Wellbeing and Regeneration

Project: Evaluation of Tower Hamlets NHS Health Check Pilot Programme.

Main contact: Dr Patrick Tobi

Project team: Dr Patrick Tobi (Principal Investigator) Professor Adrian Renton, Dr Emee Vida Estacio, Shahana Lais and Gail Barrow-Guevara

Start date: July 2009

End date: December 2009

Project funder: NHS Tower Hamlets

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Background

NHS Health Check (formerly known as the vascular check programme) is a new national initiative for people in England aged between 40 and 74. The scope of the programme entails: (a) identifying and assessing an individual's risk of developing coronary heart disease (heart attacks and angina), stroke, diabetes and kidney disease; (b) communicating this risk in a way that the individual clearly understands; and (c) managing the risk appropriately through advice, clinical management, signposting or referral to other lifestyle interventions and services. It includes being recalled every 5 years for reassessment.

In Tower Hamlets, the programme began in January 2009 as a pilot delivered from GP practices and targeting people who were not currently on CHD or Diabetes registers. There are two levels of screening:

• Level 1 (by all GP practices) - the identification and ranking according to risk of patients over 40, compilation of up to date contact details and the loading of data post-screening.
• Level 2 (piloted in 4 GP practices) - a systematic screening service (inclusive of all activites at level 1).

The Institute for Health and Human Development has been commissioned by NHS Tower Hamlets to evaluate the pilot phase of the programme and deliver learning to guide the strategy for full roll out across the borough.

Aims

• To describe the logistics of delivery highlighting what works well, what does not and why (including an appraisal of the method of inviting patients, their journey through the system, the communication of risk, the appropriateness of the delivery setting, the capacity of providers to deliver, and the impact on other services.)
• To gain insights into key patient segments and identify how they can be embedded into the programme (building on work already carried out from a pre-pilot social marketing research exercise).
• To analyse the potential impact of wider environmental factors on successful implementation.

Methods

Our approach to the evaluation is based on a framework that triangulates several data collection methods and different stakeholder viewpoints to build a coherent picture of the programme's inputs, process and outputs. It's defining features are:

• A whole system approach that generates multi-stakeholder perspectives from both service providers. User and relevant third parties.
• A mixed methods research design that combines qualitative and quantitative methods to generate information about the programme.
• A social marketing element that segments service users with a view to understanding the best communication channels and the most effective mix of intervention approaches.

The main methods are a) qualitative interviews with patients, GP staff, healthy lifestlye service managers, and PCT commissioners; b) analysis of monitoring data from participating GP surgeries; c) literature review of the existing evidence base; and d) documentary analysis.

Documents/References

Department of Health (2008). Vascular Checks risk assessment and management: 'Next Steps' Guidance for Primary Care Trusts. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_090278.pdf

Clinical Effectiveness Group (2009). The NHS Health Check: reducing heart disease, stroke, diabetes and chronic kidney disease.

Report summary

For further information please contact: Patrick Tobi

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© 2010