The following resources have been designed to assist with sending invites, completing and auditing NHS Health Checks.


Invite Reports


All NHS Health Check reports can be found by going to Reporting > Clinical Reporting > Ardens > Contracts | 2023 24 | NHS Health Checks.


Cohort


The reports in the a Cohort folder will show patients who are the correct age for an NHS Health Check and don't have any of the following pre-exisiting conditions.


  • Heart disease
  • Chronic Kidney Disease (3-5)
  • Diabetes
  • Hypertension
  • Atrial Fibrillation
  • Stroke or TIA
  • Familial Hypercholesterolemia
  • Heart Failure
  • Peripheral Arterial Disease
  • Being prescribed statins
  • Latest QRISK2/3 score >20%



Eligible


The reports in the b Eligible folder will show patients who are in the equivalent cohort report but haven't had an NHS Health Check completed or declined in the last 5 years or recorded as not appropriate in the last 1 year. These are therefore your patients who are currently eligible for an NHS Health Check.




Review before 


The reports in the c Review before folder can be used to check any eligible patients that you may wish to review before sending any invites. 



Invites by Age


Please note - the 'Invites by Age' reports exclude all Dementia, Learning Disability, Severe Mental Illness, End of Life, Care Home and Housebound patients. Please see the 'Consider Invites' and 'Consider Visits' sections below on how to invite these patients.


You can choose between inviting patients between the ages of 40 and 74 (All) or patients aged 40, 45, 50, 55, 60, 65, 70 and 74 only (5y bands). 


You can further choose between 4 years and 9 month intervals (to invite patients up to 3 months before their NHS Health Check is due), or by 5 year intervals (which will show patient who are due now).


The 40 to 74 year old (All) reports are found under the following folders:

d For 1st invite | All | 4y9m interval

d For 1st invite | All | 5y interval


The age band (5y bands) reports are found under the following folders:

e For 1st invite | 5y bands | 4y9m interval

e For 1st invite | 5y bands | 5y interval


The invites are split by birth month and patients can be sent bulk invitations based on email, SMS or letter. The invitation code to add once invites have been sent is shown in brackets - this will then trigger them to appear in the f For 2nd invite reports after 28days. There are 3rd invite reports in the g For 3rd invite folder if your practice sends three invites. 



N.B Patients in these age related invite reports will also appear in the relevant Priority Group invite reports outlined below.


Invites by Priority


Please note - the 'Invites by Priority' reports exclude all Dementia, Learning Disability, Severe Mental Illness, End of Life, Care Home and Housebound patients. Please see the 'Consider Invites' and 'Consider Visits' sections below on how to invite these patients in.


The reports in d For 1st invite | All | Priority | 5y interval help you to prioritise patients you may want to invite for an NHS Health Check. These reports are based on the priority groups listed below and cover all ages between 40 and 74 and work off a 5y interval (so are due an NHS HC now). 


The priority invites are not split down by month of birth as you would want to invite these patients in by priority group irrespective of month of birth. You can then invite these patients in bulk via Email, SMS or Post as before and bulk add the code shown on each report in brackets - e.g. XaRBT for the 1st invite.


These patients would then move into the f For 2nd invite folder after 28 days if they have not yet had their NHS Health Check - you can then repeat the process of inviting them for a 2nd invite, and then the same for a 3rd invite from the f For 3rd invite after another 28 days.



There are 13 risk factors which are used to calculate the priority groups (A-F). They are all clinical indicators used by QRISK which increase the risk of a patient developing a heart attack or stroke over the next 10 years:


•    Latest BMI >=30

•    Latest BP >=140/90 (or 135/85 if a home recording)

•    Latest Total / HDL Cholesterol ratio >=5

•    Ethnic minority

•    Family history of cardiovascular disease

•    Severe Mental Illness (Mental Health register or Lithium in last 6m)

•    Latest QRISK 2/3 >=10%

•    Registered in deprived area (recorded ever)

•    Current Smoker

•    Migraines (recorded ever)

•    Rheumatoid arthritis

•    Systemic lupus erythematosus (SLE)

•    Erectile dysfunction (recorded ever)


For more information on QRISK please click here.


Note - We do not include all clinical indicators used by QRISK, for example, diabetes and CKD 3-5 as these are exclusions for an NHS Health Check therefore patients with any of these conditions will not be eligible in the first place.


Consider Invites


The reports in the h Consider 1st Invite folder allow you to invite your eligible patients who are coded as End of Life, or on the Learning Disability, Severe Mental Illness (SMI) or Dementia register. As patients with these conditions are still eligible for an NHS Health Check these invite reports allow you to decide if you wish to invite them and if so, how.


As with the other invite searches, you can invite them in bulk via Email, SMS or Post and would then bulk add the code shown on each report in brackets - e.g. XaRBT for the 1st invite or you can individually review and invite patients depending on their individual circumstances. If invited, these patients would then move into the i Consider 2nd Invite folder after 28days and the j Consider 3rd invite folder after a further 28 days.



We have also developed a Report Output for the Learning Disability/SMI/Dementia invites so you can see exactly which of these conditions a patients has. This means you can prioritise inviting patients with one of these specific conditions over another or send invites in a different way if needed. 

  • Run the invitation report and then right click > Show Patients
  • At the top of the screen, click Select Output
  • Click Pre-defined report output, then select Appointment invitations - LD/SMI/Dementia and then click Ok.



You will then see a grid of the patients and their different diagnosis.

  • Click the top of each column on the Condition name to sort the rows by this diagnosis.
  • You can then select the patients that you wish to send an invite to depending on their diagnosis and exclude those you do not want to send an invite to.


Consider Visits


The reports in the k Consider Visit I Care Home or Housebound folder will show you eligible patients that are coded as living in a Care Home or Housebound. These reports can then be used to arrange a visit for their NHS Health Check if required. 


N.B Patients in these reports are excluded from the all other invite reports mentioned above apart from EOL patients. Any EOL patients who also live in a care home or are housebound will show in the 'Consider Invite - EOL' reports.



Patient Status Alert


Following a survey, the majority of practices can ask patients opportunistically for an NHS Health Check at any age between 40 to 74. If a patient is within this age range and have not had an NHS Health Check done (or declined) in the last 5 years, a ‘!!’ patient status alert icon will appear under their name.


If you wish to change this alert to just show on patients who are specifically aged 40, 45, 50, 55, 60, 65 and 74 please follow the steps outline below:

  • Go to Setup > Data Output > Patient Status Alerts

  • Then search for an alert called ‘Eligible for NHS Health Check’ and untick the enabled box to disable this alert

  • Then right click and copy this alert and change the trigger report to this report ‘Eligible | NHS Health Check - Age 40, 45, 50, 55, 60, 65, 70, 74 - All’


NHS Health Check Template


This template can be accessed from Auto consultations > ardens NURSES & HCAS > NHS Health Check or can be added to your F12 Favourites for quick access. 


The key elements to the health check will have a blue star next to the drop down or tick box, and completing these will add the relevant codes and numerics to the patients record. 



Lifestyle information recording is split across the Alcohol, Smoking, and Weight, Diet & Physical Activity pages. The core elements of the lifestyle health check are indicated by the blue star. Included are additional scoring tools, leaflets, and lifestyle wellbeing information. The Lifestyle Wellbeing option will open a Word document with patient information and support - for some practices, this will be localised to services available in your area. 





The Memory page allows you to document discussion with the patient about dementia awareness and any leaflets or onward information. If any concerns are present, there is a prompt for GP referral. 



The Health Advice section is not part of the formal NHS Health Check but if time and ability allows, it is good practice to remind patients about cancer prevention - as what is good for CVD prevention is also good for cancer prevention. 

Note - We have added a box at the bottom to show any relevant cancer history for the patient so this discussion can be approached with sensitivity if required. 



The CVD Assessment forms a large part of the health check and all relevant assessment information, blood tests, and risk calculation can be completed from this page. If the blood sample has already been taken and results returned, the numbers will show in the boxes greyed out. There is a link for phlebotomy to record the taking of bloods and ordering of tests if a new  blood sample is taken at this point. 


The risk section has a link to complete the QRISK score for the patient. Important - if you have just entered new data into the template, you need to click OK at the bottom and then reopen the template for the QRISK calculation to include those most recent values. Based on QRISK outcome, there are options for routine 5y recall, or referral to GP or specialist service such as the NDPP. 



The final page allows you to produce a Summary for the patient to take away from their appointment. This will pre-merge into a Word document and is formatted like a leaflet so it can be folded into three columns. 


Note - to bring in the most recent data you have entered on the template, make sure you select OK at the bottom and then reopen the template before selecting Results Leaflet. 


Activity Reports


The l Monthly activity folder will give you basic activity counts of the number of patients who had an NHS HC completed or had an NHS HC invite recorded in the selected month.



The quarterly activity folders will give you figures required for more detailed NHS Health Check activity reporting such as demographic breakdowns, invite figures, and health check outcomes. Just select the folder of the required quarter you need e.g. o Q3 activity and run the relevant reports.


Data Quality


There are some data quality reports in the q Data quality folder which can help to identify any inaccurate coding you may wish to review - for example there is a search in here to allow you to see which patients may not have responded to your NHS Health Check invites so you can mark them as failed to respond.