The Role of Health Care Needs Assessment

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The Role of Health Care Needs Assessment

• Dr. Siân Griffiths
• Specialist Registrar in Public Health

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• An Assessment of Need for Cancer Services for
  Children and Young People in England and Wales
• August 2005
• Dr. Siân Griffiths, Prof. David Fone
• and Dr. Quentin Sandifer

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Summary of presentation

• Theory of health care needs assessment
• How the method was used in the development of
  guidance for cancer services for children and
  young people
• Reflection on the contribution it made to the
  production of this service guidance and on the
  key features of the process

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Health Care Needs Assessment (HCNA)

• Systematic method of identifying unmet health
  care need
• Need defined as the populations ability to
  benefit from health care
• Approaches to HCNA
• Epidemiological
• Comparative
• Corporate
• Source A. Stevens, J. Raftery, J. Mant

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The epidemiological approach to HCNA

• Triangulation
• Prevalence and Incidence
• Services available (and their costs)
• Effectiveness and cost-effectiveness of services
• Source A. Stevens, J. Raftery, J. Mant

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Guidance Scope

• (a) children (from birth) and young people in
  their teens and early twenties presenting with
  malignant disease, including leukaemia and
  related conditions as defined by the
  International Classification of Childhood Cancer
  (ICCC)
• (b) benign tumours or conditions that require
  complex treatment pathways, potentially including
  chemotherapy and radiotherapy
• Source National Collaborating Centre
  for Cancer

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Purpose of Needs Assessment

• To inform the development of service guidance by
  providing a description of the burden of disease
  and current service provision for children and
  young people with cancer

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Process

• Set up project team
• Agreed data requirements and parameters
• Identified key contacts
• Identified need for a survey of the 17 UKCCSG and
  8 TCT centres and convened a multidisciplinary
  team to advise on its content
• Regular communication with Guidance Development
  Group

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Data sources

• National Register of Childhood Tumours
• National Cancer Intelligence Centre, Office of
  National Statistics
• Population data from Office of National
  Statistics
• Hospital Episode Statistics (England)/ Patient
  Episode Database Wales

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Specific issues

• Data availability for 15-24 year olds
• ICCC classification vs International
  Classification of Disease version 10 (ICD-10)
• Benign conditions
• Quality of clinical coding

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Survey

• 17 UKCCSG Centres plus 8 TCT Units
• Case load
• Staffing
• Clinical services
• Allied Health Services
• Palliative Care
• Shared Care
• Additional issues

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The contribution of HCNA

• At the beginning of the process of developing
  service guidance it provided
• Detailed description of the burden of disease
• Trends in health services utilisation
• Outline of current service provision
• Identification of data issues of relevance for
  future service evaluation

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Summary of key features

• First needs assessment of its type
• Comprehensive and contemporary description of the
  burden of disease and service response
• Required mixture of expertise
• Consultation with stakeholders essential
• Timescales challenging
• Process needs to be managed
• Resources

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Acknowledgements

• Dr. Brian Cottier, Head of Cancer Service
  Analysis for the Department of Health
• Mr. Simon Davies, Chief Executive Officer,
  Teenage Cancer Trust
• Dr. Brenda Gibson, Consultant Paediatric
  Haematologist
• Dr. Ann Goldman, Consultant in Paediatric
  Palliative Care
• Leanne Harry
• Dr. Richard Hain, Senior Lecturer in Paediatric
  Palliative Medicine
• Miss Rachel Hollis, Senior Sister, Paediatric
  Adolescent Oncology Haematology
• Dr. Meriel Jenney, GDG Lead Clinician, Consultant
  Paediatric Oncologist
• Nathan Lester
• Pat Linck, University of Wales, Bangor
• Dr. Fergus Macbeth, National Collaborating Centre
  for Cancer
• Dr. Mike Quinn, Director of the National Cancer
  Intelligence Centre at the Office of National
  Statistics
• Dr. Cerilan Rogers, GDG Chair, Director, National
  Public Health Service for Wales
• Louise Soanes, Senior Sister for Childrens
  Services
• Professor Mike Stevens, Professor of Paediatric
  Oncology
• Mr. Charles Stiller, Director of the National
  Registry of Childhood Tumours
• Dr. John Steward, Director of the Welsh Cancer
  Intelligence Service for Wales
• Dr. Rhiannon Tudor-Edwards, University of Wales,
  Bangor
• Mrs. Janet Vickers, Macmillan Paediatric Oncology
  Outreach Nurse Specialist