NHS Health Check Programme Training

National E-learning package

Practitioners will find the e-learning package available on the NHS Healthchecks website covers a comprehensive overview of the programme and we recommend that this is completed prior to or soon after attending the refresher training. There are 11 short video’s that range in duration from 1-5mins. Practitioners can select aspects of the e-learning package that they feel they need upskilling on. To access the programme click below. http://www.e-lfh.org.uk/programmes/nhs-health-check/open-access-sessions/

Making Every Contact Count (MECC) Training

Making Every Contact Count training is a package that is very helpful to practitioners delivering the NHS Healthcheck programme and is also helpful for all Primary Care workforces. Participants will develop skills in having very brief healthy conversations, that can be delivered within the time constraints of the NHS Healthcheck intervention.

For more information about the MECC Training please click on the link

https://www.devonhealthandwellbeing.org.uk/library/prof/making-every-contact-count-mecc/

or email: Natalie.Winterton@devon.gov.uk 

Training Resources and Frequently Asked Questions  (FAQ’s)                                          

Refresher Training slides NHS Healthchecks refresher presentation FINAL

FAQ’s

  1. What tool should be used 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 Healthcheck and is available from the link below. https://www.gov.uk/government/publications/general-practice-physical-activity-questionnaire-gppaq

  1. Is waist circumference included as part of the Healthcheck?

Whilst a waist circumference is not required in order to obtain a q-risk score it should be taken as part of the Healthcheck as it can inform the diabetes filter score. Waist circumference measures are requested as part of the service specification and are included in the read codes requested by Devon County Council.

  1. What results does the Cardiochek machine produce?

The Cardiochek machine will produce the following results:

  • Total cholesterol
  • HDL
  • Ratio of Total Cholesterol/HDL

 

Cholesterol results you hope to see
Total CholesterolLess than 5mmol/L
HDLMore than 1mmol/L in men and 1.2mmol/L in women
Total Cholesterol/HDL RatioLess than 4.5mmol/L

  What to do if the Cardiochek machine gives you the following readings:

 Possible reasonAction
Blank scoresNot enough blood on sampleRepeat test on different finger and promote blood flow with patient consent
Total CholesterolGreater than 6mmol/LBrief intervention and signpost to OneSmallStep
Total CholesterolGreater than 7.5mmol/LRefer to GP for further investigation and follow guidance in the service specification

 

  1. 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 and we suggest it is done using the results leaflets that are available from Public Health Devon. 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. We will remove the scoring boxes in future print runs to avoid any confusion.

  1. 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 you should give them the OneSmallStep card. www.onesmallstep.org.uk E: hello@onesmallstep.org.uk 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 Healthcheck.

  1. Do we need to purchase a Point of Care Testing kit to measure cholesterol and what is the process?

 A non-fasting cholesterol test is required as part of the NHS Healthcheck. Some practices chose to adopt this approach and others chose to include a full fasting blood sample. If your practice choses to provide a non-fasting blood test then Public Health Devon will order and pay for a Cardiochek machine for your practice. Practices that have previously been supplied with a Cardiochek machine are encouraged to use the machine previously supplied by Public Health Devon. The machines will remain the property of Devon County Council. It is the practices responsibility to order and pay for the consumables and maintenance costs of the Cardiochek machine. An order form is available here. A medical representative is available to provide on-site visits and support to practices using the Cardiochek machines. His contact details are: Gareth Hopkins E: Gareth@bhr.co.uk    Tel: 07720 736293 7. Can historical cholesterol results be used as part of a NHS Healthchecks? We would recommend that all the results required for the NHS Healthcheck are taken on the same day (unless using 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 Healthcheck. Height, weight, waist circumference and blood pressure readings must be taken on the day of the NHS Healthcheck. 8. What are the lower and upper limits that the Cardiochek machine? The range for total cholesterol is 2.59-10.36mmol. The range for HDL is 0.39-2.59mmol. In the event the HDL reading sits outside of this range the display will read <0.39 or >2.59. It’s important that the area being tested in cleaned properly with an alcohol wipe to remove anything that may interfere with the results i.e. moisturisers. 9. 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. 10. 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. 11. 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. 12. How does the NHS Healthcheck fit with the annual check given to those with Learning disabilities? Information about the Annual Learning Disability Healthcheck can be found: https://www.nhs.uk/Livewell/Childrenwithalearningdisability/Pages/AnnualHealthChecks.aspx Information about the NHS Healthcheck can be found: http://www.healthcheck.nhs.uk/  The 2 checks are separate and one should not replace the other 13. Read code confusion We are aware that there is a CCG programme of change which means data systems are migrating to a new language known as SNOMED. However, until further notice we ask all primary care providers to record the read codes listed within the Service Specification. If Practices have any problems with recording the data requested please notify Public Health Devon immediately of the Read codes you have problems with and the data systems you are working with so that we can work with you and our CCG colleagues to identify solutions. Incomplete datasets may result in payments being delayed or withheld.  Free Online Training Further FREE e-training courses and tools for professionals delivering health checks are also available online.  http://www.healthcheck.nhs.uk/commissioners_and_providers/training/elearning_resources1/ These include: 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.

Additional Resources

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 ‘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:

  • For South Devon and Torbay CCG click here
  • For NEW Devon CCG click here