National NHS Health Check E-learning
Everyone delivering the NHS Health Check should first complete the e-learning package developed by Health Education England and OHID (Office for Health improvement and Disparities), available on the e learning for health website.
Other recommended training:
Making Every Contact Count (MECC) training is a package that is very helpful for talking to someone who may be thinking about about changing a lifestyle behaviour, for example stopping smoking or getting more exercise
The Dementia Training Tool addresses the dementia aspect of the health check, including self-assessment section and completion certificate.
The Alcohol Identification and Brief Advice e-learning course provides professionals with support to deliver simple alcohol identification and brief advice.
Frequently Asked Questions (FAQ’s)
1. What tool should I use to assess Physical Activity?
The GPPAQ is the only validated physical activity assessment tool that assesses for risk of Cardiovascular disease and must be included as part of the Health Check and is available from the link below. https://www.gov.uk/government/publications/general-practice-physical-activity-questionnaire-gppaq
2. Is waist circumference included as part of the Health Check?
Whilst a waist circumference is not required in order to obtain a q-risk score it should be taken as part of the Health Check as it can inform the diabetes filter score. Waist circumference measures are asked for as part of the service specification and are included in the read codes requested by Devon County Council.
3. In the results leaflet there is a box asking for score, what does this mean?
You must give each person a copy of their results. Order results leaflets from email@example.com with the number you need. You only need to record scores for Alcohol audit-C, Pulse, blood pressure, BMI, cholesterol and overall risk of heart attack or stroke in next 10 years. There is no score to record in smoking, Physical activity or diet.
4. When should we refer to OneSmallStep?
Following a discussion with the patient regarding their results if they wish to access support to make a lifestyle behaviour change refer them by completing this referral form, or give them the OneSmallStep card. www.onesmallstep.org.uk E: firstname.lastname@example.org Tel (Freephone) 0800 298 2654 Tel (Local Rate) 01392 908139 A discussion about an individual’s lifestyle and an assessment of their motivation to change is an essential part of the Health Check.
5. Can historical cholesterol results be used as part of a NHS Health Checks?
We recommend that you collect all the results required for the NHS Health Check on the same day (unless you use a venous blood test for the cholesterol test). In the event that a good cholesterol result has been obtained within the last 3 months, clinical judgement should inform whether this reading is suitable to be included as part of the NHS Health Check. Height, weight, waist circumference and blood pressure readings must be taken on the day of the NHS Health Check.
6. How should we communicate the results to someone who has undergone gender reassignment?
Provide the q-risk score for both male and female genders and ask the individual which of the results they would like to base the remainder of the discussion on.
7. Can HDL be too high?
In most cases a High HDL is seen as protective against heart disease and is commonly referred to as ‘good cholesterol’. In searching reliable health related websites there is no mention of an upper limit being harmful. There is 1 study Arteriosclerosis, Thrombosis, and Vascular Biology that suggests high levels of HDL can be associated with having had a heart attack, thyroid disorders, inflammatory diseases and alcohol consumption. No figure has been placed on what levels define High HDL. We would encourage you to discuss this with GP’s who can confirm the clinical rationale for any further investigations that they may wish to conduct. We advise that in communicating the results to the patients you continue to say a good HDL score is 1mmol/L or more and for men a score of 1.2mmol/L is good for women.
8. Our website suggests a good Total Cholesterol/HDL ratio is 4.5mmol/L, what’s the source of that statistic?
At risk groups are encouraged to achieve a TC/HDL ratio of less than 4mmol/L (Diabetes UK, British Heart Foundation, NHS choices), the seemingly healthy population should aim to achieve a TC/HDL ratio of 4.5mmol/L (Heart UK, and adopted as a guide by BHR Pharmaceuticals). We ask that practitioners communicate the results to the public in a language they will understand and to consider the other lifestyle risk factors obtained in the NHS Healthcheck as part of the discussion and communication of the results. Public Health Devon is happy for you to use either 4mmol/l or 4.5mmol/l as what’s generally recommended.
9. How does the NHS Health Check fit with the annual health check for people with Learning disabilities
10. How does the NHS Health Check fit with the annual health check for people with severe mental health conditions?
The Annual Health check for people with severe mental health conditions is different from the NHS Health Check. The 2 checks are separate and one should not replace the other. Both checks should be done on all those eligible.
The Alcohol Identification and Brief Advice (IBA) Factsheet, developed in partnership between Devon and Torbay Public Health Teams, is designed to support professionals delivering IBA in primary care. The factsheet works to compliment both the NHS Health Checks programme and ‘Making Every Contact Counts’. It includes the following:
- Epidemiology and evidence
- Risk assessment and lifestyle advice
- Useful tips and conversations
- IBA training and resources
- Alcohol treatment and support services
Please access the factsheets at the following links: