Health needs assessment and needs-led health service change: a survey of projects involving public health doctors

摘要

Objectives: To describe the criteria that de. ne an effective health needs assessment and to explore which factorsnare important for the delivery of effective health needs assessment in the English National Health Service (NHS).nMethods: A postal questionnaire to all public health doctors in an English health region to describe health needsnassessment activity, including initiating factors, methods and outcomes. This was followed by semi-structuredninterviews with public health professionals and others involved in 10 purposively selected needs assessments.nResults: A response rate of 62% identi. ed a total of 102 health needs assessments undertaken between 1993 andn1998. A number of themes emerged as being important in the impact of health needs assessments on policy andnplanning. These included careful design, methodological rigour, decisive leadership, good communication,ninvolvement and ownership of the work from relevant stakeholders, support from senior decision-makers,nappreciation of the political dynamics and engagement with local priorities, availability of resources and, . nally, annelement of chance. These themes can be categorised broadly into contextual factors and quality or robustness of thenwork. Our . ndings suggest that, although methodological and analytical quality are necessary characteristics ofneffective health needs assessment, they are not suf. cient without a favourable political environment.nConclusion: There appear to be conditions under which needs assessment is more likely to be effective in terms ofnits in uence on policy and planning However, it is clear that needs assessment does not occupy a central position innhealth service decision-making, remaining vulnerable to a range of factors over which those responsible for itsnconduct have little or no control.