Abstract

BackgroundThe NHS Health Checks preventative programme aims to reduce cardiovascular morbidity across England. To improve equity in uptake, telephone outreach was developed in Bristol, involving community workers telephoning patients amongst communities potentially at higher risk of cardiovascular disease and/or less likely to take up a written invitation, to engage them with NHS Health Checks. Where possible, caller cultural background/main language is matched with that of the patient called. The call includes an invitation to book an NHS Health Check appointment, lifestyle questions from the Health Check, and signposting to lifestyle services.ObjectiveTo explore the experiences of patients who received an outreach call.Design/Setting/ParticipantsThematic analysis of semi‐structured interviews with 24 patients (15 female), from seven primary care practices, who had received an outreach call.ResultsThe call increased participants’ understanding of NHS Health Checks and overcame anticipated difficulties with making an appointment. Half reported that they would not have booked if only invited by letter. The cultural identity/language skills of the caller were important in facilitating the interaction for some who might otherwise encounter language or cultural barriers. The inclusion of lifestyle questions and signposting prompted a minority to make lifestyle changes.ConclusionsParticipants valued easily generalizable aspects of the intervention—a telephone invitation with ability to book during the call—and reported that it prompted acceptance of an NHS Health Check. A caller who shared their main language/cultural background was important for a minority of participants, and improved targeting of this would be beneficial.

Highlights

  • The NHS Health Checks preventative programme aims to reduce cardiovascular morbidity across England

  • Telephone outreach has been developed in Bristol which involves specially trained community workers or interpreting service staff telephoning patients amongst communities where people may be at higher risk of cardiovascular disease, and/or less likely to take up a written invitation, to engage them with the NHS Health Checks programme

  • The telephone outreach intervention was positively received by the patients interviewed, with the majority reporting that they did not need much information or persuasion to accept the invitation to an NHS Health Check

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Summary

Introduction

The NHS Health Checks preventative programme aims to reduce cardiovascular morbidity across England. Results: The call increased participants’ understanding of NHS Health Checks and overcame anticipated difficulties with making an appointment Half reported that they would not have booked if only invited by letter. Critiques of the programme have included the risk of widening health inequalities,[5] with concerns amongst primary care clinicians that it attracts the “worried well,” and that those who could benefit most were least likely to attend.[6,7] An evaluation of implementation of NHS Health Checks in North West England found support amongst GPs for targeting people expected to be at high risk.[8] This brings with it a requirement to define “high-­risk” individuals or groups, identify them locally and find methods of increasing the number who attend health checks

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