An analysis of the skills and knowledge base for needs assessment and service coordination : a thesis submitted in partial fulfillment of the requirements for the degree of Master of Social Work, Massey University, Palmerston North, New Zealand

Abstract

This research analysed the skills and knowledge base of the Needs Assessor and Service Coordinator (NASC), a new role created by the Health and Disability Act (1993). The purpose of this role as stated in the Act was to try to ensure that the services offered to the disability community were not only sensitive to their needs, but also appropriate and of acceptable quality (Ministry of Health, 1993). -In the seven years that this role has been in existence, much work has been done by both the Regional Health Authorities (RHAs) and its successor the Health Funding Authority (HF A) in defining acceptable standards for service delivery, (Ministry of Health, 1994) however little research has been carried out to determine what the skill base should consist of to meet those standards. Each region delivers this service differently, and there appears to be enough anecdotal evidence to suggest that there is a wide variation in the standard of service delivered to consumers. The issue of training has largely been met by internal means, rather than through a national qualification. Two focus group meetings were conducted with NASC workers and in-depth interviews were held with six consumers in the 16 to 64 age group. One group of workers provided a service to older people, (over 65 years) and the other group provided a service primarily to the adult population, but did include two assessors who worked with older people (16 to 64, and 65+ ). The questions asked in the workers' groups were to determine what skills they identified as being important to their role, whether their prior training was sufficient for the role, and what training they considered they needed for the role. From the consumers' interviews I asked for their perceptions as to the necessary skills for providing a needs assessment and for coordinating services, and compared the differences between the groups. The data was analysed under five headings, allowing for elucidation of the key findings. These headings were: assessment skills, service coordination skills, concepts of need, user participation, and professional knowledge base. The data showed that assessments by health professionals, (who make up the majority of those employed as NASCs), are client-centred and inclusive, and indicated that the concept of partnership building was understood. However, the data also showed that the more sophisticated skills of conflict management, negotiation with providers and coaching were emerging as the role continued to evolve and develop. It also showed that knowledge based around disability issues was emerging across disciplines. The final discussion considered the role of training in light of these findings.