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Revamping NHS health checks ‘waste of money’ without behaviour change

Hemant Patel: Health checks need to be followed by health coaching
Hemant Patel: Health checks need to be followed by health coaching

The plan to revamp NHS health checks is an opportunity for pharmacy, but it will be a "waste of money" if the checks do not lead to behaviour change, an LPC secretary has said.

The Department of Health and Social Care (DH) announced plans earlier this month to revamp the NHS health check, including offering more tailored health interventions based on a patient’s DNA, location and age.

Hemant Patel, north-east London local pharmaceutical committee (LPC) secretary, said the review could pave the way for more pharmacies to offer the service, but stressed that an effective health check must be followed by health coaching interventions, such as referrals to social prescribing services.

“If [the DH] is really interested in prevention – which is one of the key requirements in the NHS long-term plan – then it must improve access to, and the quality of, public health services.

“Community pharmacy is well placed to deliver on both,” he told C+D.

“Health checks are important not only as a check, but also for the activities that might follow from that.”

London pharmacies offer health checks

Eight pharmacies in Barking and Dagenham – part of Mr Patel's LPC – began offering NHS health checks to patients from the start of the month, he said.

The service is commissioned by the local authority, which pays participating pharmacies £25 per completed health check and supplies the equipment, training and publicity materials for the service, he explained.

“The local authority recognises pharmacy’s role in prevention and early detection and wants to get pharmacists involved in delivering public health services,” Mr Patel said.

Last week, he sent invitations to all the pharmacies in the LPC to encourage them to provide the service, with training expected to be rolled out in October.

He also hopes to expand the service to patients with mental illnesses, following a successful joint initiative between the LPC, North East London NHS Foundation Trust and University College London, which ran from 2016-18 and saw community pharmacies delivering health checks to people with a diagnosis for psychotic illness.

Potential barriers

Initial feedback from the eight Barking and Dagenham pharmacies offering the NHS health checks has been positive, Mr Patel said. However, not having full access to the patient’s record to determine if they have already received a health check at their GP surgery “slows things down”, he explained.

“Hopefully by the end of this year” pharmacies in north-east London will be able to read and write on the full patient record as part of a data sharing project called the East London Patient Record.

What are the DH's proposed changes to the NHS health check? 

NHS health checks are currently offered to anyone aged between 40-74, to spot the early signs of conditions that cause early death, including stroke, kidney disease, heart disease and type 2 diabetes.

“However, the checks pay little attention to people’s individual risks or needs,” the DH says.

The new “intelligent” health checks could include:

  • a special check-up for people approaching retirement age to help prevent or delay future care needs
  • increasing the range of advice the checks can offer – for example, prevention of musculoskeletal problems or early action on hearing loss
  • “digitalised” interventions, where appropriate.

Under the revamped NHS health checks, drinking advice could be targeted at 40-49-year-olds, “as alcohol use is more common in this age group”, the DH says.

Those aged 70-74 years could be targeted with advice on how to reduce their blood pressure, while those at low risk of cardiovascular disease may benefit from less frequent, online check-ups.

The public consultation closes on October 14.

Source: Department of Health and Social Care, August 16

How do you think the NHS health check could be improved?

Ranjeev Patel, Non Pharmacist Branch Manager

Pharmacy in this country is an industry which is controlled by a certain privileged few.

Leon The Apothecary, Student

All of these additional services and offerings that Pharmacists and Technicians can quite rightly provide require Pharmacy to level up so to speak. To move Pharmacists away from the mundane dispensing process, encourage greater usage of DC and ACTs, use modern technology, and optimise the workflow of prescription management.

Once that has been achieved, then Pharmacists and Technicians are in a much better position to deliver a Modern Pharmacy. 

Rajeshvari Patel, Community pharmacist

As a non pharmacist branch mamanger, you have no idea about the benefit of these health checks. Pharmacists have the knowledge and  expertise to screen this age group (40-74). I have.  been carrying out these checks for the last 8 years, supported by our area’s public health   dept. We have been adequately trained, provide        with the equipment and well remunerated so why wouldn’t you want to take this up? Benefit has  seen by all including the local surgeries, one of which is actively writing to eligible patients to have these checks done. You should facilitate  your pharmacists to be able to provide this service instead of running it down—not a very good branch manager are you? !!

Aldosterone antagonist, Locum pharmacist

How much did you get paid to say that?

N O, Pharmaceutical Adviser

"""Rajeshvari Patel, Community pharmacist"""

"""As a non pharmacist branch mamanger"""

I think you are right about that question Aldo.

Ranjeev Patel, Non Pharmacist Branch Manager

*This comment has been deleted for breaching C+D's community principles*

Ranjeev Patel, Non Pharmacist Branch Manager

Pharmacies need fewer of these "services" and just need to be paid properly for the crucial services which 99% of people go to a pharmacy for. I.e. NOT murs, nms or any of that other garbage. People go to pharmacies to pick up their prescription or to buy OTC meds. Wake up please, more services will be a disaster. In any case community pharmacy is on palliative care so I don't know why I even bother sometimes. A complete dead duck.

*This comment has been edited to comply with C+D's community principles*

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