Variations in the organization and delivery of the 'NHS health check' in primary care

BACKGROUND: To evaluate the organization of the new cardiovascular risk assessment programme, NHS Health Checks, in general practices. METHODS: All 99 general practices in two inner London boroughs were invited to participate in a cross-sectional survey by completing an online questionnaire. RESULTS: Data were analysed for 66/99 (67%) eligible practices. Training attended for delivering the Health Check included measurement methods (43%), delivering risk information (65%) and advising on lifestyle change (62%). The Framingham risk score was used by 66% of practices, the QRisk score by 12% and both by 8%. Advice given to patients identified as high risk was 'usually' brief at 26% of practices, advice was given verbally at 92% of practices, in written form at 74% and through interactive visual materials at 29%. Statins were 'usually' prescribed to high-risk patients by 34% of practices and antihypertensive drugs by 22%. The follow-up of high-risk patients was by means of a register with regular recall at 51% of general practices. CONCLUSIONS: There is considerable diversity in general practices' implementation of the NHS Health Check. A formal quality assurance process may be required in order to optimize the implementation of the NHS cardiovascular risk assessment programme.