Appendix H – Checklist: JSNA Health Needs Assessment Toolkit
(Adapted from: Lancashire JSNA health needs assessment toolkit (Intelligence toolkits – Lancashire County Council)
“The most important thing to consider before undertaking a needs assessment is whether it can and will lead to any action. There is no point spending time investigating the needs of the population if action cannot be taken due to existing policies, legislation or lack of resources for example”. (Reference: Intelligence toolkits – Lancashire County Council),
Expanded checklist
(Estimated timeline to complete is six weeks to six months dependant on ease of finding information and data)
There is no specific guidance about what should be included in a JSNA which is a matter for local determination. The following checklist proposes a structure to support you it is not a prescribed order. The items listed are suggestions for consideration, not all will be relevant.
1. Before Starting
a. Is anyone else doing anything similar in your area?
- If so, is there an option to link in with them?
- If so, is there potential for collaboration?
- Is there potential to share workload / results?
b. Will there be benefits and changes to health outcomes?
2. Identify a steering group
- If there isn’t an existing group, establish one.
- Comprising of key stakeholders (policy makers, analysts, commissioners, professionals, service managers, community members, service users, etc)
- The group needs to reflect the appropriate geography
3. Establish the drivers for change
a. Where has this come from?
- Government guidance targets, programmes budgeting financial balance)
- What is the background?
- Who is driving this?
4. Agree the scope and purpose
- What is the purpose of the JSNA?
- What questions does it need to answer?
- What funding is available?
- What are the outputs?
- Report, event, online tool
- What is the timeline?
5. Carry out a literature review using the Health Triangle
(Appendix C)
- Describe the population.
- How many people could be affected?
- What is the age and sex structure of the population identified?
- What is the ethnicity profile of the population identified?
- Where does the population live?
- What is the deprivation status of the population? How many people live in deprived areas?
- Are there any other population factors that might be relevant for this issue
a. Consider using a classification of households system, such as Mosaic for geo-demographic information.
6. Measuring (current) needs
Consider
- Felt expressed need
- Professional need
- Normative need
- Corporate needs
For each category:
- Mortality
- Health status
- Symptoms
- Determinants of health – measures of economic, education, environment, etc
- Health behaviour – e.g. alcohol, drugs, obesity, smoking, physical activity
- Use of services
Remember to capture all information sources and details
a. Consider using a classification of households system, such as Mosaic for geo-demographic information.
7. Horizon scanning for future needs
a. Consider:
- Changes in the population
- Trends in the needs identified over time
- Are there any changes in health behaviours likely to impact on the need in the future?
- Consider the impact of polices:
- 1. both live and in the pipeline
- 2. both national and local
If relevant, quantify and describe these issues.
8. Current position of the population currently accessing services
(Split by equity groups to enable the equity audit).
Describe assets, not used, but would be useful
Describe:
a, Service provision (spilt by equity group)
Is there a current service?
- Numbers using the service
- Service outcomes data
- Describe: locations, waiting times, current usage.
b. Community assets
- Describe the assets currently used
- Describe assets, not used, but would be useful
9. Health equity audit
- Identify inequalities in both use and outcomes (using the groups identified above, eg deprivation social class, and ethnicity)
- Make recommendations for consideration in the commissioning phase
10. Gap analysis
- Describe, in detail the needs identified
- Identify how far do current services meet these needs?
- Define any unmet needs – gaps between need and current service provision
11. Impact of meeting identified needs
To know how impacts and outcomes are achieved, describe an outcome measure for the following, include both a target and equity domain:
- Patient expectations and satisfaction
- Access targets (specific sections of the population accessing a service)
- Timeliness
- Health behaviours
- Health status, Healthy life expectancy at 65
- Disease prevalence
- Mortality rates – Years of life lost
- Inequalities
- Quality adjusted life years (QALYs)
- Cost and cost effectiveness
12. Conclusions and recommendations
- Interpretation and summary of all of the analysis carried out as part of the HNA
- The scope of the issue (e.g. points in the health care pathway or populations where key unmet needs are).
- Recommendations about meeting needs identified for consideration
Include:
- a judgement of the level of priority
- consequences for other areas, impacted indirectly
- Recommendations about which group should make the executive decision.
- suggestions about who should be involved in taking this forward
Finally arrange timeline for evaluation of recommendations/change.