Needs assessment at a practice level; using routine data in a meaningful way

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Abstract
General practitioners and primary health care teams are asked to take an increasing role in assessing needs and priorities for the people they serve. We describe a model, using routinely available data, to provide health and social information to all general practices in an English Health Authority (South & West Devon, population 586000, containing 103 general practices) to inform practice-based needs assessment. Practice-coded hospital activity information was used where available, otherwise the FHSA population register was used to assign spatially referenced data (OPCS birth files, OPCS mortality files, cancer registration files and census information) to practices. Additionally, indicative incidences and prevalences were calculated for each practice using age- and sex-specific rates derived from national surveys (Survey of Morbidity Statistics from General Practice and the OPCS Health Survey for England). Information was produced for each practice on births, lifestyle, social factors, incidence and prevalence, hospital activity and mortality. Patient numbers rather than rates were presented. General practitioners commented that this approach gave an understanding of the size of health and social problems and fitted with the concept of numbers needed to treat. Public health involvement in practice-based needs assessment is essential. Current public health input has mainly been on a selective individual practice basis and is very resource intensive. This approach allows all practices to have immediate access to a wide range of health and social information presented in a way that is easily understood and informs debate on health needs within the practice.

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