Foreword by Professor Sir Bruce Keogh, Medical Director, NHS England

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We all know that prevention is better than cure. Yet too often we are presented with health problems in the NHS that could have been prevented. This is attended by a human and financial cost. The NHS Health Check provides us with an opportunity to address risk factors for ill health head-on, with the active participation of individual members of the public by giving them the information they need to make choices about their own health and wellbeing.

The NHS Health Check has important links with our work around diabetes, as one of the key priorities for the NHS. We are facing around 22,000 excess deaths in England per year in people diagnosed with diabetes,^[1] and the £5.6bn spent annually on diabetes in England^[2] represents a significant part of the NHS budget. The ambition of the National Diabetes Prevention Programme (NDPP) is to be the first at-scale nationwide diabetes prevention initiative in place. The NDPP will help us find people at risk of developing Type 2 Diabetes and work with them to prevent them developing the condition. The NHS Health Check programme will serve as one of the main routes of referral into the NDPP.

Prevention can also be enabled by modifying ‘upstream’ elements to create supportive environments for better health and wellbeing. That’s why the NHS is investing £5m in the NHS Healthy Workforce programme to help improve the health of NHS staff. This includes discussions with suppliers of food and drink on NHS premises, including consideration for a 20% sugar tax.

As the first prevention programme delivered on a national scale, the NHS Health Check is an innovative initiative to identify and help those people who might otherwise be at risk of serious health problems in the future. The programme is a credit to local government and the NHS, and all those involved in its delivery and implementation. Continued commitment to NHS Health Checks is vital, as prevention is no longer merely a nicety, it’s a necessity.

 

  

 

[1] Health and Social Care Information Centre (2015) National Diabetes Audit 2012-2013 Report 2: Complications and Mortality. Available at: www.hscic.gov.uk/catalogue/PUB16496/nati-diab-audi-12-13-rep2.pdf (accessed 7 March 2016)

[2] The National Audit Office (2015) The management of adult diabetes services in the NHS: progress review. Available at: www.nao.org.uk/wp-content/uploads/2015/10/The-management-of-adult-diabetes-services-in-the-NHS-progress-review.pdf (accessed 7 March 2016)

 

Operational update - Jamie Waterall, National Lead - NHS Health Check & Blood Pressure Programmes

Earlier this month, PHE was delighted to host its third national NHS Health Check conference. Over 400 people attended the event, allowing us an opportunity to share the latest evidence emerging from national and local research and evaluations. I was thrilled to have been joined by several senior leaders, who all acknowledged the critical role the NHS Health Check is playing in supporting our efforts in ‘getting serious about prevention’. All resources from the event, including a short video, can be found on our programme website.

I know how important the NHS Health Check Best Practice Guidance is for all colleagues involved in this programme. It is essential that we keep this document current, for example, reflecting updates to programme or NICE guidelines. I am therefore pleased to advise you that the guidance has been refreshed and is available on the NHS Health Check website.  

We have recently published quarter-three data for 2015-16 and cumulative data for April 2013 to December 2015. Since local authorities inherited the statutory responsibility for making NHS Health Checks available for their local population, we have seen over eight million offers made and almost four million appointments received. This data reveals significant variation in implementation across England, which now needs to be addressed. PHE remains committed to working alongside those areas that need to make improvements to ensure that their local populations benefit from this important public health programme.

Over recent months, the NHS Health Check team has received a number of enquiries questioning if the NHS Health Check needs to be offered to all eligible people in their area. The simple response is yes as this is what is contained within the Public Health Regulations; to support local teams, we have developed and agreed the following position statement with the Department of Health.

1. The Local Authorities (Public Health Functions and Entry to Premises by Local Healthwatch Representatives) Regulations state that in the exercise of its functions under section 2B of the Act(1) (functions of local authorities and Secretary of State as to improvement of public health), each local authority shall provide, or shall make arrangements to secure the provision of, health checks to be offered to eligible persons in its area. This requires local authorities to ensure that all eligible persons are offered an NHS Health Check every five years and in accordance to the specified content detailed within the Regulations.
2. Although local aithorities are required through the Regulations to make an offer to all eligible people, PHE supports a proportionate universalism approach. This means that local authorities are free to target a greater extent of their resource towards higher risk and vulnerable communities, while keeping a universal offer to all eligible people.

Finally, I want to update you on PHE’s new One You campaign/brand which was launched on 7 March. This is an important development for the NHS Health Check, as it provides us with a brand that will target 40-60 year olds. With similar ambitions to Change4Life, this will provide us with a platform to promote key health and wellbeing interventions to the adult population. This will also provide a platform for national marketing and awareness of the NHS Health Check, which is key in supporting you to increase uptake of your local programmes. We will keep you informed of future developments and do get in touch if you would like more information on One You.

 

 

 

 

 

High blood pressure 18 months on

Eighteen months on from the launch of the Blood Pressure System Leadership Board’s shared ambition to improve the prevention, detection and management of high blood pressure, we have seen a number of initiatives put in place by our partners. The following highlights offer great opportunities to reduce variation in health outcomes and inequalities that are a consequence of high blood pressure:

• a resource hub that brings together case studies, data and guidance to support local leadership on tackling high blood pressure. An example of a more recent case study is Dudley clinical commissioning group (CCG), which commissioned the use of Practice Based Clinical Pharmacists (PBPs) to provide leadership in general practice to improve the detection and management of hypertension
• action learning events identified a number of innovative initiatives across many areas of England. For example, Cheshire and Merseyside’s cross-sector systems leadership approach to tackling high blood pressure offers a sustainable approach capable of delivering changes at a pace and scale
• in January, the National Cardiovascular Intelligence Network (NCVIN) in collaboration with PHE launched the Hypertension Profiles. These are important in helping each local authority and CCG understand where and how to focus their resources in detecting and treating high blood pressure
• development of the blood pressure tool on NHS Choices. This tool helps people understand their blood pressure numbers and what to do about them
• WeNurse twitter chat and Webinar events that have provided opportunities to build awareness and engagement on the importance of tackling high blood pressure with new audiences of health professionals

 

 

 

 

 

Staffordshire University survey - uptake of NHS Health Checks

Staffordshire University are interested in factors that might explain variation in uptake of NHS Health Checks across different general practices.

Despite some evidence that practice size is related to uptake, and that factors such as opening hours, training and advertising should be considered, we still do not understand why uptake varies so much between practices. To address this, they have designed a short survey for GP practice staff asking for information on level of uptake and a range of possible determinants, including practice characteristics and NHS Health Check processes.

Using findings they hope to provide: Tips on how you can improve your NHS Health Check uptake!

We would like all GP practices to engage with the research by sparing just 15 minutes to complete the survey. We would also appreciate if commissioners could distribute the survey link to all GP practices delivering NHS Health Checks in their area. The larger the response the more we can learn from the findings nationally.

Responses are confidential and so general practices will not be identifiable from any outputs of this work. If you would like to help us in supporting Staffordshire University by completing the survey, please click here: bit.ly/1NQHvtA

The deadline to complete the survey is 1^st May 2016

For more information about this work and other work that Staffordshire University is currently conducting, please contact Victoria.Riley@research.staffs.ac.uk

PHE centre leads update - Yorkshire and Humberside

Healthy Living/Wellbeing services workshop PHE Yorkshire and Humberside centre

PHE Yorkshire and Humberside centre recently hosted an integrated healthy living/wellbeing services workshop. This was held in response to a number of local authority teams seeking to scope, review and share thinking on local commissioning arrangements. Areas are looking to move away from a silo approach in the provision of individual lifestyle services and shift to working with individuals in a holistic way. However, this approach is still being developed in many areas, hence the focus on sharing planning and operational as well as strategic thinking.

The workshop facilitated discussion around the possibility of local authorities in Yorkshire and Humberside commissioning inclusive wellness services such as smoking cessation, alcohol identification and brief advice, healthy weight, NHS Health Check, sexual health, mental health first aid and physical activity. Self-care factors largely in the ongoing sustainability of wellness services; this is something that local authorities are keen to develop so the inclusion of the concept of self-help is one that is welcomed.

As a number of local authorities are implementing integrated healthy living/wellbeing services, this is an opportunity to consider broader place-based working, informed by local need but also learning from early adopters. A number of areas across the country have implemented this way of commissioning services: the North East has some excellent examples of commissioning services in an integrated way and this is something that we are looking to replicate in Yorkshire and Humberside.

A community of practice is being established to assist in the development of integrated healthy living/wellbeing services across Yorkshire and the Humber. This online facility will help in the dissemination of information, as well as collaboration on specifications, emerging evidence and shared learning. We will also seek evaluation support from academic colleagues regionally. To support this, the health and wellbeing lead is coordinating the development of a service specification template that can be used by any local areas interested in commissioning integrated healthy living or wellbeing services.

 

 

 

 

 

 

 

 

 

 

 

 

 

Webinar schedule

Please find below our forthcoming NHS Health Check webinars.

Registration will close when maximum numbers are reached so book now to avoid disappointment

 

2016/17, Quarter 1 

Date	Theme	Speaker
Tuesday 12 April 2016 14:00 -15:00	HEART UK Award winner: Best Impact on Patient Experience award	Claire Devy, Pennine Care NHS Foundation Trust
Tuesday 19 April 2016 14:00 – 15:00	HEART UK Award winner - the Most Improved Patient Outcomes award	Gillian Fiumicelli and Cathy Aiken, London Borough of Bromley
Tuesday 26 April 2016 14:00 – 15:00	HEART UK Award winner - Most Improved Service Delivery award: Improving NHS Health check performance in Bracknell Forest	Lisa McNally, Bracknell Forest Council
Thursday 19 May 2016 14:00 – 15:00	The Wessex approach to raising the quality of staff training for the NHS Health Check	Sue Dewhirst, PHE South East
Thursday 26 May 2016 14:00 – 15:00	NHS Health Check Patient Experience Questionnaire – early findings	Lynda Seery, Newcastle City Council, and Liz Petch Blackpool Council
Wednesday 8 June 2016 14:30 -15:30	Optimising Hypertension Management - Dudley Pharmaceutical Public Health Team	Clair Huckerby, Dudley Metropolitan City Council