NHS Health Check e-bulletin - August 2019
Foreword Prof. John Newton
I’m very pleased to be able to welcome the publication of the prevention Green Paper Advancing our Health: Prevention in the 2020s. I know that I’m preaching to the converted when I say that putting prevention at the heart of decision-making and action across Government is essential if we are to address the public health challenges we face today. This Green Paper signals Matt Hancock’s continued commitment to prevention, building on his vision and the NHS Long-term Plan to recognise that prevention is everyone’s business and to set out, for discussion, areas for action.
The upstream prevention focus of the paper offers a fantastic opportunity to focus in on ensuring we all have the quality of life that we want to enjoy during our extra years of life. This approach complements and builds on the work Public Health England (PHE) has been leading with partners on the cardiovascular disease (CVD) national ambitions, by offering the potential for:
- an ambition to ending smoking by 2030 – with a mandatory levy on industry as one option for funding this goal
- ending the sale of energy drinks to children under 16s
- options to extend the sugar levy to sugary milk drinks, if industry does not make enough progress on reducing sugar content
- delivering a plan to deliver Chapter 3 of the Childhood obesity plan, as well as pushing ahead with consultations from Chapter 2 of the plan on price promotions and the 9pm junk food advertising watershed
- undertaking a consultation on how to improve England’s nutritional labelling scheme once we have left the EU
- reducing salt intake to 7g per day
- launched the predictive prevention programme – exploring how we use data, behavioural science and digital approaches to supporting people to live healthier lives.
Many of you will have also seen that the Green Paper proposes a review of what the NHS Health Check programme should look like in the next 10 years. It is clear that local authorities have made tremendous achievements since taking responsibility for the programme in 2013. Our expert report published in 2017 shows the programme is delivering significant health gains. But the time is right – after 10 years of delivering the service – to undertake a broad-based review of the programme in light of advances in knowledge and implementation practice.This announcement does not mean stopping delivery of the programme. Rather its about how we can maximise its effectiveness in the next 10 years.
This is an exciting opportunity for us all to continue to build on the excellent foundations established, and to consider what the NHS Health Check programme should look like going forward. I would urge you to take this opportunity to have a voice: help us to shape the future direction of the NHS Health Check and what might be done to improve it by responding to this important consultation.
Last week Ministers re-announced the commitment in the prevention Green Paper to review the NHS Health Check, I’m sure many of you saw the coverage in the press. I wanted to take this opportunity to reassure you that PHE is continuing to deliver business as usual while the work on the review comes together. I also want to be clear that the intention behind the review is to further improve the programme, not to remove it, and as such it gives us a tremendous opportunity to look at new ways of increasing uptake of the NHS Health Checks programme, particularly among high-risk groups. As part of this review we will look at ways of using a tailored approach to target an individual’s likely risks, rather than making the same offer to everyone; developing digital service offers to intervene in a more efficient and tailored way; and reviewing what’s covered in an NHS Health Check. We will consider the evidence for a specific ‘MOT’ when people are approaching retirement age, to help prevent or delay future care and support needs. Your comments and suggestions will be influential, so I would urge you to respond to the consultation questions by 14th October.
In July, NHS England published the implementation framework to sit alongside the NHS Long-Term Plan (LTP). The purpose of the implementation framework is to help local system leaders refine their priorities ready for the submission of local system five-year strategic plans this autumn. As cardiovascular disease (CVD) prevention is a key chapter within the LTP, this local process provides a great opportunity to put the NHS Health Check at the heart of local CVD prevention planning and commissioning. If you haven’t already, then I would urge you to use this opportunity to engage with partners and link into the LTP commitment to improve the effectiveness of the NHS Health Check.
I am glad to announce that our annual cardiovascular disease prevention conference will be held on Thursday 6 of February 2020, at the London Kia Oval. Our call for abstracts will remain open until midday on the Monday 7 October 2019. Last year, we received over 100 submissions, highlighting the amazing work which you are all leading on, so I would encourage colleagues to use this opportunity to showcase your research, evaluation and case studies pertaining to CVD prevention and the NHS Health Check programme.
Finally, thank you to everyone for getting your NHS Health Check quarter 4 data in on time. This data has now been published. Just a gentle reminder that the portal is now open for Q1 2019/20 data returns, and will close on Wednesday 7 August.
Have a wonderful summer, and for those of you getting away, enjoy a well-earned rest!
NHS Health Check forum
The NHS Health Check Forum provides a restricted, confidential online space for commissioners and providers of the programme to discuss any queries, issues and share solutions around commissioning and delivery of the service. The forum can be accessed via the NHS Health Check website.
Community-centred practice examples
There is growing interest in community-centred approaches to improving health, reducing health inequalities and in supporting people with long-term conditions. Practice examples are an important way of capturing the evidence on what is working, why and how, and what learning is useful for other areas.
PHE is building a repository of knowledge about the application of community-centred approaches to a range of interventions and, as part of this, is looking for examples on CVD prevention and the NHS Health Check programme.
We would love to hear from you if you have undertaken work on CVD prevention or NHS Health Checks which include all of the following criteria:
- Promote health and wellbeing or reduce health inequalities in a community setting
- Use non-clinical methods
- Use participatory methods where members of the public are actively involved in designing, delivering and evaluating the project
- Have measures in place to address barriers to engagement, and enable people to play an active part
- Utilise and build on local community assets in developing and delivering the project. Local ‘assets’ can include the skills, knowledge and time of community members, informal networks and local organisations
- Develop collaborations and partnerships with individuals and groups at most risk of poor health
- Focus on changing the conditions that drive poor health alongside individual factors
- Aim to increase people’s control over their health and lives – this can be about building confidence and self-advocacy, through to having a say in shaping and running local services
If you are able to share community-centred practice examples on CVD prevention or NHS Health Checks, then please contact Keighley.Hylton@phe.gov.uk
Update on the NHS Health Check Best Practice Guidance
The NHS Health Check Best Practice Guidance is being updated, and will be published in September 2019. This guidance has been produced to support local authority commissioners and providers with getting the most from the programme. It sets out the legal requirements underpinning the programme’s delivery; identifies where there is scope for local flexibility and innovation; and signposts to a wide range of evidence, tools and resources to support the delivery of a high impact and high-quality programme. The updated version will be available on the NHS Health Check website.
Many of you will have joined one of the webinars that we’ve hosted over the last 3 years. You can find the presentations and videos for past webinars and our forthcoming programme here.
Our next webinar will take place on the 16th of October at 14:00 – 15:00 and will provide an update on key changes to the NHS Health Check best practice guidance, in particular PHE’s advice on point of care testing and the use of QRISK3.
Proposed retirement of PRIMIS call-recall tool
Since 2014 Public Health England (PHE) has commissioned a tool from PRIMIS (Primary Care Information Services, developed by the University of Nottingham) which allows general practices (GPs) to determine their eligible population for an NHS Health Check accurately.
The audit tool is a MIQUEST solution and so uses READCODES, not SNOMED CT. With the transition to the use of SNOMED CT as standard practice by the end of 2019, the existing tool will become redundant. As a result, PHE will be retiring the tool as soon as all GP IT systems have moved to SNOMED CT or by Tuesday 31st March 2020 at the latest.
Areas that anticipate any issue with the retirement of the PRIMIS tool should contact PHE CVD prevention team at firstname.lastname@example.org.
NHS Health Check national data extract workshops: options for presenting local data
Over the last 5 years, PHE’s National Cardiovascular Disease Prevention Team has worked to gain access to primary care data on patients who have been in contact with the NHS Health Check programme.
In 2018, data was successfully extracted, making national NHS Health Check primary care data available for analysis. Under the direction of subject experts, analysts from PHE and NHS Digital are now jointly working towards a phased release of local level (CCG and local authority) metrics.
To make sure the metrics provide useful and meaningful insight to NHS Health Check stakeholders, PHE organised four regional stakeholder workshops in May and June 2019. During the workshops, participants were given the opportunity to shape the online presentation of the metrics and recommend future developments for this work.
PHE is extremely grateful to the 90+ delegates who attended the workshops and shared their hopes and concerns for this work.
Most delegates agreed with the proposed metrics and were happy with the prototype. Some concerns about the narrative accompanying the data release were expressed. The Data Extract Advisory Committee (DEAC) has noted these comments and tasked PHE and NHS Digital colleagues with the development of several new documents, including a list of Frequently Asked Questions (FAQs). This will be released before the online tool comes out. A number of users will also be invited to test the tool before its release in September 2019.
If you would like to be involved in the development of the FAQs or testing the online tool, please contact email@example.com.
Total eligible population (TEP) for 2019-20
As in previous years, figures for each local authority 2019-20 TEP were estimated by PHE and those local authorities able to identify their eligible population from local general practice clinical systems or from local modelling were invited to submit a revised figure for consideration by PHE before the Tuesday 4 of June 2019.
TEP 2019-20 figures will be used as denominator to calculate the indicators:
- NHS Health Check offers made to eligible population; and
- NHS Health Check received by eligible population
2019-20 Quarter 1 data will be published on Tuesday 3 September 2019 on fingertips.
If you have any questions, please contact firstname.lastname@example.org
Online display of NHS Health Check Official Statistics: change of address!
Currently, NHS Health Check activity data are published both on the NHS Health Check programme website and on PHE’s Fingertips tool.
From 3 September 2019, NHS Health Check activity data will no longer be available on www.healthcheck.nhs.uk website.
PHE’s Fingertips (https://fingertips.phe.org.uk/profile/nhs-health-check-detailed) website will be the only place where these statistics are published.
This decision was taken in part to reduce duplication but also to align data format, timing and governance with other official statistics produced by PHE.
Please note that this change does not affect the collection of quarterly data. Local authorities should still submit their quarterly data on offers and completed checks, via the data portal on www.healthcheck.nhs.uk as per the following schedule:
Data published online
01 July 2019
07 August 2019
3 September 2019 at 9:30 am
01 October 2019
05 November 2019
3 December 2019 at 9:30 am
02 January 2020
First week Feb 2020
3 March 2020 at 9:30 am
01 April 2020
First week June 2020
7 July 2020 at 9:30 am
If you have suggestions about how we can ease the move for colleagues less familiar with Fingertips or if you have any questions, please contact email@example.com
CVDPREVENT is a national audit which will automatically extract routinely held General Practice data on the diagnosis and management of 6 high risk conditions that cause stroke, heart attack and dementia.
The NHS Long Term Plan has identified CVD prevention as a national clinical priority, with an ambition to prevent 150,000 strokes, heart attacks and cases of dementia over the next ten years by improving the detection and management of high blood pressure, high cholesterol and atrial fibrillation. The audit will enable General Practice to systematically identify individuals whose high-risk conditions are sub-optimally managed, either through non-diagnosis, under-treatment or over-treatment.
Analysis and reporting of CVDPREVENT will identify gaps, variation and opportunity for treatment at Primary Care Network, Strategic and Transformation Partnerships, Integrated Care System and national level. This will support systematic quality improvement to reduce health inequalities and improve outcomes for individuals and populations.
A first CVDPREVENT audit is planned for March 2020, with initial analysis being undertaken early in 2020/21. It is envisaged that national reporting will commence Spring/Summer 2020.
What good Cardiovascular Disease prevention looks like
The Association of Directors of Public Health in partnership with PHE have produced a guide to What Good Looks Like (WGLL) for cardiovascular disease (CVD) prevention. This publication represents the practical translation of the core guiding principles and features of what a good CVD prevention looks like in any defined place. It was developed through the synthesis of existing evidence, examples of best practice, practitioners’ experiences and consensus expert opinions. It is intended to serve as a guide and will be iterative with regular reviews and updates when new evidence and insights emerge. WGLL will be published on PHE’s k-hub, and if you are already registered (for free) you will receive an alert once the publication is live.