DH - NHS healthchecks to help reduce heart attacks, strokes, diabetes and kidney disease - Preventative checks will soon be available in England -29 Mar 09

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NHS Health Checks, which could prevent 1600 heart attacks and strokes each year and help save 650 lives will begin from April this year, announced Health Secretary Alan Johnson today.

The Health Secretary also announced the start of two further groundbreaking measures - the abolition of prescription charges for cancer patients and the start of MRSA screening for elective patients.

Everyone aged between 40-74 in England will begin to be invited for a free health check as part of a national programme to identify their risk of diseases such as coronary heart disease, stroke, diabetes and kidney disease. The programme is an essential tool in tackling health inequalities across the country.

The health checks are part of a drive to ensure that people from this age group have the necessary information about their health in order to make important lifestyle changes and reduce their risks of developing diseases like diabetes and coronary heart disease. These illnesses currently affect the lives of 4 million people in England and are responsible for a fifth of all hospital admissions.

The checks are part of the drive towards a more preventative NHS.

The health checks will consist of:

• Straightforward questions to patients on their health and diet, exercise habits and family medical history
• Height and weight measurements taken from patients
• A simple blood test for cholesterol and in some cases for glucose levels
• A follow up, personal assessment setting out the individual's level of risk and what they can do to reduce this
• Recommendations of what could be done to reduce risk including: weight management programmes, stop smoking, physical activity programmes

Local Primary Care Trusts are designing their own local implementation plans to make sure that they can deliver the checks and follow up services that will be best suit the needs of the local population.

Health Secretary Alan Johnson said:

• "The NHS is becoming more personal and responsive to individual needs; becoming as good at prevention and keeping people healthy as it is at providing care and cures; and able to offer the information and support people need to make healthy choices.
• "There are a number of different commitments that we are delivering on which will start from this April. The national programme of Health Checks could save 650 lives a year and reduce the health inequalities that blight the lives of the country's most deprived families.
• "Screening of all relevant elective patients for MRSA before admission is an and additional preventative measure that will help to protect patients against infection, and also, free prescriptions for people living with cancer and related conditions is one less worry for them at such a difficult time and will be welcomed by many patients and their families."

The preventative checks will be rolled out across England from April and will be fully implemented by 2012/13. They are likely to be available at GP surgeries, health centres, walk in centres and pharmacies to ensure as many people benefit from them as possible.

Further measures to protect patient's health being delivered by the NHS on April 1 include all NHS Trusts being able to offer MRSA screening to all relevant elective patients. This will allow the NHS to reduce the chances of patients getting an MRSA infection, or passing MRSA onto another patient. Although the number of people getting infections from MRSA is falling (latest figures show reductions of 38 per cent), we still have further to go and this is part of our continued efforts to reduce numbers even further.

April 1 is also the date when the abolition of NHS prescription charges for everyone undergoing treatment for cancer, the effects of cancer, or the effects of cancer treatment, will also come in to effect. Up to 150,000 patients already diagnosed with cancer are expected to benefit, saving them £100 or more each year in prescription charges.

Notes:
1. Copies of Putting Prevention First are available on the DH website: http://www.dh.gov.uk/vascularchecks

2. In January 2008, the Prime Minister announced our intention to bring forward new check-ups to help prevent heart disease, stroke, diabetes and kidney disease.

3. Modelling work undertaken by the Department shows that the free health checks will prevent at least 1,600 heart attacks and strokes a year, 4,000 people a year from developing diabetes and detect at least 20,000 people a year earlier with diabetes or kidney disease, allowing individuals to be better managed and improve their quality of life.

4. This is an ambitious programme, which covers a cohort of approximately 15 million people (the total aged 40-74 in England). Delivery of this programme, which covers both risk assessment and provision of appropriate interventions, has to be staggered.

5. The programme has been designed on the basis of a five year call and recall. When fully implemented, we expect around 3 million people a year to be invited to checks. We have modelled an uptake of 75% (based on uptake rates for breast cancer screening). This would lead to around 2.25 million people receiving checks each year.

6. We have asked the NHS to aim for full implementation by the year 2012/13. In 2009/10 the first year we expect all Primary Care Trusts (PCTs) to begin to offer checks. It is essential that they plan and resource both the actual checks and the delivery of the interventions before starting to offer checks.

7. We do not expect every PCT to offer checks from 1 April, although a number of PCTs already have very similar programmes running.

8. The expected reduction in prescription charge income as a result of the exemption for cancer patients is estimated to be around £15m per year.

9. The Prime Minister announced on 23rd September 2008 in a speech to Labour Party Conference, Manchester, that people with cancer should be exempt from prescription charges.

10. Cancer patients will be able to apply for a medical exemption certificate by asking their doctor for the relevant application form. A GP(or at the GP's discretion a member of the GP's practice who can access medical records), hospital or service doctor will need to countersign the form. The form will then be sent to the NHS Business Services Authority (BSA), who will issue an exemption certificate. The patient can then show their exemption certificate to the pharmacist as proof of exemption. The medical exemption certificate will last for 5 years, once the certificate has expired a new application can be made. The NHS BSA will send a reminder to the patient before the expiry date.

11. If a patient has not received their certificate by 1 April and needs to pay for an NHS prescription they should ask for a receipt from FP57, which is also an NHS prescription refund form, at the time they pay (they cannot get one afterwards).

12. Around 60% of the English population do not pay prescription charges because of their age, because they have an income related exemption (e.g. they receive income support) or because they have a specified medical condition.

13. In his 23rd September 2008 speech the Prime Minister also announced that over the next few years patients with long-term conditions will also receive free prescriptions. Professor Ian Gilmore, President of the Royal College of Physicians is undertaking a review of prescription charges for people with long-term conditions that will report to Ministers in Summer 2009.

14. There are about 11-12 million elective admissions each year. Not all of these will be screened however; there are some patient groups where screening isn't appropriate because the risk of an MRSA infection is so low, or non-existent - e.g. day case ophthalmology, or minor skin procedures such as the removal of warts using liquid nitrogen.

15. MRSA screening is one element of our Clean, Safe, Care strategy to reduce healthcare associated infections (HCAIs).

16. Many people carry MRSA harmlessly on their skin or in their nose. It does not make them ill and the presence of the bacteria does present not a risk to healthy people. This includes older people, pregnant women, children and babies. We all carry lots of bacteria and usually it doesn't cause a problem. However, when a person goes in to hospital carrying MRSA and has a procedure that involves breaking the skin, then the MRSA can get in to the body and may cause an infection.

17. Therefore, from 1 April, the majority of patients with planned admissions will be offered a simple swab test to see whether they are carrying MRSA. If a patient is found to carry MRSA before they go into hospital, then they will be offered treatment to get rid of as much of it as possible (treatment involves using an antibacterial wash or powder and using a special cream in your nose). This will help protect patients against infection: by reducing the chances of them infecting either themselves (by MRSA bacteria entering wounds/or their bloodstream) or others (usually by transfer of bacteria from one patient to another by healthcare workers). For more information visit http://www.nhs.uk

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