Bath and North East Somerset Council has a good track record of inviting and getting people in for NHS Health Checks. Strong partnership work with GP practices has been key to that success. The team is now looking at how digital Health Checks could bring new opportunities to reach those least likely to take up the offer.
The challenge and response
Prior to the COVID-19 pandemic, all of the GP practices in Bath and North East Somerset (B&NES) were signed up to and delivering NHS Health Checks, with effective systems in place which ensured good population coverage. As a result, B&NES Council has been the top-performing council in the South West region and ranks highly on the England comparison table.
Cathy McMahon, Public Health Development and Commissioning Manager, said the key to this success is a strong and proactive relationship with GP practices. “Pre-COVID, all of our GP surgeries were supported to systematically identify and invite their eligible population, in line with the advice and guidance we had given them.”
Since the pandemic, most of the 22 practices are now back up to speed with Health Checks, but a few are not currently offering them due to capacity and staffing issues. “Whilst not all our surgeries are delivering at the moment, those that are have really excelled. The number of checks delivered in 2022/23 exceeded 2019/20 numbers.”
GPs were involved in developing the NHS Health Checks programme from the earliest stage. B&NES Council directly managed the contract for five years, maintaining a strong focus on organisational development, support, regular training and sharing performance data. The contract was then awarded to a prime provider who now manages it on the council’s behalf, sub-contracting to GP practices and directly providing an outreach programme.
Outreach work
Alongside the whole-population approach through surgeries, outreach is offered for particular population groups, vulnerable communities and those least likely to come for a Health Check.
One focus of this work is reaching eligible people in certain occupations. For example, public health worked with the council’s licensing team to invite local taxi drivers for an NHS Health Check, which was hosted at their depot. There was very good uptake, with more than 40 drivers taking up the offer over a five-day period.
The outreach service works with the HR department at Royal United Hospitals Bath to reach NHS workers, particularly those in routine and manual jobs such as cleaners and porters. Staff are offered appointments in the workplace, with the support of their managers. This approach has also been used within B&NES Council’s environmental services, with workplace appointments offered to employees such as the waste services team.
One sticking point in terms of workplace delivery has been the eligibility criteria for the NHS Health Check. To get around this, the outreach team now offer ‘mini’ wellbeing checks for those staff who are not eligible.
The outreach service also targets vulnerable communities such as the Gypsy, Traveller and Boater community, people with learning disabilities, people accessing drug treatment services and residents using local food banks. Cathy McMahon explained: “An outreach vaccination service was already in place, facilitated by community organisations and groups. We have wrapped the Health Check offer around that work. Outreach workers go out with the vaccination team and provide a wider wellbeing offer. Where someone is eligible, they are offered an NHS Health Check.”
Looking ahead
While the outreach work is a key part of the B&NES Health Check programme, the number of people accessing checks in this way is relatively low. Like other areas, Bath and North East Somerset has struggled to get pharmacies involved. However, the move to a digital offer could bring new opportunities to work with a wider range of community providers to support a more targeted face-to-face offer.
Cathy McMahon said: “We want to build on the outreach model as we move to the digital offer. We need to look at what can be done digitally, without exacerbating the inequalities around the digital divide. Our GP practices and other partners could then focus on targeting more at-risk groups and those least likely to take up the offer.”
B&NES peaked at about 52 per cent take-up pre-COVID for NHS Health Checks. “With the transition to a national digital offer, we will be able to use our local resources in a more defined way.” As well as targeting under-served populations, that could include reviewing the age of eligibility. “Bringing some people in earlier, say from 35 years old, could help ensure that those at higher risk of cardiovascular diseases are prioritised for support earlier, hopefully preventing or slowing the progression of disease.”
Contact:
For more information contact Cathy McMahon, Public Health Development and Commissioning Manager: [email protected]