Agenda item

The Divisional Director Public Health to submit a report describing the Health Checks programme in Leicester for 40 – 74 year olds.  The report explains the background to the national and local NHS Health Check programme and the outcomes of the NHS Health Check programme in Leicester.    

The Divisional Director Public Health submitted a report describing the Health Checks programme in Leicester for 40 – 74 year olds.  The report explained the background to the national and local NHS Health Check programme and the outcomes of the programme in Leicester.  Ivan Browne, Consultant in Public Health, also presented the report with the Divisional Director.

It was noted that the percentage of cardio-vascular deaths in Leicester as a proportion of all deaths was higher than the national average.  In Leicester the proportion was 24.7% for people aged under 75 years and 35.6% for people aged over 75 years, compared to 23.8% and 34.7% nationally.  Cardiovascular disease was the second largest cause of premature mortality under age 75 in England and Leicester.

The health check programme was not only about screening but also about delivering an information programme to make people aware that they were at risk and that they were able to make lifestyle changes to reduce the risk.  Cardiovascular disease had a high impact upon individuals and their families and also had a high cost impact upon health services, so there was mutual benefit in reducing premature mortality from the disease.  It was estimated that the Health Check Programme could reduce 1,600 premature deaths from cardiovascular disease and 4,000 from diabetes nationally.

The programme was mandated from the Department of Health and the responsibility to provide the health checks together with many other public health services transferred to local authorities following the implementation of the Health and Social Care Act 2012.  The Council worked closely with the Leicester City Clinical Commissioning Group to constantly tweak and manage the programme and streamline the process to make it as accessible as possible.  Leicester currently exceeded the national expectation that 70% of the eligible population attended a health check and the city was currently one of the highest performing areas in England for the uptake of the programme.   The City has been cited in Diabetes UK magazine and has been commended as a beacon authority for the health check programme. 

The local outcomes for the programme based on the national modelling estimates are that for 20,000 checks being carried out it could be expected that there would be 10 fewer heart attacks, 10 fewer stroke events and 32 cases of diabetes prevented in the local population each year.

Checks had been carried out on the programme to see if any groups were disproportionately disadvantaged in engaging with the programme.  No group appeared to be disproportionately disadvantage and it appeared that the programme had done well in reaching younger people, those at high risk, especially people from southern Asia and people in the wards of high deprivation.

Following the transfer of responsibility for the health check service to the Council, the local NHS Health Check service was undergoing re-procurement.  It was proposed to have the local authority selected provider/s in place by 1 April 2015.

Following questions from Members, it was noted that:-

a)         The information in Table 1 would be reviewed to present it in a more user friendly manner.

b)         Issues of data sharing had delayed implementing the tasks of internal audit but meetings had been held to identify the problems and resolve then in the future.

c)         Approximately a third of patients found to have a cardiovascular condition as a result of the screening had benefited from subsequent GP intervention.

d)         The audit by Leicester University on the clinical effectiveness of the local health check programme was not expected to be completed until the end of November.

e)         Healthwatch’s offer to assist in discussing better ways to capture more detailed data for specific groups such as was welcomed, as it was recognised that some specific groups had different health issues and it was important to have sufficient data to assess and address these needs. For example, further data was required in relation to analysis on groups for religion, belief, homelessness, gypsy and travellers, sexuality, trans-gender and disability.

f)          Although the specification for the Health Check Programme was originally focused on cardio-vascular health other items have been gradually added such as dementia and screen for alcohol dependency.

g)         The programme had received £83k and 20% had been used each year for five years to complete the screening process.  It was understood that the programme would continue in the future and that those people who were screened in year 1 of the programme would be rescreened in year 6 and so on.

The Chair commented that the Commission supported the programme as it contributed to the wider preventative and proactive screening initiatives being carried out.  Screening was important to deliver but the consequences were sometime harder to address, often it was difficult for older people to undertake exercise compared to taking a tablet for a condition.

RESOLVED:

That the report and comments made at the meeting be noted and that a further on the outcome of the audits of the Health Check programme be submitted to a future Commission meeting.