034C NHS Health Check

034C NHS Health Check

Notes
This folder sits within Primary Care IT - Reporting Group within folder 034 Eligibility. 

The NHS Health Check eligibility searches are provided to help Practices call and recall patients based on the nationally specified criteria. A separate folder of searches (030 NHS Health Check reporting) is provided to make the detailed reporting requirements as easy as possible to submit each quarter. 
Warning
Primary Care IT strongly recommends that this article is understood before the searches are used in your Practice.

Cohort for NHS Health Check

PA-301) Eligible for a NHS health check, which takes all 40-74 year olds, then excludes any patient with a pre-existing cardiovascular condition. Do not use this search for recall as it includes anybody who is eligible for the programme, even if they received an NHS health check within the last 5 years. 
Idea
The Eligible for a NHS health check search could be used to gauge the level of demand; take the total number and divide by 5 to obtain a theoretical annual number, then multiply by an expected uptake percentage (eg: 40% or 0.4) to estimate the number of appointments needed across a 12 month period.

The cardiovascular condition search is the crucial search as it identifies patients with any of the following conditions or medications:
  1. Unresolved hypertension
  2. Coronary heart disease
  3. History of stroke or TIA
  4. Unresolved diabetes mellitus
  5. Familial hypercholesterolaemia *
  6. Peripheral Arterial Disease
  7. Chronic Kidney Disease (CKD3-5 or renal failure)
  8. Unresolved atrial fibrillation
  9. Unresolved heart failure
  10. An issue of a statin in the last 6 months
  11. An issue of an alternative lipid lowering drug in the last 6 months (bempedoic acid / ezetimibe / icosapent ethyl / inclisiran / PCSK9 inhibitor)
  12. The most recent QRISK result is at least 20%
Info
* Familial hypercholesterolaemia has been defined rather than a broader definition of Hypercholesterolaemia (to include Pure and Secondary) since this is the definition written in the NHS Health Check Best practice guidance. PCIT reached out to the national health check team for clarification in June 2024. 

Notes
Patients on the palliative care register are also excluded from this search which is intended to avoid inappropriate invitations being sent to patients who may be at end of life. 

Data Admin

Declined NHS health check in last 5 years
This search counts the number of eligible patients who have actively declined an NHS Health Check in the last 5 years. These patients are still eligible to receive an opportunistic NHS health check, but it is not necessary to invite them again.
Notes
Patients who declined but were subsequently made ineligible either by age or a new diagnosis are not counted, nor are patients who declined but subsequently changed their mind and completed an NHS Health Check.

Has had NHS health check in last 5 years
This is a standalone search to identify currently registered patients who have had an NHS health check. Some patients counted may be no longer eligible if they have been subsequently diagnosed with a cardiovascular condition or turned 75.
Notes
Patients who completed their NHS Health Check at a previous surgery are included in this figure.
Inappropriate for NHS health check ever
This search will show you patients that are eligible for a NHS Health Check and have also had NHS Health Check not appropriate code added to their record. 

Coding

Idea
All invitations for programmes such as NHS Health Checks should be routinely coded. Some areas have a reporting data point to monitor how many patients have been invited. Adding invitation codes also helps to ensure that the same patients are not invited too frequently. While there is no limit to the number of times a patient can be invited in any 5 year period, the Practice's capacity to process invitations and provide appointments will be limited so these searches have been designed to limit the number of invitations a patient is offered over the 5 year period.

Relevant coding for NHS Health Check invitations is provided below.
Invitation
SNOMEDTerm
758661000000102NHS Health Check invitation
523261000000108NHS Health Check telephone invitation
522261000000101NHS Health Check verbal invitation
523281000000104NHS Health Check invitation first letter
523301000000103NHS Health Check invitation second letter
523321000000107NHS Health Check invitation third letter
980621000000105NHS Health Check invitation email
980641000000103NHS Health Check invitation short message service text message

Declined
SNOMEDTerm
758661000000102NHS Health Check declined

NHS Health Check completed
SNOMEDTerm
523221000000100NHS Health Check completed
840391000000101
NHS Health Check completed by third party
1053551000000105
NHS Health Check completed under NHS Healthy workplace Programme

NHS Health Check not appropriate 
SNOMEDTerm
884221000000109NHS Health Check not appropriate 



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