Assessing population needs in primary health care: the problem of GP attachment

Recent government policy has emphasised the benefits of assessing need at a local level, For Health Authorities operating a system of strict GP attachment, attempting to do this for localities within districts is not straightforward. Easily available quantitative data indicating need (such as that contained in the national census) can be useful in health service planning, but are mostly based on tightly fined geographical areas. This paper describes the problems which exist in defining need for local areas within Norwich Health Authority which is an example of a district where community nursing and paramedical staff are organised in a system of GP attachment with a commonly dispersed patient population. These problems would be reduced, and multidisciplinay teamwork enhanced, if teams could be organised to work within explicit geographical boundaries