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Executive Summary
1. The aim of the unmet needs pilot projects was to provide evidence as to whether supplying increased resources to Health Boards with deprived areas would lead to an improvement in access to NHS services in these areas.
2. They were announced in 2004, following research on unmet needs that was conducted for the Standing Committee on Resource Allocation ( SCRA). Established in 2001, the Committee sought to consider alternative methods of adjusting the health funding formula, the Arbuthnott Formula, for inequalities.
3. The announcement recognised that there was evidence that those in the most deprived areas were not accessing healthcare services at the same rate as their more affluent neighbours.
4. A total of 19 unmet needs pilots were implemented across three Health Board areas (Argyll & Clyde, Greater Glasgow and Tayside) with funding typically granted for two years.
5. The pilots covered a wide rage of perceived unmet health needs from mental health and stress, to the treatment of the causes of much ill health (smoking, addiction), to services aimed at specific hard to reach groups (e.g. homeless people, ethnic minority groups).
6. In terms of providing evidence for alternative methods of adjusting the Arbuthnott Formula, differences in implementation, monitoring and evaluation across Health Boards made it difficult to directly assess the impact of all the pilots. However, in the main, there was general support for the proposal that targeted funding could address areas of unmet need.
7. Tayside Health Board subjected all their unmet needs pilots to independent evaluation and the results of a cross-cutting evaluation of all the Tayside studies identified five service characteristics that facilitated the likelihood of service uptake. These were:
1. Proximity
2. Responsiveness
3. Convenience
4. Timing
5. Continuity
8. Consideration of the findings from all 19 unmet need pilot projects enabled these five service characteristics to be further developed and refined. As a result, a set of recommendations has been developed for future service planners and providers which can be used when developing services designed to improve access by those in deprived areas who have unmet needs.
9. The recommendations consist of eight points:
1. Shape and adapt services to fit users
2. Deliver services at appropriate times
3. Deliver services in the community
4. Integrate with other services
5. Provide patient pathway support
6. Use a personal approach
7. Be persistent
8. Provide services that users value
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