Abstract
BackgroundThe NHS Health Check was designed by UK Department of Health to address increased prevalence of cardiovascular disease by identifying risk levels and facilitating behaviour change. It constituted biomedical testing, personalised advice and lifestyle support. The objective of the study was to explore Health Care Professionals’ (HCPs) and patients’ experiences of delivering and receiving the NHS Health Check in an inner-city region of England.MethodsPatients and HCPs in primary care were interviewed using semi-structured schedules. Data were analysed using Thematic Analysis.ResultsFour themes were identified. Firstly, Health Check as a test of ‘roadworthiness’ for people. The roadworthiness metaphor resonated with some patients but it signified a passive stance toward illness. Some patients described the check as useful in the theme, Health check as revelatory. HCPs found visual aids demonstrating levels of salt/fat/sugar in everyday foods and a ‘traffic light’ tape measure helpful in communicating such ‘revelations’ with patients. Being SMART and following the protocolrevealed that few HCPs used SMART goals and few patients spoke of them. HCPs require training to understand their rationale compared with traditional advice-giving. The need for further follow-up revealed disparity in follow-ups and patients were not systematically monitored over time.ConclusionsHCPs’ training needs to include the use and evidence of the effectiveness of SMART goals in changing health behaviours. The significance of fidelity to protocol needs to be communicated to HCPs and commissioners to ensure consistency. Monitoring and measurement of follow-up, e.g., tracking of referrals, need to be resourced to provide evidence of the success of the NHS Health Check in terms of healthier lifestyles and reduced CVD risk.
Highlights
The National Health Service (NHS) Health Check was designed by United Kingdom (UK) Department of Health to address increased prevalence of cardiovascular disease by identifying risk levels and facilitating behaviour change
Checks are held in UK General Practice (GP) surgeries and in the community and are delivered by General Practitioners (GPs), practice nurses and Health Care Assistants (HCAs)
Approval was obtained from Birmingham and Black Country NHS Research Ethics Committee and Research and Development Department to recruit patients, Health Care Professionals’ (HCPs), GPs, practice managers and other staff involved in recruitment and/or delivery of the NHS Health Check programme in the Heart of Birmingham Teaching Primary Care Trust (HoBtPCT) region in 2010–11
Summary
The NHS Health Check was designed by UK Department of Health to address increased prevalence of cardiovascular disease by identifying risk levels and facilitating behaviour change It constituted biomedical testing, personalised advice and lifestyle support. Its aim is to identify cases of CVD and reduce its risk by preventing new cases of CVD and preventing further complications when a diagnosis is made It involves inviting all patients (aged 40–74) to health check appointments every five years and providing them with a 10 year CVD risk score and personalised management plan. This plan involves personalised advice and lifestyle support, which were embedded in the programme to help tackle behaviour change (e.g., diet, physical activity, smoking, alcohol consumption). We were commissioned by Heart of Birmingham Teaching Primary Care Trust (HoBtPCT; subsumed under Public Health England in Birmingham) to examine patients’ and Health Care
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