01.08.14
NHS Health Check: Promoting preventative health
Source: National Health Executive July/Aug 2014
Jamie Waterall, national lead for NHS Health Check, was interviewed by NHS on the success of the programme and the role of local authorities in expanding its message.
NHS Health Check allows adults in England aged 40-74 without a pre-existing condition to have a free ‘mid-life MOT’. The check assesses people’s circulatory and vascular health and their risk of getting a disabling vascular disease.
Jamie Waterall, national lead for NHS Health Check, told NHE that the programme gives doctors the opportunity to talk to patients about their individual risks and what they can do to manage, treat or even prevent that risk from developing.
Noncommunicable diseases (NCDs), also known as chronic diseases, are on the rise in England because of very common sets of risk factors like smoking, high blood pressure, cholesterol, obesity, lack of physical activity and alcohol.
In fact, World Health Organization figures indicate that NCDs kill more than 36 million people a year worldwide. “We know there is clear evidence that these risk factors are leading to people dying prematurely and developing NCDs. So it is a major challenge for us to address this,” said Waterall.
Since its introduction by the Labour government in 2009, Waterall noted that the NHS Health Check has been used as a tool to help rebalance the healthcare system by focusing on ‘prevention’.
Legal change
However, up until 12 months ago, implementation had only been steady, with PCTs only putting the Health Check into their operating frameworks in the last year of their existence.
A change in the law has altered things for the better. Since last year, when local government took charge of public health, out of the eligible population, 2.82 million people across all 152 local authorities in England were offered an NHS Health Check, and 1.38 million people had a check-up between April 2013 and April 2014.
“It was a major change to the programme when responsibility shifted to local authorities and they became the commissioner of the NHS Health Check,” said Waterall. Councils have a legal responsibility to ensure that 100% of their eligible population is invited each year. “It has been incredibly successful in stimulating the numbers,” he added.
That’s not just because it’s mandatory, he said, but because local government has bought into the principles of the programme. “If we just keep treating people who develop conditions, we will never shift the curve in terms of healthcare spend,” said Waterall. “Given it was a year of transition, we ended up having the most number of people ever invited into the programme, and the most number of people receiving an NHS Health Check.”
Recent figures also highlighted that of those people offered an NHS Health Check, 49% were reported as taking up their check. Public Health England (PHE) has committed itself to working with councils to increase overall take-up of the NHS Health Check ‘towards’ 66% by March 2015.
Innovative approaches
Waterall said local government had been “very innovative” in its approach to commissioning. In the past, under PCT management, the Health Check was largely commissioned out of general practice. But there has been a shift towards thinking about other providers and perhaps using community pharmacy and outreach services.
Waterall added: “I was in Manchester recently and a project, led by a GP who’d worked with the local authority, used a converted double-decker bus and took Health Check around the most deprived areas of the city.
“There has already been a response in terms of understanding the population, and trying to move to a much more customer-centric perspective on how to deliver the programme in a way people are going to access it. I’m sure that’s driving improvements in the system.”
He also noted that ‘great leadership’ from health leaders, directors of public health and Public Health England have raised the programme’s profile. In fact, a new marketing toolkit has been launched for local authorities, with free resources to boost Health Check’s branding and marketing.
Developing understanding
“We’ve also just launched a new public facing website on NHS Choices, which gives the public a lot more information about the programme,” said Waterall.
“Compared to breast screening or bowel screening, which have been around for a while and people understand them, the public still don’t really know about Health Check and it’ll only be through getting the engagement right that we will see a greater uptake.”
On the new site, there are some useful tools providing information, videos, case studies and lists of health and fitness apps to help people take control of their health. The programme partners are also introducing a national Health Check services directory.
Waterall concluded: “There is now a much greater focus on what people can expect from NHS Health Check.
“It is about giving people an opportunity to take responsibility around their health risks.”
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