Foreword from Nada Lemic, Director of Public Health, Bromley
Thank you to Public Health England for inviting me to write this month’s foreword for the NHS Health Check e-bulletin. I am director of public health for the London Borough of Bromley and I also chair the NHS Health Checks London Network.
I would like to share our experience of the NHS Health Check programme in Bromley and the work of our London Network.
When designing our programme in Bromley, we used a tried and tested method of employing nurses as facilitators. Each public health nurse covers a specific geographical patch in the borough and has established excellent relationships with all providers. The nurses have a clear understanding of the challenges and problems faced by GP practice staff, community pharmacies and our community outreach company. They provide practical guidance, training and supervision, promote best practice and assess competencies of those providing the checks. We plan to use our nurses in the roll-out of the new national competency framework.
However, we appreciate this model is not replicable in every area. Other areas have chosen to invest in software to support the monitoring of the NHS Health Checks. We chose not to do this in Bromley, mainly because of our close relationships with our providers, who submit comprehensive anonymised data quarterly. Our public health analyst helps us to examine the data for inconsistencies or gaps in order to assess quality and manage payments. This can be time consuming but it gives us an in-depth understanding of where the problems are so we can act accordingly.
The addition of AUDIT C to the NHS Health Check programme has been particularly challenging for some of our providers and, although we have provided some training events, when we surveyed our staff, it became evident that more training in alcohol and AUDIT C was required.
When asked to be the lead director of public health for NHS Health Checks in London in 2013, I was keen to promote the quality of the NHS Health Checks across the capital. The London Leads Network agreed to develop pan-London quality standards to provide a tool to measure the quality of our programmes. A sub-group was set up and the standards were finalised in 2013. With the publication of the PHE national quality standards, we noted that both sets of standards contained some elements that were not common to both. The group then developed and agreed an evaluation tool which incorporates both the national and London standards. We have recently used this evaluation tool to assess our Bromley programme. This proved an extremely valuable exercise in identifying areas for improvement which we are using in Bromley to guide further development and monitoring of outcomes.