Frequently asked questions
We thought it would be helpful to share with you some of the questions and answers that the national team get asked each month. You can find a couple of points that were raised recently below.
Why are the HbA1C POCT tests no longer undertaken for patients referred to the diabetes prevention programme?
On the 23 May 2019, the national diabetes prevention programme confirmed that HbA1c POCT tests will no longer be undertaken on individuals referred to the service. This change has been implemented for three reasons a) this data was primarily being used for evaluation purposes and the programme now has a sufficiently large dataset to no longer require it and b) in having completed some evaluation/analysis of the data it shows that results are less accurate compared to lab testing c) removing blood testing will simplify the patient journey. The NDPP programme has confirmed that referrals to the service on the basis of a diagnosis of Non-diabetic hyperglycaemia will still be accepted from referring professionals using POCT.
What Care Quality Commission (CQC) registration do NHS Health Check providers need?
The requirement for CQC registration is based upon the specific activities of a service provider and is detailed on the CQC website at http://www.cqc.org.uk/organisations-we-regulate/registering-first-time/regulated-activities. For community based delivery of NHS Health Checks by a provider other than a GP Practice, guidance from CQC for the regulated activity of Diagnostics and Screening procedure is that non-ambulatory blood pressure and blood tests carried out by means of a pin prick test are excluded from the need to have registration. GP Practices require CQC registration as they deliver a far wider range of activities. It is important to note that this guidance from the CQC is for the activities specified only and that provider organisations are responsible in law to satisfy themselves whether CQC registration is required for any other service they provide.
Is a pregnant woman eligible for an NHS Health Check and if so, what guidance is there on calculating the risk score as pregnancy will affect weight and BMI?
Pregnancy could have an effect on key metrics such as blood pressure and BMI, which in turn will affect the CVD risk score. We advise that the person should not be excluded but deferred until after delivery.
Why are people over the age of 75 excluded from the programme?
The NHS Health Check is available to individuals between 40 and 74 years of age without existing cardiovascular disease. Individuals over the age of 75 have a named accountable GP. One of the responsibilities of the accountable GP is to provide a health check on request where an examination hasn’t been performed in the preceding 12 months.
Will PHE be producing guidance on how to commission the NHS Health Check programme?
No. Local authorities are required, as part of the constitution, to produce a procurement strategy and procurement rules and each local authority publishes these on its website. Each procurement strategy is bespoke specialist procurement and legal teams are employed by local authorities. These teams provide specialist support and advice on implementing the local strategy and procuring the wide range of public services that local authorities are responsible for.
Public health commissioners with the support of their own council's local procurement and legal experts are best placed to make local commissioning decisions about the NHS Health Check programme. PHE will continue to publish the programme’s best practice guidance to support both commissioners and providers in securing the delivery of a high quality service that the service meets the requirements of the Local Authorities Regulations 2013. You can also find general information on local government procurement including the national Local Government Procurement Strategy on the LGA website.
If a person attending an NHS Health Check is under the lower height limit for the CVD risk tool should their risk score be calculated?
The risk calculator provides an estimate of CVD risk using a statistical model. The developers have advised that either the height or weight field can be left blank and the tool will make an estimate of the overall score without an accurate BMI value. However, it is important to recognise that there may be a greater margin of error with these results. Practitioners should share the results of each of the individual risk assessments and use these as the basis of the discussion regarding lifestyle and or clinical management.
Should Local Authorities deliver NHS Health Checks to individual's who live outside of their geographical boundary but work or are registered to a GP within it?
The Local Authority Regulations 2013 confirm that an eligible person is a person in the “local authority's area” who is aged from 40 to 74 years. It is at the discretion of the local authorities to determine the approach to adopt in engaging this eligible population. Some approaches include targeting residents, people that work in the area and those registered with a GP in the area. As local authorities have a legal duty to provide the NHS Health Check they are responsible for resourcing the delivery of the programme whatever the approach adopted.
What NHS health care do migrants have access to?
Under current rules anyone can register with a GP practice in England and receive free primary care consultations from doctors and nurses. However, access to NHS hospital treatment depends on the migrant's residential status. You can find more information at:
Last updated 01/04/2021