1. NHS Health Check programme An opportunity to engage 15 million people to live well for longer Louise Cleaver National Programme Support Manager

2. Policy background  Policy proposal published 1st April 2008  170,000 (36%) deaths caused by vascular disease in England  Responsible for 20% of hospital admissions  Largest single cause of long term illness  Disproportionately impacts people living in deprived circumstances and certain ethnic groups 2NHS Health Checks programme

3. NHS Health Check background From 1 April 2013, local authorities (LAs) are responsible for the NHS Health Check programme, previous responsibility was with Primary Care Trusts (PCTs) It is mandatory for LAs to offer and provide NHS Health Check risk assessments Legal duties exist for local authorities to make arrangements to: Those eligible aged 40-74 to be offered a NHS Health Check once in every 5 yrs, and for each person to be recalled every 5 yrs if they remain eligible 3NHS Health Check programme

4. First a question to consider: What percentage of risk factors associated with someone having their first heart attack are modifiable? 90% Men 94% Women Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study 4NHS Health Check programme

5. The positive impact ‘Why have an NHS Health Check?’ Dr Dawn Harper, GP and TV presenter (Click on the image to play the video)

6. NHS Health Check NHS Health Check is a world leading large-scale prevention programme It aims to reduce the risk of non-communicable disease across the population by tackling the top 8 disease risk factors The check assesses an individual’s risk of developing heart disease, stroke, diabetes and kidney disease by looking at their behavioural and physiological risk factors There are 15 million people eligible for an NHS Health Check in England The programme has the potential to prevent 1,600 MI s and strokes and 650 cardiovascular disease related deaths a year It could detect at least 20,000 cases of diabetes or kidney disease earlier 6NHS Health Check programme

7. Burden of disease 7NHS Health Check programme

8. Premature mortality After cancer cardiovascular disease is the most common cause of death in people under the age of 75. Two thirds of death in the under 75’s are preventable or avoidable through better treatment. NHS Health Check has a pivotal role in prevention, earlier diagnosis, better management. 8NHS Health Check programme

9. NHS Health Check programme Aim To improve health and wellbeing of adults aged 40-74 years through the promotion of earlier awareness, assessment, and management of the major risks factors and conditions driving premature death, disability and health inequalities in England. 9NHS Health Check programme

10. Objectives To promote and improve the early identification and management of the individual behavioural and physiological risk factors for vascular disease and the other conditions associated with those risk factors. To support individuals to effectively manage and reduce behavioural risks and associated conditions through information, behavioural and evidence based clinical interventions. To help reduce inequalities in the distribution and burden of behavioural risks, related conditions and multiple morbidities. To promote and support appropriate operational research and evaluation to optimise programme delivery and impact, nationally and locally. 10NHS Health Check programme

11. Economic modelling Prevent  1,600 MI & strokes annually  650 CVD related deaths  4,000 new case diabetics  20,000 DM + CKD diagnosed early in the disease pathway  Using NICE QALY model <£3,000 “very cost effective” 11NHS Health Check programme

12. NHS Health Check components Age, gender and ethnicity Family history Height, weight and BMI Smoking and alcohol use Physical activity levels Blood pressure Cholesterol HbA1c or fasting glucose (if dictated from BP and BMI measures) Raising awareness of dementia and signposting (for those aged 65-74 years) 12NHS Health Checks programme

13. NHS Health Check programme13

14. Delivery of the NHS Health Check 14NHS Health Check programme This is a compressed film of the NHS Health Check (Click on the image to play the video)