Rounding-up 2013's public health debates and looking forward to the coming year

2013 has proved to be a significant year for English primary care. With the transition of public health from PCT to local authority, April saw the introduction of a whole new system of structures for healthcare commissioning and provision. Whilst it’s still too soon to say whether this move has delivered the desired effect of making local health services more relevant for the communities they’re provided for, the indications from the second half of the year suggest that there’s an increased sense of stability in the sector by comparison to this time last year. For many however, this will hardly come as a surprise given how many NHS departments, let alone individual positions, had uncertain futures twelve months ago.

Plain packaging

One of the biggest public health stories from 2013 was the debate around the plain packaging of tobacco products. The issue became increasingly mired in controversy after it emerged that Lynton Crosby – a campaign consultant at the heart of Downing Street – was also actively representing the interests of the tobacco industry. Although out of the limelight for the time being, this issue along with other public health measures such minimum unit pricing are unlikely to be out of focus for long. Their importance in combating what Dr Zafar Iqbal and others have described as the ‘social and market forces which help to perpetuate health inequalities’ will undoubtedly mean their re-emergence in 2014. Our coverage and perspective on the story can be revisited here.

CVD prevention

The summer also saw Public Health England placing an increased emphasis on promoting cardiovascular disease prevention. However as PHE and the Health Secretary served up the evidence on the predicted benefits of England’s flagship CVD prevention programme – the NHS Health Check – others were voicing their doubts as to the projected net gain. As it has emerged, many of the charges levelled against the programme by critics have been based on misrepresentations of the English model of CVD prevention. Again, our in-depth critique which draws out the specifics of the argument can be read here.

Going forward: the macro view

Fortunately, for those on the ground and working hard in communities to provide the health checks and increase awareness on the effects of poor lifestyle behaviours, the news looks positive. Recognising that ‘doing nothing’ in regard to national health inequalities ‘is not an option’, NHS England’s chief financial officer this week announced an increase in funding for NHS commissioners from £96bn to £100bn over the next two years. As well as the increased budget, a new funding formula for local health commissioners ‘that more accurately reflects population changes and includes a specific deprivation measure’ is said to be being introduced. With the NHS Health Check at the very centre of CVD prevention policy, these announcements should provide the means to continue increasing the efficiency and effectiveness of a programme that is already estimated to ‘prevent 1,600 heart attacks and strokes, at least 650 premature deaths, and over 4,000 new cases of diabetes each year’.

Developments at Health Diagnostics

With this comprising the macro-outlook, a big question going forward for us at Health Diagnostics is: how can we best support the drive to alleviate health inequalities and the growing social and economic burden of cardiovascular disease in our own capacity? We’ll certainly be working hard to continue providing a first-class service to all our NHS partners, however in addition a handful of the new developments will include:

• Working closely with reputable academic institutions to help establish empirical outcome data on the efficacy of the NHS Health Check. The potential benefit of using Health Options® software in delivering the health checks will be investigated in particular.

• A new software release is planned for January 2014. This latest version will include some exciting new developments including the integration of the Diabetes UK questionnaire.

• To coincide with this software release, Health Diagnostics are launching the new range of client report fact sheets. With a keen emphasis on design and clarity, the new reports are intended to facilitate the communication of essential health information. With tens of thousands set to be distributed, the team at Health Diagnostics have been working hard to make the reports as coherent, concise, and informative as possible.

• We’ll again be attending the Commissioning Show in June, with details set to be announced closer to the time. To view the findings of the events run in conjunction with the 2013 show, click here.

Until 2014 then, wishing you a happy and healthy Christmas and new year!

Evidence and outcomes: research into pharmacy delivered NHS Health Checks

Questions over measurable outcomes have been a consistent feature of the NHS Health Check debate since the programme was rolled out in 2009. Given the scope and ambition of the service, as well the vocal opposition to it, articles calling for evidence have become a regular feature in public health journals. In this post, we’ll be drawing attention to some of the empirical studies that are currently informing the debate. Specifically, these studies focus on alternative delivery methods, particularly via pharmacy.

A crucial factor to bear in mind when considering the evidence is that despite the programme being nationally mandated, there is no single mandated way of delivering it. The systems in use across England vary widely in terms of the emphasis they place on design, user-friendliness, and encouraging lifestyle improvement. The studies cited here all use a patient-focussed solution developed by Health Diagnostics. A demo of the software component of the solution may be watched here).

Evaluating Leicester City’s Healthy LifeCheck programme

This evaluation focussed on a service that was delivered by community pharmacists in Leicester City.

In the introduction to the research that was published in the Journal of Public Health in March 2013, the rationale for evaluating the pharmacy-led programme is explained:

‘‘In the past, risk screening programmes have been exclusively undertaken within primary care sites. It has been suggested that such an approach may widen health inequalities by excluding those who do not routinely access organized health care… Subsequently, emphasis has been placed on the importance of incorporating second sector organizations in delivering a vascular risk assessment service’

This work thus assess precisely how important it is to have a ‘many-pronged’ approach when tackling local health inequalities. The study involved a sample of 2,521 individuals, which were recruited from 39 pharmacies. The method and results may be read in full here.

In short, the conclusions to the study spoke resoundingly in favour of pharmacy’s ability to identify and engage with people that may otherwise slip under the radar:

‘‘Cardiovascular risk assessment led by community pharmacists can successfully assess people from large, multi-ethnic UK populations and identify those at high cardiovascular risk or with undiagnosed cardiovascular disease. The service may improve rates of assessments undertaken by individuals who do not access health care through traditional routes.’’

By way of a comment on the particular advantages offered by pharmacy, the study’s authors noted:

‘‘The current study demonstrates the suitability of a pharmacy-led system in including those from a minority ethnic background; perhaps due to the extent to which pharmacies are integrated within local communities and their ability to provide information in a number of languages and formats.’’

Evaluating Sefton PCT’s Cardiovascular screening programme

This second study was carried out in the School of Pharmacy and Biomolecular Sciences at Liverpool John Moores University. It engaged 10 pharmacies delivering the NHS Health Check programme and was published in June 2010.

The report makes the following comment in regard to the collated views on the pharmacy CVD screening service:

‘‘Almost all of the participants had a positive experience of the screening process, with 96 (99.7%) agreeing that they were given enough time for the screening and that pharmacists made them feel at ease. Similar high numbers felt comfortable discussing their lifestyle with the pharmacist. Indeed for many, their expectations of what the screening would cover were exceeded. A further 91 (93.8%) participants agreed that the screening had been done in a suitable place. However, nine (10.8%) had questions that were not discussed during their consultation.’’

Seeing empirical research confirm that NHS Health Checks are being well-delivered by providers outside of GP practices is dispelling the myth that targeted lifestyle interventions can only be carried out by doctors. Given the strain that GP’s are under, as well as the pressing need to raise widespread awareness about the importance and practicalities of leading a healthy lifestyle, looking to the secondary sector should really be something for local authorities across England to consider.

For further information or a localised appraisal of the potential impact of extending the provider network, contact Health Diagnostics at info@healthdiagnostics.co.uk or on 01244 311811. All reports are produced using evidence-based economic modelling.

Response to NHS Health Check criticism

The following post was submitted as a letter to the editor of the Times newspaper last week in response to their leading article on the benefits of NHS Health Checks:

Given the recent conflicting headlines in regard to NHS Health Checks, providers of the programme are understandably confused and frustrated by the inconsistency of the messages being reported in the press.

On 21^st July 2013, Public Health England (PHE) announced a drive to extend the national health check programme and widely praised its potential to ‘save up to 650 lives a year’.

Less than a month later on 20^th August, the Times ran with the front page headline ‘NHS checks on over-40s condemned as ‘useless’’, with an accompanying article that focussed on a study from the Nordic Cochrane Centre that was originally published and reported on last October. The study alleges that health checks don’t have an impact on morbidity.

Both of these mutually exclusive claims cannot be true at the same time. The pressing question is therefore ‘which is accurate and relevant to the English NHS Health Check programme?’

It should be noted that one of the major criticisms of the Cochrane Review is that it doesn’t actually apply to the current model put forward by PHE. According to the Department of Health’s (DH) response to the Cochrane Review:

‘Most of the trials considered are old, dating from as long ago as the 1960s when understanding of health risks and particularly how they may be modified was at an early stage of development.  Most of the risk reduction measures now used post-date these trials.’

As a result:

‘The review conclusions can have little if any relevance to NHS Health Checks.’

Given how separate the research conditions are from what’s actually happening in this country, it can hardly come as a surprise that the DH rebuffed the Cochrane Centre’s request for the research to be posted on the NHS Health Check website. It was this declined request that the Danish researchers took issue with and condemned in their letter to the Times that acted as the original catalyst for the story.

However, far from being an attempt by the NHS ‘to stifle debate’, it is difficult to see how there could be any assumed requirement for the DH to publish findings which bear no relevance to the English model.

The current approach championed by PHE is – first and foremost – a targeted lifestyle intervention which should encourage positive behaviour change if an individual has poor lifestyle habits. Individuals are made aware of their risk of cardiovascular disease, offered advice and signposted for further support if necessary.

The point is that through the effective communication of risk and appropriate service referral, individuals can fully grasp their likelihood of having a heart attack or stroke and, if needed, be offered support to do something about it.

Moreover, the NHS Health Check is unique in the fact that it combines a number of elements and tests – all of which are ‘based on evidence of clinical and cost-effectiveness from trials’ – and brings them into a single risk assessment programme. As Dr Bill Kirkup, retired Chief Medical Officer at the Department of Health, noted, ‘none of the trials assessed by Lasse Krogsbøll and colleagues tested this’.

I must stress that we fully encourage lively and healthy debate on this blog and recognise that such dialogue is essential to ensure that public health programmes such as the NHS Health Checks are worth the money that’s spent on them.

The issue in this instance is that recent criticism has rested on research that does not accurately reflect or relate to what’s happening on the ground. From an academic perspective, it’s essential that the studies being used in evidence are not disconnected from the reality of the situation.

The discussion as to the merits of the NHS Health Checks is not new. As mentioned, the Cochrane Centre’s findings were first published and in the news last October. This time however the chair of the Royal College of GPs also came out in staunch opposition to the programme.

One of Dr. Clare Gerada’s main claims was that the programme constitutes ‘a waste of money for asymptomatic people’; a statement which translates as ‘if you’ve not already developed complications, you shouldn’t be receiving a health check’.

In response, public health experts appropriately drew attention to the burden of ill health that threatens to overwhelm the NHS during the coming decades. PHE’s official statement written by the organisation's Medical Director - Dr. Paul Cosford - can be viewed here.

It is for precisely these reasons that the programme targets lifestyle factors associated with preventable diseases before they become unsustainably costly for the NHS.

One needs only to look at the facts staring us in the face. It has been estimated that by 2050, ‘90 per cent of today’s children will be overweight or obese.’

Even by 2030, ‘Three in four adults are likely to suffer illnesses such as heart disease or diabetes’ according to the Daily Telegraph’s article from the 21st August; ironically, a publication that only the day before ran with the story about health checks being ‘useless’.

Specifically in terms of diabetes, treating the condition currently costs the NHS £1million an hour. Given the other estimates, the direction in which this financial burden is likely to move looks bleakly clear.

The net financial benefit of acting whilst there’s an opportunity to do so has hard evidence associated with it. As Barbara Young, Chief Executive of Diabetes UK stated to the BBC:

‘Once you factor in the savings in healthcare costs, the NHS Health Check is actually expected to save the NHS about £132 million per year.’

The DH assures that the above figures are based on expert guidance, all of which can be viewed here. 

Furthermore, research published in the BMJ on the 13th May 2011, found conclusively that:

'A programme across the entire population of England and Wales... that reduced cardiovascular events by just 1% would result in savings to the health service worth at least £30m a year compared with no additional intervention.' 

As a result, once the evidence is examined and objectively considered, the claim coming from the programme’s critics that the Cochrane Centre’s findings constitute the ‘best available evidence’ seems to look less and less empirically accurate.

NHS Health Checks in pharmacy: Hillingdon’s high performer

(Rishi Verma from Ruislip Manor pharmacy takes a patient through an NHS Health Check)

The context

In recent weeks, Public Health England (PHE) declared that 15 million NHS Health Checks will be delivered between now and 2018/19. In an article with Pulse, Prof Kevin Fenton, Director of Health and Wellbeing at PHE, stated the opportunity this represents for pharmacy:

‘‘What we’re also seeing as local authorities take up leadership of the programme is that they’re beginning to identify other key partners in the primary care family who can also be a part of health checks. This may involve community pharmacies, particular voluntary or community sector providers who can also be involved in the risk assessment and management activities associated with the community.’’

However, in order for pharmacy to make a meaningful contribution to the programme, a proactive and engaged mind set is key. A common discussion topic amongst those who commission and manage the delivery of the NHS Health Checks has been ‘what level of value can pharmacy bring to a health check delivery network?’

The answer is that it depends entirely on how committed and enthusiastic the pharmacies are. The variation in performance can be wide, however when done well pharmacy carries the potential to be an incredibly valuable weapon in the public health arsenal.

Making it happen in Hillingdon

Of the 20 pharmacies delivering the health checks across the London borough of Hillingdon last financial year, a standout performer was Ruislip Manor pharmacy. The person responsible for driving the CVD assessments is Rishi Verma, the pre registration student at the pharmacy.

Of all the health checks conducted in the pharmacy last year – of which there were well over a hundred – the overwhelming majority were done when Rishi began working in the pharmacy and took it upon himself to champion the health checks.

‘Every interaction is an opportunity’ Rishi explained; ‘delivering the health checks can be really rewarding and they’re great for building patient rapport... Crucially, if you offer someone good care, they’ll keep coming back to you.’

The impact of Rishi taking responsibility for the checks underlines how important strong leadership is at every stage of health check delivery. Regardless of if you're commissioning the service or delivering the checks, the success of the programme depends hugely on energised individuals taking the reins.

‘It’s about creating an atmosphere of positivity and opportunism’ said Rishi. ‘The pharmacy team all got on board and found potential patients in the client group. This gave us a good cohort to target. Additionally however, if anyone comes into the pharmacy and they’re over the age of 40, I let them know that there’s a brilliant scheme to help them find out their risk of developing cardiovascular disease. What surprises a lot of people is if I tell them that the same test done privately could cost the upwards of £80.’

Rishi openly admits that he’s obsessively driven to do the best he can possibly achieve; so much so that he’s taken it upon himself to go round local businesses handing out leaflets during his lunch hour. One particularly motivating factor was identified as a training day that was run by Health Diagnostics last year. ‘We were really enthused by the PCT meeting where the agenda was set and the staff trained’ explained Rishi.

Going forward, Rishi has big ideas for hosting community events in his locality: ‘I’ve even engaged a local library where I’ve been delivering health checks. The libraries have community targets to meet so I said to them that I’d come in and deliver the assessments for a day; all they’ve needed to do is promote the event.’

Having championed the checks at Ruislip Manor and completed a university project on public health which fit closely with the NHS agenda, Rishi has accumulated some valuable learning. For those providers who’d are looking for advice on how to boost your numbers, Rishi has a series of recommendations:

-  Mention it to anyone and everyone that looks eligible

-  Have yourself a ‘pitch’ at the ready

-  Stick your individual pharmacy stamps on the leaflets so that people register your venue as the place to get checked

-  Word of mouth can work wonders. Tell people to inform their loved ones who may be eligible

-  Pharmacies can use MURs to determine eligible clients

-  Maximise any community events that go on in the area. Ruislip pharmacy, for example, do well off the back of the local fun day that runs twice a year where local businesses open up a stall on the main street

If pharmacy is to ‘stand up and be counted’ in the reformed NHS – as Chemist and Druggist put it in an article published in April – this kind of innovative and ambitious approach will need to be exploited by pharmacists everywhere. And with PHE aiming to do 15 million NHS Health Checks, the opportunity is certainly there for those that want to make a name for themselves and their business.

Sanjay Doegar, the pre registration tutor at Ruislip Manor had this to say: 'Rishi's performance in health checks is outstanding and his drive to bring on new services has been exemplary. Through his actions we have successfully taken on the free condom service a key performance target for both prevention of STI and teenage pregnancy. We are also a high performer in the Chlamydia screening service.'

(Rishi Verma and Sanjay Doegar at Ruislip Manor)

NHS Health Checks Compete with tobacco and alcohol policy for headlines

Plain cigarette packaging as has been introduced in Australia. Photo: AFP

July has turned out to be a topsy turvy month for public health. Whilst Public Health England has revealed its plans to drastically scale up the delivery of NHS Health Checks, other policy announcements have delivered significant blows to those campaigning for public health reforms.

Despite a drive to deliver 15 million NHS Health Checks over the next five years, July also saw the shelving of plans to introduce minimum unit pricing on alcohol and a rejection of proposals that would have meant cigarettes needing to be displayed in plain packets.

For many, this contradiction is likely to prove problematic. Whilst the government’s commitment to assess and advise the population on cardiovascular risk is ambitious, the political messages are mixed. Decisions that are likely to have a detrimental effect on people’s health mean that the government’s overall approach cannot really be deemed ‘holistic’.

As David Cameron has stated ‘health inequalities in 21st century Britain are as wide as they were in Victorian times. We can't go on like this.’ Despite sounding decisive, there is arguably a mismatch between the rhetoric and the policies actually being implemented (or not in the case of tobacco and alcohol).

In regard to plain packaging, the government argued last week that there was lack of evidence that such measures would work. This is no longer the case. On the 22^nd July a study entitled ‘Introduction effects of the Australian plain packaging policy on adult smokers: a cross-sectional study’ was published by the BMJ. A very brief summary of the study’s conclusion is as follows:

‘‘The early indication is that plain packaging is associated with lower smoking appeal, more support for the policy and more urgency to quit among adult smokers.’’

The above was strongly suspected by many involved in public health. The Faculty of Public Health even felt it appropriate to withdraw from responsibility deals and issue a strongly worded statement when the government decided in favour of allowing cigarette manufacturers to continue branding their goods.

What does seem clear at this stage is that the introduction of plain packaging would constitute an extremely grim medicine for those with vested interest to swallow. The importance of a market identity to cigarette companies is perhaps most potently demonstrated than by the fact that, in 2003, the industry allegedly spent a combined total of $15.12 billion on promotion and advertising. To remove the ability to brand the products is therefore, arguably, to take away one the tobacco industry’s most effective and refined tools.

Given that the evidence has now been published, the government can re-establish the debate armed with the knowledge they were previously lacking. Hopefully in doing so they’ll be able to standardise a consistent approach to promoting healthy living.

That said, if the contradictions ensue, one could argue that the drive to deliver 15 million health checks runs the risk of having its rationale undermined by the detrimental impacts of other big decisions that promote damaging lifestyle behaviours. Despite being a crucial element in the country’s public health programme, the NHS Health Checks need to be part of an overall set of directives that work towards preventing widespread poor health from overwhelming the NHS over the coming decades.

Yes, the issue is ultimately one of education, however the potency that lies within regulating the pricing, advertising and branding of unhealthy, ‘demerit’ goods cannot be underestimated.



Published findings from the NHS Health Check Leadership Forum

On 12th June, the first NHS Health Check Leadership Forum took place during the 2013 Commissioning Show. Initial findings from the National Evaluation were announced and discussed by public health experts from around England. Ambassadors from successful programmes also presented on innovative strategies for commissioning, delivery and management of NHS Health Checks. The event was filmed and key findings have been collated as video and PDF thought piece. These are freely available at www.healthdiagnostics.co.uk

The long-term outcomes of the NHS Health Checks have yet to be measured. However, Dr Michael Soljak, Clinical Research Fellow at Imperial College London, kicked off the Forum by presenting encouraging early results from his team’s National Evaluation of the programme. These indicate that uptake has been greater in more deprived areas, suggesting the health checks had been targeted effectively to address those at highest risk from cardiovascular disease, stroke, diabetes, liver or kidney disease. The findings have been accepted for publication in the Journal of Public Health.

The Leadership Forum identified the ‘top five’ factors key to successful provision and uptake of NHS Health Checks:-

1.      Flexibility to fit local needs
2.      Complete quality assurance
3.      Delivery of the check in a single session
4.      A patient-focused IT solution
5.      Seamless data transfer to patient records

Jayne Herring, Public Health Contracts Manager for NHS Tees, explained the need to be flexible and to fit local needs. Tees Public Health has carefully targeted the NHS Health Checks to over 65,000 local individuals, 20,000 of whom were found to be at high risk. Underpinning this project – which has achieved year-on-year DH performance targets – is reliable and efficient IT support. Herring went to lengths to say: “I cannot overestimate the importance of investing in good primary care informatics and IT solutions for the health checks.”

The need for total quality was underlined by panel member Jacqui Deakin, Quality and Health Improvement Lead for Durham County Council. In an article featured in the Guardian on 10th July, Deakin described her team’s approach as a ‘‘non-medical lifestyle intervention’’. Many of County Durham’s NHS Health Checks are carried out in community settings rather than surgeries or hospitals, making the quality of delivery essential if GPs are to trust the data landing on their clinical systems. Deakin also emphasised the importance of, “Doorstep provision, making every contact count (MECC), and offering choice so that individuals feel they ‘own’ their care pathway.”

Julie Evason, Managing Director of Health Diagnostics, drew attention to the advantages of delivering checks in a single session using Point of Care testing, (as opposed to asking patients to return to their GP to collect results). ‘‘Individuals can then be given brief opportunistic advice immediately after they’ve had a pin-prick blood test and received their health check results. This is about maximising every single intervention.’’ Similarly, a software programme which is patient-focused and designed for use during a consultation can enable individuals to conceive of their level of risk easily through the use of intuitive illustrations, graphs and imagery. Evason explained ‘‘Health Diagnostics have tried to incorporate all of these practical features into Health Options®.’’

Recent innovations in paperless data transfer to patient records were also announced. Evason stated, “If we’re not getting the data back, it simply won’t count towards local authority targets,” adding that data should be getting onto clinical systems within a matter of clicks. The paperless approach doesn’t require data to be re-inputted by GP surgery staff, therefore avoiding the potential for human error and reducing administrative costs to practices. Ultimately, it enables those at particularly high risk to be immediately flagged as the data is sent to the patient’s record quickly and securely.

As the Guardian Healthcare Network stated earlier this month, “We don’t need to wait around for technology to improve to meet this challenge, but instead use the technologies available to us now, to leapfrog our way closer to 2018, when Hunt wants the NHS to go paperless.”

Using Motivational Interviewing during NHS Health Checks

Among the most keenly discussed topics at this month’s NHS Health Check Leadership Forum was the need to make every contact count. The approach aims to ensure that NHS Health Check providers maximise every opportunity to talk to individuals about their health. What’s more, meaningful and motivational consultations are essential if the programme is to achieve the impact it promises.

In reality, the process of encouraging individuals to consider behaviour change is a delicate task. However, having constructive conversations can be greatly assisted by practicing certain Motivational Interviewing (MI) techniques. A central idea of MI is that individuals are far more likely to be convinced by their own arguments than those imposed by others. As such, the method looks to elicit an individual's inner motivation to change. Above all, a non-judgemental attitude that facilitates a conversation that’s relevant to the concerns of the person having the health check is essential.

Achieving these objectives is possible through a combination of techniques outlined by Miller and Rollnick in MI-3. However, given the specific circumstances offered during a health check, brief interventions often need to be – as their name would suggest – brief. As such, delivering a 20 minute counselling session is often not possible. The question for health check providers is then, ‘how can we make a difference in the minutes that are available to us?’

In order to provide guidance on precisely this matter, Health Diagnostics have produced a pack of training and consultation materials. These are provided to anyone trained at a Health Diagnostics training day. (See below for image). The pack includes:

• A booklet that condenses the techniques outlined in MI-3 into a framework for approaching NHS Health Check consultations
• A range of Top Tip cards which may be used by practitioners to offer bite-size practical advice on lifestyle choices
• Access to a video demonstrating some of the MI techniques in action

Due to the time pressures during a NHS Health Check, using visual tools as a support is an invaluable way to encourage behaviour change. With this in mind, Health Diagnostics have built a number of tools into Health Options® in order to aid the user in explaining and eliciting information about lifestyle. Targeted use of these tools is covered in the pack materials, as well as being featured in the forthcoming video of the recent NHS Health Check Leadership Forum which was hosted by Health Diagnostics earlier this month.

During the Leadership Forum, a number of topics were examined by public health experts implementing and delivering health checks. The audience and panel discussed many issues, including how to cleverly target the checks, transferring data electronically to the patient’s record, and innovative ways of boosting uptake. The initial findings from the national evaluation were also presented by Dr Michael Soljak, Clinical Research Fellow at Imperial College London.

As a follow up to the event, the findings will be published on www.healthdiagnostics.co.uk as both as a video and PDF thought piece in early July. More details on the panel can be accessed here.

In addition to the aforementioned resources, there are some useful interactive online learning resources provided by the NHS that can be accessed through the professional learning environment.

(above: the Motivational Interviewing pack)

The NHS Health Check Leadership Forum

On Wednesday 12^th June 2013, London’s Excel centre will be playing host to this year’s Commissioning Show. With keynote speakers that include the Minister for Care and Support, the Chair of NHS England, and the Shadow Health Secretary, the event is set to attract an audience keen to stay abreast of current developments in health.

In conjunction with the Commissioning Show, the NHS Health Check Leadership Forum will be staged for those individuals specifically involved in the commissioning and coordination of the NHS Health Checks.

The Leadership Forum – made up of a panel and a select audience – will provide the only event specific to the NHS Health Checks at this year’s show. As such, the platform it offers will be catering for all and any discussion associated with the challenges and benefits currently facing those deploying population-based cardiovascular screening programmes.

Panel members involved in innovative service delivery will talking about their experiences at the sharp end. Others concerned with researching the evidence base and developing systems to get data into GP practices will be sharing their findings.

The panel will be made up of the following individuals:

Andy Cowper: Comment Editor at Health Service Journal, Editor of Health Policy Insight and Event Chair and programmer for Wellards. Andy will chair the session

Dr. Michael Soljak: As a Clinical Research Fellow at Imperial College London, Dr. Soljak is part of the research team evaluating the NHS Health Check programme. With work published in both the British Medical Journal and the Journal of Public Health, Dr. Soljak is in an ideal position to respond to questions concerning the emerging NHS Health Check evidence base.

Jayne Herring: As a member of the Directorate of Public Health in the North East, Jayne oversees the management of public health contracts in North Tees. Having been commissioning population based CVD screening since before the NHS Health Check programme came into being, Jayne has had to recognise and overcome many challenges. She’ll be sharing this experience in innovative public health provision.

Jacqui Deakin: As Durham’s Quality and Health Improvement Lead, Jacqui’s knowledge covers the spectrum of roles and responsibilities associated with the NHS Health Checks. From getting different providers to ensure a consistent delivery, to engaging with communities and motivating providers to perform, Jacqui will be talking about the practical considerations of the programme.

Julie Evason: Managing Director at Health Diagnostics. For 30 years Julie has been developing health screening solutions and has supported the rollout of NHS Health Checks projects across 25 PCTs. Latest developments include coordinating the return of granular data to any clinical system.

Due to the specialist topics under discussion, attendance at the event is via invite only. If you’re you’d like to attend, please send your declaration of interest to info@healthdiagnostics.co.uk. Include your name, organisation and job role.

The NHS Health Check Leadership Forum will take place at a venue on the doorstep of London’s Excel on the 12^th June @ 12.30.

FREE delegate passes to the Health+Care show (which includes the Commissioning Show) are available for healthcare and public sector professionals. To book a complimentary pass to the show, click here

The public’s health: pitfalls and possibilities

And so it begins...

Welcome to Health Diagnostics’ new blog. Having developed a cutting edge cardiovascular health screening solution, it seemed time to take to the online message boards to tell people about it!

That’s precisely what we’ll be doing here. Expect to read about the latest developments within population health screening, with particular attention being paid to England’s NHS Health Check programme.

The challenges currently facing primary care will prove demanding, whilst the changes afoot are equally as diverse. With the UK economy set to have to accommodate for an extra 11 million obese adults by 2030, a central question public health is asking itself is, ‘how can we meaningfully intervene now and prevent this predicted burden from overwhelming the NHS?’

The diabetes epidemic associated with this dangerous hike in obesity levels has been well documented, with charities such as Diabetes UK doing valuable research on the likely economic and social impacts. The simple fact has been stated – we’re ‘sleeping walking into a crisis’. The question now arising is ‘are we’re really doing enough to shake ourselves into action?’

The anticipated response needs to be as profound as the potential problem. For the UK to avoid a situation whereby the average person leads an inactive and inhibited life due to largely preventable ill-health, the measures that Public Health England take now will have a drastic effect on the shape of the coming years.

Fortunately PHE appear to be rising to the challenge. The recently published Our Priorities 2013/14 document explicitly states the organisation's intent towards:

'Helping people to live longer and more healthy lives by reducing preventable deaths and the burden of ill health associated with smoking, high blood pressure, obesity, poor diet, poor mental health, insufficient exercise, and alcohol'

And a primary way in which they’re going to support people to live healthier lives is: 

'By implementing NHS Health Checks to 15 million eligible people. We will support the roll-out of the Health Check programme by local authorities, assuring full implementation across the country'

The proof will lie in the pudding – and specifically whether more people pick the healthy option more of the time – however the intent from the newly endowed health authorities is loud and clear.

There will be trying tests associated with carrying out these aims well and ensuring the programme is both targeted with measured outcomes. However with experience in health screening that long pre-dates the inception of the NHS Health Check programme in 2009, Health Diagnostics are well placed to analyse and coordinate the solutions.

As such, some of the topics you’ll see appearing on this blog over the coming weeks will involve:

-         Plans for the NHS Health Check Leadership Forum

-         Developments in behavioural science and how they’re being integrated into provider training

-         Details on getting patient data back into all GP clinical systems electronically

Comment is encouraged on this blog, and please do also share your views with us on Twitter.

Details on the panel and programme for the NHS Health Check Leadership Forum, which is taking place at this year’s Commissioning Show, will follow next week.

Thanks for reading.