informed by health needs assessments to ensure that the population for whom services are being commissioned have their health needs more closely met. Reducing inequalities in health should also be an explicit aim of health needs assessment, care commissioning and service provision.
Health needs assessments (HNAs) are conducted to inform the development of services, so a health problem is only considered a health need if it can be addressed by an effective intervention or service provision. Such a need is described as ‘normative’ (implying that the health need should be met) as it is defined by professionals rather than patients or the general public. An identified health need may be met by prevention or treatment services, by agencies other than health services or by wider social or environmental change. Health problems may generate demand for health services – influenced by patients’ expectations of possible benefits or by health professionals’ influence on patients – but demand does not necessarily indicate need.