Evaluation of the Southwark NHS Health Check service
Evaluation in progress. Expected completion date May 2024
What does the research mean for Local Authorities?
Uptake of the NHS Health Check programme is typically low throughout local authorities in England, particularly among people living in deprived areas. Southwark Council have developed a digital version of the Health Check (DHC), which may help to increase uptake and be a more cost effective way of delivering the programme. This study will provide initial evidence to inform local authorities on: 1) the reach of the DHC; 2) the potential effectiveness in terms of prompting positive health actions of both the digital and standard Health Checks; and 3) the costs associated with the DHC.
What does the research evaluation mean for the Public?
The NHS Health Check programme aims to detect early signs of cardiovascular disease (CVD), type 2 diabetes (T2DM), kidney disease, stroke and dementia in 40 to 74 year olds in England. The DHC may provide a way for more people to access the NHS Health Check programme and thus increase the early detection and management of long term conditions and associated behaviours, and help to reduce health inequalities. If this study finds evidence of the DHC reaching more people, prompting positive health actions or lowering costs (compared to the standard Health Check), more local authorities may consider adopting the DHC.
How are the public involved in the evaluation?
We have talked with local residents of Southwark who may use the Health Check service to ensure that our plans for the research are acceptable. As a result of their feedback we created a audio version of the participant information sheet, which can be opened via a QR code, to help make the information accessible and engaging to more people. We will share our findings with the local residents and work with them to plan how best to share the findings with the wider community.
We also have recruited a project steering group with two local Southwark residents, a local GP and practice nurse – the steering group will meet with the research team and the Southwark public health team quarterly to check study progress and help with the interpretation of results.
Lay summary of research
The NHS Health Check programme aims to detect early signs of long-term conditions among 40-74 year olds in England. If a person is found to be at high risk of developing a condition, they may be offered support to change their behaviour (e.g., help to quit smoking) or medications to lower their risk. Roughly 25% of adults who are eligible for a Health Check actually attend. Unfortunately, people who do not have a Health Check tend to be those more at risk of developing long-term conditions.
To encourage more people to have a Health Check, Southwark Council have made a digital version that people can complete online using a smartphone, tablet or computer. The digital Health Check (DHC) is going to be trialled in central Southwark in January-March 2023. Approximately 6000 people in this area will be sent invitations to complete the DHC - they will be able to choose to complete it at their GP practice (i.e., a standard Health Check) if they prefer.
Our research objectives are to:
- Assess the extent to which the DHC is effective at engaging those groups that have not been reached by the standard Health Check
- Explore to what extent the service overall is effective at encouraging people to take positive health actions and how the Health Check process could be improved
- Explore whether effectiveness, in terms of encouraging positive health actions, differs among those completing the DHC versus a face-to-face Health Check
- Explore practice nurses’, healthcare assistants’ and practice managers’ perceptions and experiences of both the standard and digital Health Checks and the impact on GP practices of the addition of DHCs, in terms of clinician and administrative burden
- Investigate the cost of the DHC as business as usual and assess whether it represents good value.
To do this, we will look at health record and survey data, comparing data for those sent invitations to standard Health Checks with those sent invitations to the DHC. We will also conduct interviews with Southwark residents and GP practice staff. The findings from this project will help Southwark and other councils throughout the UK to improve the Health Check service.
Paul Stokes (Head of Programmes – Health improvement, Public Health Division)
PHIRST Insight Research Team
Professor Russ Jago, Dr Lis Grey, Professor Rona Campbell, Professor Frank De Vocht and Dr Hugh McLeod, University of Bristol