NHS Health Check PCIT template
Overview
The NHS Health Check template PCIT is part of Primary Care IT's (PCIT) standalone template collection. It is located within the OneTemplate Non-Prescriber or via F12
Page structure
Each page covers a different aspect of the NHS Health Check. The layout is designed to the flow of a typical consultation, with a natural break in the middle for Practices that deliver the NHS Health Check over at least two consultation: the first being a data gathering exercise while the latter being a review once blood results are available and QRISK2 has been calculated.
Home Page
This page serves two purposes. First, it provides guidance (Health Check Best Practice Advice) and allows clinicians to check patient's eligibility for the NHS Health check, as well as record reasons when the check cannot be completed. Reasons for ineligibility are
- Too young - patient is under the age of 40
- Too old - patient has had their 75th birthday
- Existing cardiovascular condition or on lipid lowering therapy
- Patient has had an NHS Health Check in the last 5 years
The screenshot below shows the embedded the NHS health check edibility checker which is a protocol that users can simply launch.
Second, it provides navigation buttons that link to each section of the NHS Health Check consultation. While the layout is designed to reflect how a typical consultation may run, clinicians can freely jump directly to any section by clicking the blue buttons, and return by clicking 'Home', located at the bottom-right corner of the page.
Navigation buttons
Home button to return to Home Page (bottom right)
Gender, Ethnicity and Reasonable Adjustment
This page serves as an introductory page where clinicians can complete the following actions:
- Update a patient's reported gender (this does not change the Male/Female flag on the NHS spine)
- Update ethnic origin information
- Update reasonable adjustment
Smoking
Review and update a patient's most recent smoking status. This page has been kept deliberately simple, without going into too much information about smoking history and cessation.
Alcohol Screening
This page provides the ability to record a patient's alcohol consumption history, education, as well as calculators for AUDIT-C questionnaire and the more detailed AUDIT version. Clinicians will be able to complete this by launching the AUDIT C protocol highlighted in the screenshot below
Activity, Diet and Family History
Calculate a GPPAQ grading and record information about diet. For both elements it is possible to record additional information about education and advice given as a result of the patient's response.Under the Family history section, record a patient's cardiovascular disease history, including adding affected family members.
Examination
Record basic observations such as BMI, waist circumference, blood pressure, pulse.
Atrial fibrillation screening is not a reportable part of the NHS Health Check, but best practice guidance recommends that pulse rhythm is checked prior to a blood pressure.
A section is provided for recording the blood test as either Venous blood sampling (X74UW) or Finger Prick Sampling (Xa0jj). Following this, the user is prompted to pause the consultation depending on the type of blood sampling used.
When the local protocol calls for venous testing, it is expected that the NHS Health Check will take place over at least 2 consultations, perhaps weeks apart.
The keystone of the NHS Health Check is a QRISK score so the advice given is to not tick NHS Health Check completed following taking the blood since it may introduce confusion when the quarterly data return is being finalised, particularly if the blood test has been done at the end of the quarter.
The blood sample type codes record the type of blood sampling rather than the procedure itself, so these codes could be used internally to help incomplete NHS Health Checks.
Results & QRISK
Depending on the type of testing used (finger prick sampling or venous sampling), the NHS Health Check continues to the second phase on the results page. The new cholesterol result will influence the patient's calculated QRISK score result using the QRISK2 Calculator, or the QRISK3 website.
If using the QRISK2 section, complete a final check of the recorded data which can influence the score, then click the calculate button.
Advice, assessment, referral
Education, intervention signposting, and referrals arising from the patient's responses during the NHS Health Check can be recorded with additional text information. Clinicians should use the Letter template located on the side toolbar of the template (see screenshot below) to complete the referral form.
Memory Screening
For patients who are old enough, the memory screening page will display. This is an additional element of the NHS Health Check intended as an early screening tool for memory problems in patients who may not otherwise attend regular appointments in the absence of long term cardiovascular conditions.
PSA testing
PSA testing is not part of the NHS Health Check, but it is often a question asked during the Health Check. The page only shows on men over the age of 50, who are entitled to ask for a PSA test on the NHS even if they do not have symptoms.
GP surgeries or entire areas may have policies on PSA testing. Please consult local policy and/or a GP prior to conducting any PSA test.
Complete NHS Health Check
This section serves as a checklist for mandatory data points for an NHS Health Check as well as recording the important NHS Health Check completed code.
Patients who have recently turned 75, those who have recently been diagnosed with a cardiovascular condition, and those who have been started on lipid lowering therapy as a result of their NHS Health Check in the past 3 months will still see the primary page enabling the user to apply retrospective updates to the recorded data.
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