NHS Health Check programme: a realist review
Award Number
NIHR129209Programme
Health and Social Care Delivery ResearchStatus / Stage
CompletedDates
1 March 2020 -31 December 2021
Duration (calculated)
01 years 09 monthsFunder(s)
NIHRFunding Amount
£233,523.31Funder/Grant study page
NIHRContracted Centre
University of OxfordContracted Centre Webpage
Principal Investigator
Associate Professor Geoff WongPI Contact
geoffrey.wong@phc.ox.ac.ukPI ORCID
0000-0002-5384-4157WHO Catergories
Tools and methodologies for interventionsDisease Type
Dementia (Unspecified)CPEC Review Info
| Reference ID | 202 |
|---|---|
| Researcher | Reside Team |
| Published | 12/06/2023 |
Data
| Award Number | NIHR129209 |
|---|---|
| Status / Stage | Completed |
| Start Date | 20200301 |
| End Date | 20211231 |
| Duration (calculated) | 01 years 09 months |
| Funder/Grant study page | NIHR |
| Contracted Centre | University of Oxford |
| Contracted Centre Webpage | |
| Funding Amount | £233,523.31 |
Abstract
The NHS Health Check programme, launched in 2009, aims to identify individuals at increased risk of stroke, kidney disease, heart disease, type 2 diabetes and dementia among the adult population in England aged 40 to 74, through a five yearly assessment. The Health Check covers measurement of risk factors, enabling calculation of CVD risk, plus discussion and agreement on pharmacological and lifestyle approaches to managing the risk, including referral to lifestyle support services. The programme is commissioned by Local Authorities (LAs) hence it is delivered by a range of different providers in different settings, supported by Public Health England (PHE). Annually the programme costs £165 million to run. Ten years on, of the total eligible population of over 15.5 million people across England, 12.6 million (81%) have been offered a Health Check of whom 48%, (6 million) have received one. However, there is significant variation in delivery activity across the country, with uptake ranging from 5.6% to 100% between LAs. Variation in both uptake and outcomes have been the focus of many studies ranging from primary empirical research to evidence syntheses. Despite these efforts, at present it is still unclear why some areas have better uptake than others; uptake varies between eligible population groups and; patient experiences and outcomes differ across the country. Our study will address these knowledge gaps. Methods: We aim to understand how the NHS Health Check programme works in different settings, for different groups, so we can recommend improvements to maximise intended outcomes. We will do so by undertaking a realist review. We believe this is the best evidence synthesis approach to use as the NHS Health Check programme is a complex intervention that has outcomes that vary depending on context and populations. Our realist review will follow Pawson’s five iterative stages namely: 1) Locate existing theories; 2) Search for evidence; 3) Article selection; 4) Extract and organise data and; 5) Synthesise evidence and draw conclusions. We will recruit a stakeholder group (including PHE, commissioners and providers of Health Check, plus members of the public and patients) to advise and give us feedback throughout the project. We will follow the RAMESES quality standards for realist reviews. Our review will be unique because we will deliberately seek out unpublished evaluations carried out for/by local commissioners through an online survey which will be sent to all 152 LAs in England. This is because we are aware that a wealth of documents exists at the local level which are likely to contain relevant data for the realist review, but which to date have not been used in previous evidence syntheses on the NHS Health Check programme. Our survey will also enable us to map current programme invitation and delivery processes across England, thus enabling these to be related to available data on uptake. Outputs and dissemination: Our findings will be used to provide recommendations on tailoring, implementation and design strategies to improve the current delivery and outcomes of the NHS Health Check programme in different settings, for different groups. We will collaborate closely with PHE and our stakeholder group to ensure our findings are developed into a range of outputs suitable for the various stakeholders in the NHS Health Check programme. PHE will also help us disseminate through their established channels.
Aims
We aim to understand how the NHS Health Check programme works in different settings, for different groups, so we can recommend improvements to maximise intended outcomes. We will do so by undertaking a realist review. We believe this is the best evidence synthesis approach to use as the NHS Health Check programme is a complex intervention that has outcomes that vary depending on context and populations.