Foreword from Dr Paul Wright GP
It is a privilege as a doctor working on the NHS Health Check to be invited to write the foreword for this bulletin.As a full time GP partner, I naturally spend the majority of my time providing and coordinating clinical care to our patient population. However, my interest in the role of IT systems, combined with a role for identifying opportunity for our practice, resulted in me coordinating our approach to the NHS Health Check programme in 2011.
At that point, I wasn't looking much further than the contractual responsibilities and financial remuneration offered for providing this service. We developed dedicated roles to manage patient recall using texting and calling to provide the NHS Health Check.
Our enthusiastic engagement was reciprocated by a significant proportion of our patients. The skills learnt by the team have supported the practice in all aspects of long-term condition management, improving our performance in QOF and extending into clinical audit beyond the quality framework. The staff costs were more than adequately covered by the remuneration offered. Our disease registers have swelled, and led to promising results with regards to the impact of early intervention (especially in our patients identified with impaired glucose regulation).
I believe that a single system approach will never enable us to reach our entire population, which is why I support a mixed model of delivery. There are certainly challenges in reaching the aspiration of the 66% uptake but by using alternative ways to deliver the service, we can reach those under-served members of the population. Public Health Manchester has recognised this, and we have been fortunate to be the service provider on the Manchester Health Bus which has enabled us to reach people in workplaces and community settings on days and times that suit them.
Under the strain of increasing pressures and service redesign, GPs may actually be the true hard-to-reach population. In neighbouring practices the provision of NHS Health Check has been mixed, with some remaining disengaged from the service.
A primary care cardiovascular disease leadership forum is being established and I look forward to the supportive message that they will be sending to their peers. This will hopefully encourage more GPs to come on board. I believe this would be an essential positive move as GPs are optimally placed to provide a key role in supporting the prevention of cardiovascular disease, and ongoing involvement in this important service is vital.