Many of us are missing out on important health checks. But there is a way to change that

Taking health screening into the community could improve take-up rates, and deliver key benefits to the NHS – as long as you approach it in the right way, writes Becky Gulc

People aged between 40 and 74 can go for a free NHS Health Check, which aims to spot early signs of stroke, kidney disease, heart disease, type 2 diabetes and dementia.

Yet more than half of us who are invited for a check – 54% – do not take it up. Why is the take-up so low when we’re constantly being urged to lead more healthy lives?

Of course it can be challenging to get an appointment at GP surgeries. And to be fair, how many of us would take the time to make an appointment for an NHS Health Check if we’re feeling fine?

But the fact we lead busy lives should not be seen as a good enough reason to fail to look after ourselves.

Then there is the impact on the NHS to consider. Yes, it takes resources to carry out a health check. But the estimated cost of care for a person in the first 12 months after a stroke is £45,409. The cost of diabetes to the NHS in England and Wales is estimated to be £25,000 per minute.

So there’s a clear economic case for encouraging more people to access health checks and screening programmes, which can identify risks early and set in place preventative measures.

A different approach

So what if health screening is taken out of the GP surgery or health centre and into the community? At Qa we’ve been exploring this approach.

With one of our clients we’ve looked at two specific programmes: blood pressure and atrial fibrillation testing, done through community pharmacies and in the workplace.

Taking services out into the wider world is never going to be straightforward, and it won’t be appropriate for every type of health check. But the approach can and does work.

What we uncovered were specific factors which appear to be critical to success. Here are four of our key discoveries.

1. Skillset

You’re asking people to deliver community testing – but do they have the skills required? Not only the clinical expertise, but the soft skills too. The right approach is key. If you are looking to educate people on lifestyle matters, consider techniques such as motivational interviewing – will this be a new skill to learn? Are the right people being trained? Will they be required to work with new systems? What implications does this have?

2. Insight

Insight work is key, both prior to commissioning services and when contemplating the approach to working with particular employers. Consider the demographics: is the required reach practical for the community pharmacies who are interested? Troubleshoot challenges they may face.

For workplace consultations, what are the practical considerations – do people work shifts, how can they best be engaged? By troubleshooting beforehand you can identify and eliminate possible risks.

3. Buy-in

Buy-in – particularly in the case of employee testing – is a key driver of success. If an employer’s chief executive, HR department and seniors managers are enthused by, and committed to, the idea of making testing available to all employees a workable model can unfold. Understanding the merits of participation, both for the employer and employees, is key to instilling buy-in.

4. Existing commitments

Community pharmacies are keen to offer additional services and support people in their area but they face increasing funding and staffing pressures. So it is essential that the resources required for additional services are identified before the point of application, and that those commissioning the services agree to commit the appropriate budget.

Conclusion

Anyone thinking about taking screening services into the community should bear these findings in mind.

Community health screening can be done, and done well, and there is certainly appetite for driving such services forward, particularly through the community pharmacy model.

Meanwhile employers are placing a greater emphasis on the health and wellbeing of their employees. A relatively simple step, such as allowing health screening within work time, can appeal to managers as a way to demonstrate that they value the wellbeing of their staff.

However, to make any new scheme work requires planning, consultation and partnership.

Becky Gulc is a research manager at Qa Research. You can contact her on becky.gulc@qaresearch.co.uk or 01904 632 039

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