For the past few weeks I have been working flat out implementing NHS Health Checks in my practice. You are probably a bit dubious about the health benefits of this scheme which was first introduced in April 2013 and this fact was hinted at in an article in Pulse earlier this year, NHS Health Checks programme stalling amid poor uptake and critical MPs’ report which suggested the scheme was ‘stalling’.
Is it worth doing? Ignoring the criticisms of the health benefit, either individual or for the population as a whole, then I would say yes.
In the current economic climate a payment of £28 (if you do a fasting blood through your local pathology department) or £25 (with a near patient test) has got to make sense. But be mindful of the window of opportunity – our local area team has said the contract will run until October but with no guarantee for longer.
The scheme is designed to offer eligible patients between the ages of 40 and 74, who are not currently on a vascular register, advice to help prevent the onset of vascular disease and vascular dementia by supporting changes to and management of behavioural and physiological risk factors.
The Health check consists of a basic dataset:
- Smoking status
- Family History of coronary heart disease
- Body mass index (BMI)
- Cholesterol level
- Blood Pressure
- Physical activity level
- Cardiovascular risk score using an appropriate tool such as QRISK2
- Alcohol Use Disorders Identification Test (AUDIT) score.
Following the assessment, patients can be classified into low risk for cardiovascular disease, moderate risk and high risk. Patients can then be offered appropriate advice depending on their relative risk.
A fasting glucose test should be offered to patients with a blood pressure >140/90 or a BMI >30. Patients can be signposted to local smoking cessation, weight management and alcohol support services depending on individual risks.
The payment for the NHS Health Check is £28 per patient. On the face of it this sounds like a good deal but when you factor in staff time and the cost of consumables the payment falls significantly.
For example, the cost of undertaking an immediate cholesterol check with a machine supplied (for free) is about £2.80 per test as the practice must buy the test strips though there are cheaper machines available.
High-risk patients as identified by the system should be invited in for Health Checks, and this is how we plan to use our spare nurse-led clinic appointments. But any eligible patient may be offered screening and we plan to do this in our surgeries opportunistically too.
Will you be doing the Health Checks too?
Dr Hadrian Moss is a GP in Kettering, Northamptonshire. You can tweet him at @DrHMoss.