Why conduct needs assessments?

Across the country, local authorities and NHS organisations collaborate to gather data they hope will help them both to understand the health and care needs in the communities they serve, and to inform how they provide the services people need.

But we are asking, do commissioners and service leaders really get enough high-quality insights grounded in evidence from these traditional needs assessments and other plans? 

At Cordis Bright, time and again we observe needs assessments that are rich in data but don’t reflect the complexity of people’s lives – especially some of the most vulnerable people who access services.

What’s wrong with traditional needs assessments?

If our health and care systems are like a complicated jigsaw puzzle, a traditional needs assessment might tell you that we have 500 puzzle pieces, and some of them are blue and some are green. But it won’t assemble the puzzle to show you a complete picture. 

Among the many barriers to understanding health and care needs in a complex system, one of the most common is that although many organisations hold data, this is often a) of variable quality and b) very difficult to join up. 

As a result, we see traditional needs assessments that include huge lists of data, showing prevalence of different needs or breakdowns of demographic data.

But a list of prevalence statistics will never capture the complexity of the real people, with their varied characteristics and intersecting identities, who live in our communities and access services.

Working with complexity requires more nuance

Whether we’re talking about older people living with multiple long-term health conditions, adults with a complex learning disability, or children on the edge of care, throughout our health and care systems, citizens with complex needs exist. 

Although these people are of high priority and may receive a wide range of support, services often struggle to support them to achieve positive outcomes.

At times, the way health and care systems are working together (or not) may even make things worse.

But to understand this, traditional needs assessment is inadequate; it doesn’t capture how multiple needs interact, or how services or pathways are responding.

Instead, a system approach to needs assessments

Recently, Cordis Bright has carried out a range of needs assessments focused on children and young people who could be described as having complex needs, i.e., needs that are multiple, persistent, severe, and framed by a family context.

We heard a clear sense in all the areas we supported that there was a group of children who were well known to a range of services, but not well understood.

So to help better understand need locally, we took a system approach that included the following steps:

What did we learn by using systems-thinking?

In each needs assessment, it was clear that where services failed to work together effectively, this failure became a driver of need.

For children with complex needs, who often fell between the gaps of one service or another, this was especially true and resulted in their circumstances worsening before they received the right support.

Our needs assessments highlight the need for alignment of policy between health, social care and education to help address complex needs collaboratively. This will improve joint responsibility and avoid unnecessary resource being used to agree who should provide support, to the detriment of this support being prompt and intensive.

Our needs assessments contribute to a more strategic conversation, which instead of telling us how much of any given service might be required – focus on how agencies need to work together differently and better to improve outcomes.

Continuing the conversation

To hear more about our work on needs assessments or to discuss this further, please do get in touch by emailing:

• Eleanor Southern-Wilkins at EleanorSouthernWilkins@cordisbright.co.uk
• Joshua Butt at JoshuaButt@cordisbright.co.uk