The potential benefit of NHS Health Checks is in identifying the unknown, high risk individual, let's call him Dave the van driver. Dave is 45 and hasn't seen his GP for 15 years since his last football injury, he is now 18Kg heavier, smokes and eats where and when he can (burger and chips!). He is hourly paid so any invite for screening goes straight in the bin. How many Dave's have been through Health Check so far and how many will turn up in A&E in 15 years time?
Congratulations Pulse, you've managed to provide the Mail/Telegraph/Murdoch Press with another stick with which to beat the NHS. And who are these maverick CCG organisations that are giving all this money away? As every half interested person knows, CCGs are the bodies run by GPs that make decisions about where to spend there taxes
As Tony said tge problem is caused by protocols ending in "Call GP". A local CCG has trialed and now commissioned a community support and TRAINING team to ensure that care homes stop referring every cough, sniff and ache to GPs, looks promising so far.
Based on a case study of 1 (my mother!), I wonder if inappropriate glucose testing is partly to blame for the "observed increase" in T2D? She is now labelled as T2D based on a finger prick whilst in hospital immediately after eating lunch (jam sponge and custard!) 4 years ago. She does nothing to manage her diet and had had a normal HbA1c ever since.
I have been involved in several CRP assessments but in all cases the final stumbling block was funding. Primary care is not funded to provide diagnostics (some LES excepted) but is funded to send patients away happy with an unnecessary pharmaceutical.
NHS Health Check will only work and provide national benefits when it targets those individuals who never access the health service and who's first sign of CVD is being carried into A&E. As an overweight man in his mid fifties who hasn't seen his GP in 20 years, I'm still waiting for an invitation?
Most practices will have insufficient experience to manage anticoagulation accurately and the idea of cooperation across practices is always a non starter (even within one building)! The pharmacy "clinic" mentioned above is a great solution, a really effective system was introduced in Lewisham a few years back, hopefully it's still running?
So there I was going along quite happily thinking that Health Checks was designed to identify the mass of humanity that never sees their GP but will develop CVD in 10-20 years (not that they'll turn up when invited!); when all along it was an income generation scheme. Now that this has been properly explained, I'm sure the scheme will be much more popular.
Urinary "pregnancy tests" are not appropriate for the elimination of ectopic pregnancy. The test is only as reliable as the concentration of hCG in the sample, The quoted performance of "as early as three to four days post-embryo implantation" is dependant on a concentrated urine i.e. an early morning sample. In an acute, clinical setting this will rarely be the case and worst, patients will often be given large volumes of water to drink to obtain a sample or in preparation for a scan.
Whilst a positive test is valid in confirming pregnancy, a negative test should never be used to exclude ectopic pregnancy.