This is a systematic approach to assessing a population for its healthcare needs which has evolved in its use since the 1990s. Initially its use involved identifying services that were considered to be cost-effective and would meet a population’s health needs. The move towards a primary care led NHS has meant that within England, Primary Care Trusts (PCTs) now take on this role of assessment.
The common approaches used to assess population healthcare needs are described as corporate, comparative and epidemiological approaches to HNA.
Using the corporate approach to HNA, the knowledge and views of stakeholders are gathered in a systematic manner. Stakeholders may include clinicians working in either primary or secondary care, health service managers, commissioners of services, experts in the field of practice and service users. The benefit of this approach is that it can be responsive to local concerns and encourages ownership of the issues that need to be addressed. The disadvantage is that if it is carried out in isolation it can focus on the stakeholders concerns, which may be influenced by political agendas, and can identify demands rather than need.
The comparative approach uses a comparison between different localities of the levels of service provision provided. The comparison can be between countries or at a more local level comparing service provision between two towns of similar profile. It is a fairly quick and inexpensive approach but it can be difficult to achieve an accurate comparison.
There are three elements to the epidemiological approach to HNA in that it:
- determines the incidence and/or prevalence of the health problem
- identifies the effectiveness and cost-effectiveness of current interventions for the problem
- identifies the current level of service provision.
It has been described as an evidence-based approach to HNA but whilst it is systematic and objective there is often lack of local epidemiological data to use along with lack of evidence for certain interventions.