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NHS Health Check

Everyone is at risk of developing heart disease, stroke, type 2 diabetes or kidney disease.

However these diseases can often be prevented. The NHS Health Check is for adults in England between the ages of 40 and 74, who have not already been diagnosed with diabetes or vascular diseases (heart disease, stroke or kidney disease).

The NHS Health Check will assess your risk and provide you with personalised advice on how to reduce it.

The NHS Health Check is a few straightforward health tests, measurements and a set of questions about your medical history. All the elements of the Health Check are simple to carry out, and there will be plenty of time to discuss the results with your GP or health professional afterwards.

The results of your NHS Health Check will give you and your GP a clearer picture of your health and your risk of developing cardiovascular disease (heart disease, stroke or kidney disease), and of type 2 diabetes (which can lead to vascular disease). You will be offered personalised advice on how to maintain or improve your health and lower your risk of developing heart disease, stroke, type 2 diabetes or kidney disease and by taking action you will improve your chance of a longer, healthier life.

Background

Putting Prevention First (2008) set out plans for the NHS to introduce a systematic and integrated programme of vascular risk assessment and management (the NHS Health Check link).

The South London Cardiac and Stroke Network continues to work with health professionals in South London to support them in the development, implementation and delivery of the NHS Health Check progamme and to ensure that patients receive an equitable service.

Raised Lipids and familial hypercholesterolaemia

SLCSN documents

Cholesterol testing is a component of NHS Health Check and the identification of increased numbers of individuals with raised cholesterol is to be expected. A proportion of those found to have raised cholesterol will require further investigation to explore the possibility of familial hypercholesterolaemia (FH). In South London it was identified that FH cascade testing services were needed.

A suitable pathway has been developed which should enable PCTs to have the flexibility needed as they develop their NHS Health Check and FH services. It incorporates additional methods for screening for familial hypercholesterolaemia using a lipoprotein (a) exclusion test and ultrasound carotid intima-media thickness (c-IMT).

Diabetes identification

SLCSN documents

An aspect of the NHS Health Check is identifying patients at high risk of having or developing diabetes and the Department of Health (DH) offered guidance and a diagrammatic pathway for this.

In South East London PCTs there was some concern about the lack of capacity and the financial implications to undertake all the potential oral glucose tolerance tests that might arise from the proposed pathway. As a result, a sub group was formed to review the DH diabetes filter and make a decision about the best pathway for South East London (SEL). After much discussion and debate the final SEL pathway has been developed to take on board the future proposed changes in the diagnosis of diabetes using HBA1C.

In South West London PCTs there was some concern about the DH diagrammatic pathway and its ease of use. As a result a sub group was formed to review the DH diabetes filter and make a decision about the best pathway for South West London (SWL). After much discussion and debate the final SWL pathway has been developed.