Assessing potential local routine monitoring indicators of reach for the NHS health checks programme

Abstract

ObjectivesSuccess in reaching target populations is an important factor in determining the impact of public health programmes. The NHS Health Check (NHSHC) Programme is directed towards reducing excess cardiovascular mortality in England. As the programme is locally commissioned, local monitoring of programme reach is essential. This study aimed to assess indicators of programme reach available to local service commissioners. Study designEcological. MethodsThe programme reach of NHSHC was assessed in three health districts in the North East of England. Local data returned from GP practices to commissioners on their NHSHC activities was collated for the period October 2010 to March 2013 together with related national published data. Three candidate indicators were chosen and the association between each of these and NHSHCs at GP practice level was examined by univariate logistic regression. ResultsData were available from 101 GP practices, together undertaking almost 20,000 health checks a year.Number of NHSHCs by practices explained most (77–92%) of the variance the numbers identified at high risk of cardiovascular disease (two for every ten NHSHCs). NHSHCs were not associated with growth in GP practice disease registers for either diabetes or hypertension.NHSCHs predicted practices identification of new cases of hypertension (with one case identified for every ten checks), albeit the proportion of variation explained was much more variable (2–60%) less consistent effect. ConclusionsData routinely available to NHSHC commissioners can support monitoring programme reach, with numbers of new cases of hypertension being the most promising indicator of reach.