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NHS Health Check ProgrammePriscilla WongGPST2
+Objectives
What is the NHS Health Programme?
What are the benefits of having such a programme?
What is involved?
+Background
Local authorities responsible for provision of NHS Health Check Programme
Mandatory requirement
Public health programme
Local authorities can decide where health checks take place depending on needs of each area e.g. pharmacy, GP surgery.
Aim for take up rate >75%
+
Preventative programme intended to help people stay healthy for longer
Risk management through provision of lifestyle interventions is not a legal responsibility of local authorities
+Aims of the programme
To prevent/ delay onset of diabetes, heart, kidney disease and stroke
Reduce levels of alcohol related harm
Raise awareness of the signs of dementia
Narrow health inequalities
2 parts- risk assessment and risk management
+Why is it needed?
Early detection individuals with increase cardiovascular risk is estimated to prevent up to 1600 non-fatal heart attacks and strokes
An estimated 20,000 cases of diabetes or kidney disease are identified earlier = early intervention
Lack of RCT evidence supporting NHS Health Checks
Addresses lifestyle factors increasing risk of diseases
+Eligibility criteria
People aged 40 to 74
Every five years
No other chronic conditions e.g. CHD, CKD, diabetes, HTN, AF, TIA, hypercholesterolaemia, heart failure, PAD, stroke.
Not taking a statin
Cardiovascular risk less than 20% over the next 10 years from previous checks.
+What is involved?
Age
Gender
Smoking status
FH- CHD
Ethnicity
BMI- >=27.5 in Indian, Pakistan, Bangladeshi, Asian or Chinese require random glucose, >= 30 if other ethnicity
Cholesterol level
+
BP- >= 140/90, fasting glucose or HbA1c needed, HTN assessment and assessment of CKD.
Physical activity level- GPPAQ, ?exercise referral
Cardiovascular risk- QRISK 2
Alcohol consumption- AUDIT-C score >5, needs full AUDIT
+
Raising awareness of dementia Age 65-74 Prevalence 800,000 in UK and increasing Awareness of symptoms/signs of dementia Referral to memory clinic if appropriate
+References
NHS Health Check Website: http://www.healthcheck.nhs.uk/commissioners_and_healthcare_professionals/
NHS Health Check Best Practice Guidance Oct 2013
Public Health England Press Release
https://www.gov.uk/government/news/nhs-health-checks
NHS Health Check: Our approach to the evidence July 2013
+Scenario 1
32 year old female, normally fit and well comes to see you during your morning surgery.
She wants a general health “MOT”.
How would you approach this situation?
+Scenario 1 continued
She’s been feeling quite tired recently despite sleeping the same hours.
Friend from work has just been diagnosed with hypothyroidism and had similar symptoms.
Concerned she may also have the condition
+Scenario 2
36 year old male
Smoker- 15/day
Otherwise fit and well
Recently watched a bbc 2 programme about diet- fat vs sugar
Would like a general check up for “everything”
+Scenario 2 continued
Concerned re: his own diet and weight. Doesn’t do much exercise and his parents both had ischaemic heart disease
Weighs 105 kg
Height 1.80m
BMI 32.4
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