This template doesnβt directly attract QOF or IIF income but plays a vital role in:
Capturing structured data used by multiple clinical templates
Enabling clinicians to focus on decision-making while HCAs gather key metrics
Supporting NHS Health Checks, weight management, vaccination administration, and more
Itβs an essential part of the workflow for LTC reviews, screening programmes, and pre-consultation prep.
This form consolidates key data points that feed into:
NHS Health Checks
QOF and IIF indicators
Preventive and lifestyle support
Vaccination recall and coding
It is designed for Healthcare Assistants (HCAs) to complete during structured appointments or opportunistic checks.
Tickboxes for:
RSV: Invite sent or declined
Flu: Invite sent or declined
Supports accurate recall recording and helps drive uptake for seasonal vaccinations.
Tickboxes for:
Healthcheck Invite
Not appropriate
Declined
Complements the full NHS Health Check template.
Fields to record:
Height (cm)
Weight (kg)
BMI (auto or manual)
Waist circumference (inches)
Radio buttons to record:
Diet quality (Good, Average, Poor)
Inappropriate diet or restricted patterns
Exercise level (drop-down menu)
Tickboxes for:
Never smoked
Ex-smoker
Current smoker
Advice provided on smoking cessation
Fields for:
Blood pressure (systolic & diastolic)
Pulse rate
Whether pulse is regular or irregular
Tickboxes for:
Declined intervention
Advice given
Captures early risk indicators for:
CVD
Stroke
Diabetes
Kidney disease
Hypertension
Includes space for:
Free-text family history detail
Age cut-offs for inherited risk (e.g. MI in men <55)
Use this as a pre-review capture ahead of LTC clinics
Information recorded here populates other templates like:
NHS Health Check
Diabetes, Hypertension, Asthma reviews
Integrates well with OneDiary for recall management
Also ideal for health promotion clinics run by HCAs or nursing associates
Ensure family history questions are explained clearly β they influence QRISK3 and screening decisions