Agenda item

The Committee received a report presenting an update on delivery in Oldham of the NHS Health Checks programme, a national health risk assessment programme looking to help prevent vascular disease, including heart disease, stroke, diabetes and kidney disease. Patients aged 40 to 74 years not already diagnosed with one of these conditions or not in receipt of certain prescriptions (the ‘eligible population’) are invited every five years to have a health check to assess their risk of developing one or more of these conditions.  The Health Check gave a personalised risk of developing a heart or circulation problem in the next 10 years and provided tailored advice and management plans to lower the risk, which may include improving physical activity levels, dietary advice, prescribed medicines for cholesterol or blood pressure, and support to stop smoking.  Introduced in 2013, the programme was now to run to 2023 and the Committee was advised of research indicating national outcomes of the programme.

Locally, on completion of a health check risk assessment, feedback and advice on achieving and maintaining healthy behaviours is given. If necessary, the individual is directed to either a health improvement intervention, referred to their GP for clinical follow up, or referred to secondary care.  Those at high risk of cardiovascular disease are placed on disease registers and clinically managed through their GP practice.  During the first five year programme Oldham had moved from one of the lowest performing local authorities to being an example of good practice, and between 2014/15 and 2018/19, 45.4% of Oldham’s eligible population had taken up the offer of a health check.  While slightly below the England average, this was one of the top performances by a Greater Manchester authority.  Performance had dipped in 2018/19 due to GDPR and a new provider being required in-year, but 2019/20 figures were expected to be representative of Health Check performance when these became available.

Local outcomes of the Health Check Programme were reported, and it was advised that 348 cases of diabetes, chronic kidney disease, hypertension, coronary heart disease or atrial fibrillation, or as being morbidly or super-morbidly obese which could now be managed through primary care and/or health improvement services had been identified over five years. 

Going forward, the key focus would be on improving the outcomes from the programme, including higher numbers of appropriate patients put onto care pathways for diagnosed conditions and better and earlier condition management.  Other activities would include work to increase referrals to support services, including social prescribing and to health improvement services such as smoking cessation, weight management and alcohol support, and to also identify common mental health conditions to support timely referrals.  The submitted report also reflected on wider public health work undertaken with primary care and work progressing in this area.

Members sought clarification on data presented, asking whether the data available extended to indicate measures such as male/female, age profiles, by ethnic group etc that might enable specific targeting; whether there was data as to how many individuals took up follow up treatments after Health Checks; and how the 348 conditions identified compared with outcomes in other areas.  It was noted that the figures presented were either mandatory or, in the case of outcomes, just illustrative of the local outcome.  While some data was collected from GP practices this was often variable: some work had been undertaken to seek common standards and this would be implemented from April 2020. 

Further queries from Members were considered as follows –

·         with regard to responding to referrals, it was acknowledged that the offer was strong in some areas, such as smoking cessation, but less strong in others such as weight management.  Work to address this, and to enable widening of the Health Check offer to include certain mental health issues, was being looked into;

·         while acknowledging that younger people might have hidden health conditions, it was advised that the age range of 40-74 years was set by a national programme through which GP surgeries received money for each Health Check undertaken;

·         a small number of pharmacies were involved in the programme, but as this relied on access to medical records further pharmacy based provision would be dependent on local GPs.  It was, however noted that there were a number of ‘healthy living’ pharmacies talking about lifestyle issues;

·         it was confirmed that people found clear on a first Health Check would receive an invite to a further Check after five years, and that those who did not respond to invites were followed up and remained eligible.

RESOLVED that -

1.            the performance of the NHS Health Check programme be noted and support be given to the work being undertaken to improve the quality of the programme and to ensure that it reaches those most at risk of long term conditions; and

2.            a further update on the NHS Health Check programme, to also include progress on work undertaken to seek common standards on data recording, be submitted in 15-18 months.