NHS Health Check

NHS Health Check - Case Studies

As part of NHS Health Check Learning Network, NHS Diabetes and Kidney Care and the Policy Team at the Department of Health are in the process of collating a series of case studies on existing vascular risk assessment and management programmes.

The main aim is to showcase and share some of the achievements, positive outcomes and learning points from the various existing schemes, initiatives and services with a wider audience to assist other areas with the successful delivery and implementation of the NHS Health Check. 

The case studies are not intended to provide definitive guidance on 'how to do it'; nor are they 'model' schemes endorsed by the Department of Health or NHS Diabetes and Kidney Care. However, we hope that they will help guide commissioners and providers with what works (and what doesn't work!) with various aspects of vascular risk assessment and management including, for example, social marketing techniques, clinical engagement, checks in community settings, data transfer and so on.

Please note that many of the case studies were written prior to the publication of the Department’s NHS Health Check: Vascular Risk Assessment and Management Best Practice Guidance. This important document provides best practice guidance to support PCTs in their implementation of the NHS Health Check programme and to help ensure consistency, quality assurance and safety across England. Download the guidance here.

If you would like to add your story to the 'library' of case studies, please email Eleanor Kent-Dyson

Case Studies

Evaluation of 'Phase One' NHS Health Check Programme in Cambridgeshire: November 2009 to March 2010
NHS Cambridgeshire had no existing systematic cardiovascular risk detection programme in place, and so the introduction of the health checks programme was a completely new initiative for the PCT. The NHS health checks programme was introduced in November 2009. Being a completely new project implemented by the PCT, evaluation has revealed important lessons to guide a better service delivery for the second phase of implementation. See here to read the full story (PDF 137KB).

Building the referral pathways first: NHS Manchester
With over a third of all deaths in the area resulting from cardiovascular disease (CVD), NHS Manchester recognised that simply increasing the number of checks would not be enough to make an impact on vascular risk.  Instead, it developed an end-to-end strategy to tackle the problem which started ensuring that suitable referral pathways were in place. See here to read the full story (PDF KB).

Working with a whole community: Muslim Doctors and Dentists Association
With evidence showing that Muslims in the UK are at a far higher risk of cardiovascular disease than other groups, the Muslim Doctors and Dentists Association is seeking to raise awareness of the problem within the Muslim communities.  It is taking the message to community fairs across the UK, offering free health checks and lifestyle advice.  See here to read the full story (PDF KB).

Planning an outreach programme in Barking and Dagenham
With one of the highest levels of CVD in the country, NHS Barking and Dagenham decided that new approach to prevention was needed.  Working with independent charity, the Blood Pressure Association, NHS Barking and Dagenham is taking cardiovascular health awareness on to the high street to give as many people as possible the opportunity to have a vascular check.  The carefully planned programme went live in March 2009.  See here to read the full story  (PDF KB).

Piloting QRISK2 screening: Tower Hamlets PCT
With one of the highest national rates of coronary heart disease, stroke and smoking-related deaths, and a low life expectancy particularly among its Bangladeshi populsation, Tower Hamlets PCT has chosen to adopt the new QRISK2 CVD risk scoring method to identify those most at risk of developing vascular disease in its area.  See here to read the full story (PDF KB).

Find and treat in Ashton, Leigh and Wigan
A vascular checks programme in Ashton, Leigh and Wigan has found more than 1500 undiagnosed cases of hyperlipidaemia, 214 new diabetes cases and 431 patients with hypertension.  This is out of just over 5000 screened patients.  The focus now is on incresing the numbers tested.  See here to read the full story (PDF KB).

The Cardiovascular Prevention Health Inequalities Project on the Isle of Wight
Drawing on targeted funding from the Strategic Health Authority to tackle health inequalities, the Isle of Wight Primary Care Trust (PCT) has introduced a cardiovascular prevention programme. This successfully identifies more patients at risk, and is changing lifestyles too. The key to the programme’s success is the involvement of a wide range of partners. These range from pharmacies to gyms, and from commercial weight loss services to the Chamber of Commerce. See here to read the full story (PDF KB).

Sandwell PCT: a systematic approach to CVD screening
Having identified that more than 20,000 borough residents were likely to be at risk of CVD (but had not been officially diagnosed), Sandwell PCT decided to introduce a more systematic approach to vascular screening. To date the scheme has tested over 2000 people, with more than 950 receiving new medication, and almost 550 lifestyle referrals. An estimated 95 heart attacks and strokes have been prevented and 31 lives saved. See here to read the full story (PDF KB).

Introducing a joined-up approach: Bromley My Action
Medical intervention alone can’t tackle heart disease – what is needed instead is an integrated approach including stopping smoking, making healthy food choices and taking regular physical activity. But in many communities, the support and services to help people make those lifestyle changes aren’t connected. The MyAction programme, piloted in Bromley, takes a different approach – unifying diet, physical activity and medical advice through a sixteen-week intensive programme with a follow- up one year on. See here to read the full story (PDF KB).

A targeted and systematic approach to reducing health inequalities: NHS Leeds
With a ten-year gap in life expectancy between people living in the most deprived and affluent areas of Leeds, the local PCT (NHS Leeds) decided to introduce a targeted vascular risk assessment programme in the most deprived areas with an overall aim of reducing health inequalities. The programme is delivered through GP practices enabling patients to be managed effectively. See here to read the full story (PDF KB).

Cardiovascular Disease Risk Assessment- The Barnsley Way
Barnsley people suffer from cardiovascular disease (CVD) more than many other people in England. CVD risk assessment and managing those at high risk is part of Barnsley’s approach to turning this around.
This case study details:

•     Barnsley’s Approach: The what and the why;

•     Problems encountered;

•     Achievements to date;

•     Estimated unit cost to date;

•     Future plans and challenges.

See here to read the full story (PDF KB)

Actioning the Lifestyle Support Programme in Stoke on Trent
As part of a drive to reduce the marked health inequalities in the area, NHS Stoke on Trent (formerly Stoke on Trent PCT) launched a comprehensive primary prevention programme targeting those at higher risk of developing cardiovascular disease (CVD), in addition to people with established CHD and diabetes.

The programme, which is being rolled out to all 55 GP practices across the city, essentially comprises a comprehensive CVD risk assessment scheme which aims to identify all those at high risk of developing CVD using a powerful software tool called 'Oberoi', supported by a Lifestyle Support Programme (LSP) which aims to deliver a range of community-based lifestyle interventions. See here to read the full story (PDF KB).

The BIG Bolton Health Check
Launched in April 2008, the 'Big Bolton Health Check' is aimed at tackling cardiovascular disease- the leading cause of premature death and health inequalities in the area- head on by systematically inviting every person in Bolton over the age of 45 years without existing circulatory disease or diabetes to attend a free health check in one of a number of community venues. Click HERE to read the full story…

Health is Your Business Project, West Sussex
The Health is Your Business project is a small exploratory project that commenced September 2007. It evolved from a Local Area Agreement (LAA section 22B) to "Improve the Quality of Life in the Most Disadvantaged Neighbourhoods within West Sussex". One of the aspects of this local area agreement was to look at a community-based project that involved promoting healthy lifestyles and targeting health needs by focusing on manual unskilled workers within these areas. The main vehicle chosen to do this was to offer health checks in workplaces and community venues. Click HERE to read the full story…

Happy Hearts, Nottingham
Happy Hearts is a collaboration between Nottingham City Primary Care Trust, The Pharmaceutical Industry and the people of Nottingham. The project aims to identify people at risk of developing cardiovascular disease (CVD) and support them to make healthier lifestyle choices and where appropriate, offer relevant medical advice and pharmaceutical interventions. Targeted at patients in Nottingham City's most deprived areas, the project also seeks to tackle the health inequalities associated with deprivation. Click HERE to read the full story…

Improving Male Life Expectancy, Birmingham
The difference between male life expectancy (MLE) in Birmingham and other comparable cities in England is high and improving MLE is a major challenge for the city.

South Birmingham PCT on behalf of the three Birmingham PCTs, supported by the Birmingham Health and Wellbeing Partnership, commissioned an opportunistic cardiovascular disease (CVD) risk assessment service, called 'Heart MOT', from community pharmacy. In conjunction with this scheme, Birmingham Health and Wellbeing Partnership also commissioned a separate but complementary cardiovascular risk assessment service in various community venues outside pharmacies under a European Journal tender process. Click HERE to read the full story…

Cardiovascular Risk Management in Doncaster
Given that premature mortality and morbidity from cardiovascular disease is a major contributory factor towards the current inequalities in health in Doncaster, the development of a structured approach to cardiovascular risk management has been identified as a key priority by Doncaster Primary Care Trust (DPCT).

The cardiovascular risk management programme in Doncaster essentially comprises two components - a specific service aimed at identifying people at risk of developing cardiovascular disease (the 'Test Your Heart' scheme) and ongoing management in primary care via a Local Enhanced Service (LES). Click HERE to read the full story…

Community Health Checks, Knowsley
Knowsley at Heart is supported by Knowsley Health and Wellbeing Partnership, an enterprise which is using the combined force and expertise of Knowsley Council and Knowsley PCT, along with key third sector partners, to tackle health inequalities in the borough.

Launched in October 2008, the Community Health Checks initiative- which aims to offer free health checks to the 13,000 plus people in Knowsley at risk of cardiovascular disease- is poised to become an integral part of one of the largest prevention programmes in the country. Click HERE to read the full story…