ASSESSING LOCAL HEALTH NEEDS IN PRIMARY-CARE - UNDERSTANDING AND EXPERIENCE IN 3 ENGLISH DISTRICTS

Background-Assessing the health needs of a local population has been p romoted as a key component in effective targeting of healthcare servic es and quality improvement. The understanding and experience of assess ing health needs in general practice were investigated in three Englis h districts. Aim-To identify the issues surrounding the potential for assessing health needs in primary care. Method-Postal survey of 347 ge neral practices in three health authorities. Telephone interviews with a random stratified sample of 35 general practitioners.Results-Althou gh most practices identified assessing health needs as important, it i s clear that this identification was typically based on an understandi ng of assessing needs as primarily focused on individual patient care, based on clinical priorities and involving practice held data. Most p ractices had not undertaken local consultation, whatever their underst anding of assessing health needs. The few practices which had complete d population oriented, proactive assessment of needs considered it to have led to tangible improvements in clinical or practice management. Overall, there was apparent confusion over the nature and purpose of a ssessing needs, although the principled aims and objectives of a popul ation oriented, proactive component to primary care were generally uph eld. The need for additional resources and support was identified. In four out of the five cases where specifically population based assessm ent of health needs had been undertaken, the local public health depar tment had been involved. Conclusion-The value of the concept of assess ing health needs in primary care holds considerable uncertainty and am bivalence. The findings from this study show that any attempts to prom ote assessing needs into primary care which focus either primarily or exclusively on the provision of ''education'' are unduly simplistic. M ore fundamental questions about the perceived relevance and opportunit ies for assessing health needs should be considered if primary care gr oups are to meet future commissioning challenges.