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NHS Health Check ProgrammePriscilla WongGPST2

+Objectives

What is the NHS Health Programme?

What are the benefits of having such a programme?

What is involved?

+Background

Local authorities responsible for provision of NHS Health Check Programme

Mandatory requirement

Public health programme

Local authorities can decide where health checks take place depending on needs of each area e.g. pharmacy, GP surgery.

Aim for take up rate >75%

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Preventative programme intended to help people stay healthy for longer

Risk management through provision of lifestyle interventions is not a legal responsibility of local authorities

+Aims of the programme

To prevent/ delay onset of diabetes, heart, kidney disease and stroke

Reduce levels of alcohol related harm

Raise awareness of the signs of dementia

Narrow health inequalities

2 parts- risk assessment and risk management

+Why is it needed?

Early detection individuals with increase cardiovascular risk is estimated to prevent up to 1600 non-fatal heart attacks and strokes

An estimated 20,000 cases of diabetes or kidney disease are identified earlier = early intervention

Lack of RCT evidence supporting NHS Health Checks

Addresses lifestyle factors increasing risk of diseases

+Eligibility criteria

People aged 40 to 74

Every five years

No other chronic conditions e.g. CHD, CKD, diabetes, HTN, AF, TIA, hypercholesterolaemia, heart failure, PAD, stroke.

Not taking a statin

Cardiovascular risk less than 20% over the next 10 years from previous checks.

+What is involved?

Age

Gender

Smoking status

FH- CHD

Ethnicity

BMI- >=27.5 in Indian, Pakistan, Bangladeshi, Asian or Chinese require random glucose, >= 30 if other ethnicity

Cholesterol level

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BP- >= 140/90, fasting glucose or HbA1c needed, HTN assessment and assessment of CKD.

Physical activity level- GPPAQ, ?exercise referral

Cardiovascular risk- QRISK 2

Alcohol consumption- AUDIT-C score >5, needs full AUDIT

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Raising awareness of dementia Age 65-74 Prevalence 800,000 in UK and increasing Awareness of symptoms/signs of dementia Referral to memory clinic if appropriate

+References

NHS Health Check Website: http://www.healthcheck.nhs.uk/commissioners_and_healthcare_professionals/

NHS Health Check Best Practice Guidance Oct 2013

Public Health England Press Release

https://www.gov.uk/government/news/nhs-health-checks

NHS Health Check: Our approach to the evidence July 2013

+Scenario 1

32 year old female, normally fit and well comes to see you during your morning surgery.

She wants a general health “MOT”.

How would you approach this situation?

+Scenario 1 continued

She’s been feeling quite tired recently despite sleeping the same hours.

Friend from work has just been diagnosed with hypothyroidism and had similar symptoms.

Concerned she may also have the condition

+Scenario 2

36 year old male

Smoker- 15/day

Otherwise fit and well

Recently watched a bbc 2 programme about diet- fat vs sugar

Would like a general check up for “everything”

+Scenario 2 continued

Concerned re: his own diet and weight. Doesn’t do much exercise and his parents both had ischaemic heart disease

Weighs 105 kg

Height 1.80m

BMI 32.4