NHS Health Checks: A Community Pharmacy Service?
Clare Kerr, Head of External Affairs at Celesio UK, which includes LloydsPharmacy
The British Journal of General Practice has recently reported on research conducted by Public Health Warwickshire which reveals that the NHS Health Check, offered to people aged 40 to 74, provides no extra health benefits, as any disease detected could have been spotted by a GP.
Since its launch in 2009, the NHS Health Checks have aimed to prevent diseases such as heart attacks, strokes and diabetes, by spotting early warning signs such as high blood pressure and risk of heart disease. The study however, found the checks had not detected any more cases than GP care would have, yet cost £300m a year. The suggested conclusion is that GP care is just as effective, if not more so, at detecting conditions such as diabetes and heart disease than the NHS Health Checks.
It has been well documented though that the demand on GP services is on the increase, as our population is living longer and often with multiple long term conditions. The reality of the challenge currently facing the NHS is the range and volume of primary healthcare demand is too great to funnel the needs through GP surgeries alone.
There is a variety of reasons many people seek advice, support and treatment in care settings other than GP surgeries, including convenient access during working hours, not being registered with a GP, and not wanting to “bother” their GP.
Community pharmacy is an area that can help alleviate this pressure and widen access. Awareness that health checks are not about treating the ill, or the ‘worried well’, is needed. Preventing diseases and long-term conditions by addressing public health issues can be provided by other primary care providers, such as community pharmacies.
Pharmacy teams interact with their local community on a daily basis, and are able to assess lifestyle risk factors through services such as smoking cessation programmes and Type 2 diabetes screening. They engage with a number of people, including those who would not normally visit their GP on a regular basis, and can offer advice on positive lifestyle changes.
Expanding the NHS Health Check service at scale and outside of the general practice setting into community pharmacy will free capacity within the NHS, and engage with people through having conversations about lifestyle health issues. LloydsPharmacy has already demonstrated that this kind of engagement has a significant impact within the healthcare environment through its Type 2 diabetes screening and blood pressure measurement service.
The recent cross-sector report, We Are Primary Care, discusses how primary care providers, if working together, can have a greater potential for preventing ill health and improving health and wellbeing within the community. However, it also revealed the issues with funding within primary care; 90% of care takes place in primary care but it only receives 20% of the NHS budget.
It could be debated that NHS Health Checks should be provided primarily outside of the GP setting. People who visit their GP will no doubt receive checks, but health checks and lifestyle assessments should be available to all and with the constraints on GP appointments, it shouldn’t just be for those able to make an appointment. Checks are a preventative measure, and to truly work in reducing the number of people developing long term conditions or being admitted to hospital, should be embraced by and available to all.