Article Figures & Data
Tables
- Table 1. NHS Health Check fidelity checklist based on NHS Health Check Best Practice Guidance1
Item Criteria Risk assessment Ethnicity Asked patient their ethnicity Height Measured height Weight Measured weight Blood pressure Measured blood pressure Pulse rhythm Palpated pulse and verbalised comment regarding pulse Cholesterol Evidence of cholesterol measurement taken Family history of CVD Asked patient about any family history of cardiovascular disease Alcohol usage Asked patient about alcohol consumption per week Smoking history Asked patient about smoking status Weekly physical activity Asked patient number of hours of physical activity completed per week Risk communication QRISK2 score Told patient their QRISK2 percentage score Blood pressure Told patient their blood pressure BMI Told patient their BMI Cholesterol Told patient their cholesterol AUDIT-C Told patient their AUDIT-C score Risk management Lifestyle advice Suggested, or encouraged the patient to suggest, specific lifestyle changes for risk reduction Clinically appropriate lifestyle advice As for 'lifestyle advice', but where lifestyle advice is given which relates to at least one lifestyle factor for which the patient was outside of the recommended limits Dementia risk information Told patient the key message that the risk factors for CVD and dementia are the same BMI = body mass index. CVD = cardiovascular disease.
Characteristic n (%)a Mean a ge, years ( range, SD) 52.2(40 to 73, 9.3) Sex Female 26 (68.4) Male 12 (31.6) Ethnicity White 34 (89.5) Mixed/multiple ethnic group 0 (0.0) Asian/Asian British 1 (2.6) Black/African/Caribbean/Black British 3 (7.9) Family history of CVD in a first-degree relative 19 (50.0) BMI >25 26 (68.4) Weekly moderate physical exercise <2.5 hours 14 (36.8) Weekly alcohol consumption >14 units 7 (18.4) Current smoker 2 (5.3) QRISK2 >10% 7 (18.4) Education level University 18 (47.4) Secondary 19 (50.0) Primary 1 (2.6) Deprivation quintile b 1 4 (10.5) 2 14 (36.8) 3 11 (28.9) 4 9 (23.7) 5 0 (0.0) aUnless otherwise stated. bIndex of Multiple Deprivation quintile: 1 = least deprived, 5 = most deprived. BMI = body mass index. CVD = cardiovascular disease. SD = standard deviation.
HCP Role Consultations, n Elements (N = 18)completed, mean (%) Elements (N = 18) completed, range (%) A HCA 5 14.0 (77.8) 11 to 16 (61.1 to 88.9) B Practice nurse 2 14.5 (80.6) 14 to 15 (77.8 to 83.3) C Practice nurse 2 16.0 (88.9) 15 to 17 (83.3 to 94.4) D HCA 6 15.0 (83.3) 15 to 15 (83.3 to 83.3) E HCA 18 14.1 (78.4) 12 to 17 (66.7 to 94.4) F Practice nurse 3 15.3 (85.2) 14 to 16 (77.8 to 88.9) G HCA 2 14.0 (77.8) 14 to 14 (77.8 to 77.8) HCA = healthcare assistant. HCP = healthcare professional.
Element of NHS Health Check Consultationscompleted, n (%) Risk assessment Ethnicity 12 (31.6) Height 38 (100) Weight 38 (100) Blood pressure 38 (100) Pulse rhythm 29 (76.3) Cholesterol 36 (94.7) Family history of CVD 25 (65.8) Alcohol consumption 38 (100) Smoking 38 (100) Physical activity 38 (100) Risk communication QRISK2 37 (97.4) Blood pressure 36 (94.7) BMI 35 (92.1) Cholesterol 34 (89.5) AUDIT-C 13 (34.2) Risk management Lifestyle advice 34 (89.5) Clinically appropriate lifestyle advice 34 (89.5) Dementia 6 (15.8) BMI = body mass index. CVD = cardiovascular disease.
Of participants with lifestyle factor outside recommended range, number receiving: Lifestyle Factor Participants outside of UK Chief Medical Officer’s recommended range, n (%) Risk assessment communicated, a n (%) Clinically appropriate lifestyle advice, n (%) Overweight 26 (68.4) 24 (92.3) 22 (84.6) Exercise 14 (36.8) No relevant risk score 9 (64.3) Alcohol 7 (18.4) 5 (71.4) 4 (57.1) Smoking 2 (5.3) No relevant risk score 2 (100) BMI = body mass index.
↵a Risk scores communicated: weight = BMI; alcohol consumption = AUDIT-C.