NHS Health Checks

HeaderWhat are NHS Health Checks?

The NHS Health Check programme is a public health programme in England for people aged 40-74 which aims to keep people well for longer. It is a risk assessment and management programme to prevent or delay the onset of diabetes, heart and kidney disease and stroke.

Why should i have an NHS Health Check?

Everyone is at risk of developing heart disease, stroke, diabetes or kidney disease. The good news is that these conditions can often be prevented – even if you have a history of them in your family. Have your free health check and you will be better prepared for the future and be able to take steps to maintain or improve your health.

We know that your risk of developing heart disease, stroke, type 2 diabetes and kidney disease increases with age. There are also certain things that will put you at even greater risk.

These are:

  • being overweight
  • lack of exercise
  • smoking
  • high blood pressure
  • high cholesterol

Both men and women can develop these conditions, and having one could increase your risk of developing another in the future.

  • In the brain a blocked artery or a bleed can cause a stroke.
  • In the heart a blocked artery can cause a heart attack or angina.
  • The kidneys can be damaged by high blood pressure or diabetes, causing chronic kidney disease and increasing your risk of having a heart attack.
  • Being overweight and a lack of exercise can lead to type 2 diabetes.
  • If unrecognised or unmanaged, type 2 diabetes could increase your risk of further health problems, including heart disease, kidney disease and stroke.

Even if you’re feeling well, it’s worth having your health check now. We can then work with you to lower your chances of developing these health problems in the future.

What happens at the check?

This check is to assess your risk of developing heart disease, type 2 diabetes, kidney disease and stroke.

  • The check will take about 20–30 minutes.
  • You’ll be asked some simple questions. For example, about your family history and any medication you are currently taking.
  • We’ll record your height, weight, age, sex and ethnicity.
  • We’ll take your blood pressure.
  • We’ll do a simple blood test to check your cholesterol level

What happens after the check?

We will discuss how we can support you to reduce your risk and stay healthy.

  • You’ll be taken through your results and told what they mean.
  • You’ll be given personalised advice on how to lower your risk and maintain a healthy lifestyle.
  • Some people with raised blood pressure will have their kidneys checked through a blood test.
  • Some people may need to have another blood test to check for type 2 diabetes.
  • Your health professional will be able to tell you more.
  • Treatment or medication may be prescribed to help you maintain your health.

For more information on the NHS Health Check, call us on 0800 328 8829 or click here to download the flyer.

Why is the Government offering free Health Checks?

Reducing avoidable premature mortality is a Government priority. Through early identification and management of risk factors and early detection of disease the NHS Health Check will help achieve the ambitions set out in two key documents: A Call to Action to Reduce Premature Mortality, and the Cardiovascular Disease Outcome Strategy.

Together diabetes, heart and kidney disease and stroke make up a third of the difference in life expectancy between the most deprived areas and the rest of the country. Addressing these differences is a key aim of the programme. With the rise in levels of obesity and type 2 diabetes, and the associated costs to the NHS and social care, prevention of this disease is also a key driver.

The programme also aims to reduce levels of alcohol related harm, and to raise awareness of the signs of dementia and where people can go for help. Everyone attending a NHS Health Check will have their alcohol consumption risk assessed. In addition, people aged 65-74 will be informed of the signs and symptoms of dementia and sign posted to memory clinics if needed.

Summary of statutory requirements

The Local Authorities (Public Health Functions and Entry to Premises by Local Healthwatch Representatives) Regulations 2013 S.I. 2013/351 set out a number of mandatory public health functions for local authorities from 1 April 2013. These Regulations have been made by the Secretary of State under powers conferred by the National Health Service Act 20065 and the Local Government and Public Involvement in Health Act 20076. Legal duties exist about the offering of NHS Health Checks (referred to as health checks in the Regulations), the content of the risk assessment, communication of results, data recording and transfer and take up rates.

Legal duties exist for local authorities to make arrangements:

  • for each eligible person aged 40-74 to be offered a NHS Health Check once in every five years and for each person to be recalled every five years if they remain eligible 
  • so that the risk assessment includes specific tests and measurements
  • to ensure the person having their health check is told their cardiovascular risk score, and other results are communicated to them
  • for specific information and data to be recorded and, where the risk assessment is conducted outside the person’s GP practice, for that information to be forwarded to the person’s GP.

Local authorities are also required to seek continuous improvement in the percentage of eligible individuals taking up their offer of a NHS Health Check. In the recently published document, Public Health England Our Priorities for 2013/14, which identifies support for the successful implementation and scale-up of the NHS Health Check programme by local authorities as a high priority action in support of the goal to reduce preventable deaths. This reinforces both the importance of the programme as well as the roles in commissioning, implementing, evaluating and championing this key public health activity.

The ambition is to invite 20% of the eligible population and reach a minimum of 50% uptake. This is the fourth year of implementation and the first year of full roll-out. Nationally there were 2.57 million offers made and 1.26 million NHS Health Check appointments received. Public Health England PHE is now challenging Local Authorities to push further and faster, to continue to increase coverage so that all areas of the local population are offered access to this mandated programme, that there is increased levels of uptake and referral to appropriate risk management services, particularly in those communities at greatest risk. Increasing coverage, uptake and onward referral for the NHS Health Check programme is a priority for local governments, PHE, and NHS England as the problems of premature mortality and health inequalities are tackled.

Local authorities have a statutory obligation to make arrangements for everyone eligible aged 40 to 74 to be offered a NHS Health Check once in every five years and, where people remain eligible, for them to be recalled for another check every five years after that. 
As the programme is a public health programme aimed at preventing disease, people with previously diagnosed vascular disease or meeting the certain criteria set out below are excluded from the programme. These individuals should already be being managed and monitored through existing care pathways. Local authorities have the flexibility to extend their programmes to cover a wider age range or include everyone aged 40 to 74 years old but they will need to consider the cost and benefits of doing so.

Specifically people diagnosed with the following are excluded from the programme:

  • coronary heart disease 
  • chronic kidney disease (CKD)7
  • diabetes
  • hypertension
  • atrial fibrillation
  • transient ischaemic attack
  • hypercholesterolemia
  • heart failure
  • peripheral arterial disease
  • stroke

Also excluded are people:

  • being prescribed statins 
  • who have previously had an NHS Health Check, or any other check undertaken through the health service in England, and found to have a 20% or higher risk of developing cardiovascular disease over the next 10-years.

Local authorities can decide where these take place and, as long as the staff are appropriately trained and qualified, and who carries them out. For example, they may wish to use a combination of pharmacies and other community settings, as well as GP practices to help ensure the programme is as accessible to as many people as possible.

The tests, measurements and risk calculations that make up the risk assessment part of the NHS Health Check are however stipulated in legislation because of the importance of a uniform, quality offer and guidance is provided below to support local commissioning.

The risk assessment requires a number of tests and measures to be carried out, and information collected as set out below. Where the risk assessment is conducted outside the person’s GP practice, there is also a legal duty for the following information to be forwarded to the person’s GP:

  • age 
  • gender
  • smoking status
  • family history of coronary heart disease
  • ethnicity
  • body mass index (BMI)
  • cholesterol level
  • blood pressure
  • physical activity level - inactive, moderately inactive, moderately active or active
  • cardiovascular risk score
  • Alcohol Use Disorders Identification Test (AUDIT) score

In addition, those aged 65-74 should be made aware of the signs and symptoms of dementia and sign posted to memory services if this is appropriate.

NHS Health Checks are a mandated service, that are coming under increasing scrutiny at both a local and national level. Whilst significant progress has been made in Shropshire we are still behind national targets. Locally, Health Checks have been provided through General practice, and as part of the commissioning process, in order to increase both patient choice and access Wellness International where appointed to provide targeted activity and support delivery of DH targets.. As part of their approach to ensure wider access they have targeted Housing associations in order to offer Health Checks to their residents, staff can take up the checks if they meet the criteria.

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Wellness International Ltd ensure corporate health and wellbeing through occupational health, health screening, fitness testing, exercise stress tests, lifestyle coaching and full health assessments. With health centres in Manchester and Canary Wharf, looking after your employee's healthcare with Wellness International Ltd is easy.

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