NHS Health Check Training Lauren Seamons – Norfolk LPC October/November 2015
Jan 18, 2016
NHS Health Check Training
Lauren Seamons – Norfolk LPCOctober/November 2015
What is an NHS Health Check?
Cardiovascular Risk
What is an NHS Health Check?
Norfolk Fire and rescue service video
Norfolk County Council Health Check Video
Why have an NHS Health Check? Video
Can I offer NHS Health Checks?
• Consultation room• Clinical Waste disposal• Equipment - CardioChek or LDX
- Scales (Class 3)- Height Chart- Tape measure- BP Monitor (BHS approved)
• Staff (www.bhsoc.org/bp-monitors/bp-monitors)
• IT availability• Contract• SOP
Recruiting patients NHS Health Checks
• Counter Staff• Letter from GP• Links to/from other services• Eligibility• Do you have a booking system?
Eligibility• Patient MUST: be aged 40-74 years old
reside and/or registered in Norfolk
• Patient must not have been diagnosed with:Coronary heart disease Chronic kidney disease (CKD)Diabetes HypertensionAtrial fibrillation Trans ischaemic attack (TIA)Hypercholesterolaemia Heart failurePeripheral disease Stroke
or be taking a statin
• Patients may access the service ONCE every 5 years
Eligibility
Available from the Health Information Leaflet Service now accessible via the Norfolk’s Living Well website
Performing an NHS Health Check
Explain what will happenPatient DetailsConsentHeight Weight and BMI calculationBlood pressureDiabetic Risk Risk ScoreCholesterol measurementLifestyle
Blood Pressure• Use correct cuff size
• Advise patient to sit comfortably with feet flat on the floor (no crossed legs)
• Breathe normally
• Keep arm relaxed
• Repeat if >140/90
• Repeat a third time towards the end of the check if still >140/90
Body Mass Index
BMI =
Calculator on PharmOutcomes
Alternative template for discussion
Waist Measurement (optional)
BMI classification Waist circumference Low High Very highOverweight (25-29.9) No increased risk Increased risk High riskObesity 1 (30 – 34.9) Increased risk High risk Very high risk Men: Low = less than 94cm, High = 94-102cm, Very high = more than 102cmWomen: Low – less than 80cm, High = 80 – 88cm, Very high = more than 88cm
• For individuals with a BMI between 25 - 35
• Measure from the side
• The tape measure should be snug but not indent the skin.
Physical ActivityCalculator on PharmOutcomes
Alternative template for discussion
AUDIT -C
http://www.alcohollearningcentre.org.uk/eLearning/IBA/platforms/ALC/ then click Pharmacy E-Learning
0 – 7 Lower risk8 – 15 Increasing risk16 – 19 Higher risk20+ Possible dependence
Dementia
http://www.healthcheck.nhs.uk/increasing-dementia-awareness-training-resource/
Communicating Risk
Who will communicate the risk score?
Be clear when a GP referral is necessary
Encourage the patient to choose their own changes
Get the balance right
Support Materials
Health Information Leaflet Service
Making ReferralsReason forappointment
Threshold Action Time
High CVD risk ≥ 20% Referral to practice nurse or GP for cardiovascular risk assessment
Within 2 weeks
Blood pressure 140 to 159 systolicand / or90 to 110 diastolic
Referral to practice nurse or GP for Hypertension risk assessment and Chronic kidney disease risk assessment.
Within 2 weeks
160 to 179 systolicand / or> 110 diastolic
Within 1 week
≥ 180 systolic Urgent referral to GP for Hypertension risk assessment, Chronic kidney disease risk assessment and other CVD risk management.
Same Day
FPG ≥ 7mmol/l Repeat FPG, intensive lifestyle advice or Referral to practice nurse or GP for diabetes risk management.
Within 1 week
HbA1c ≥ 6.5%/48mmol/l Repeat HbA1c, intensive lifestyle advice and Referral to practice nurse or GP for diabetes risk management.
Within 1 week
Total cholesterol > 7.5 mmol/l Referral to practice nurse or GP to assess possible familial hypercholesterolemia
Within 2 weeks
Weightmanagement
BMI ≥ 35 Referral to practice nurse or GP for weight management.
Within 2 weeks
Making Referrals