The Role of Health Care Needs Assessment

Dr. Siân Griffiths

Specialist Registrar in Public Health

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

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

Health Care Needs Assessment (HCNA)

• Systematic method of identifying unmet health care need

• Need defined as the population’s ability to benefit from health care

• Approaches to HCNAEpidemiologicalComparativeCorporate

Source: A. Stevens, J. Raftery, J. Mant

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

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

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

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

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

Specific issues

• Data availability for 15-24 year olds

• ICCC classification v’s International Classification of Disease version 10 (ICD-10)

• Benign conditions

• Quality of clinical coding

Survey17 UKCCSG Centres plus 8 TCT Units • Case load• Staffing• Clinical services• Allied Health Services• Palliative Care• Shared Care• Additional issues

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

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

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 Children’s 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