An insight into the
NHS Health Check Programme
in Birmingham
NHS Health Check National Learning Network
14th Workshop - London
17th July 2012
Implementation of
NHS Health Checks
286,766
147,121
Number
who have
received an
NHS Health
Check
104,251
91,449
Gaining an insight...
• Aim to provide an insight into people’s experiences of
NHS Health Check Programme in Birmingham.
• Specifically interested in understanding:
– How the Health Check programme is working in
Birmingham?
– What is happening after people attend their
appointment?
– How effective in leading to lifestyle changes?
– Implications for lowering health risks associated
with CVD?
Methodology
▪ Qualitative approach: semi-structured interviews,
prompted to talk about all aspects of NHS Health Checks
experience.
▪ Sampling: randomly drawn. Initial response rate was low.
Second recruitment drive undertaken.
▪ Response Rate: 345 recruitment letters issued, 21
consent forms returned, 10 participants recruited.
▪ Sample: 8 females, 2 males; mean age 58.4 years;
predominately White British.
Qualitative Analysis
• Transcripts analysed using qualitative analysis.
• Stepped approach; i) audio interviews copied into
written transcripts ii) emerging patterns noted iii)
compared amongst sample and developed into
themes.
• Two master themes identified:
1) Awareness & Understanding
2) Reassurance
Awareness &
Understanding
Meaning of
Results
Awareness &
Understanding
Understanding
of NHS Health
Checks
Programme
Perception of
NHS Health
Check as
Health MOT
Service User
Comments
“I thought it
would be a good
overhaul, you
know, an overall
body check for
everything”
“I’d never heard
a thing about it”
“Results should be
explained more clearly”
“I didn't’ know
“I expected more,
not just the CV bit”
what 5.8
meant,
whether it was
high or low and
whether I need
to be worried”
Reassurance
Mechanism
Immediacy of
receiving
results
Selective
focus on
positive
results
Reassurance
Confirmatory
role of health
check
Reasons for
attending
health check
Role of Health
Professional
Service User
Comments
“I just wanted
it confirmed”
“She gave me the impression
that everything was ok”
“It was good to
underline that
everything was
fine”
“The driving force to go was
the intrigue to know I’m ok”
“I wanted it
confirming
that I was
doing all the
right things”
Summary of key
findings
• Little understanding & awareness of both the existence of
and the purpose of the NHS Health Check Programme.
• NHS Health Check perceived as a ‘general health MOT’
rather than a CVD prevention programme.
• Need for the meaning of results to be explained and put
into context for participants to understand.
• Both a reassuring and confirmatory role of positive health,
as opposed to a communication of risk for CVD.
Recommendations
1. Training for
providers
2. Marketing
3. Meaningful
Results
Training for Providers
▪ The NHS Health Check needs to be promoted and
delivered as a ‘behaviour and lifestyle prevention
programme’ as opposed to a ‘check up’.
▪ Equip facilitators with skills and knowledge to begin
facilitating behaviour change e.g. language & terminology,
development of structured discussion tools.
▪ Embed a self-management model of care.
▪ Concordance not compliance!
Social Marketing
▪ Use of consumer insight to guide local marketing &
promotion strategy.
▪ ‘Real life’ experiences are powerful motivators for
attending a NHS Health Check.
• Local residents to ‘champion’ local NHS Health Check
Programmes (e.g. In-house health advocate training
programme, engagement of survivors families).
▪ Empower local communities to take more ownership of
their own health.
Meaningful Results
• Results need to be understood before they can be acted
upon.
▪ Avoid references to ‘% risk’ and numerical values. Instead
focus on level of risk of developing specific diseases.
▪ Information alone is not enough not prompt behaviour
change.
▪ Results should be made applicable and transferred into
concrete goals to prompt positive lifestyle change.
Next Steps....
Nationally…
• National collaboration of existing qualitative research
findings.
• Commitment to further qualitative research (focus groups,
patient experience surveys, follow-up).
Locally…
• Exploration of NHS Health Check providers’ views.
• Implementation of goal setting & evaluation.
Thank You!
Dr Laura Chipchase
Health Psychologist
Birmingham Public Health
Email: [email protected]