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Health researchers have developed and trialled training for practitioners providing NHS Health Checks in a bid to make the results easier to understand.
People aged 40–74 across England are invited to a free NHS Health Check every five years to spot early signs of stroke, kidney disease, heart disease, type 2 diabetes and dementia.
Despite this, researchers at Staffordshire University have found that many patients often don’t understand the results of these tests and the risks to their health.
Victoria Riley, Research Associate from the Centre for Health Development, explained: ‘At the end of the assessment patients are given a percentage risk score which estimates their risk of heart attack or stroke within the next 10 years.
‘However, our research shows that patients don’t always understand what that number actually means. We also found that some practitioners don’t fully understand this either, so they find it difficult to explain it to patients.’
The team also found that patients preferred being given a ‘heart age’ – an estimation of their heart’s health which can be compared to their actual age – instead of a risk percentage score because it gave context and was easier to understand.
Victoria and colleagues have developed a training programme looking specifically at improving how practitioners communicate the risk of cardiovascular disease (CVD).
The resulting training programme was tested with practitioners from Oldham, Manchester and Stockport who were delivering NHS Health Checks and compared with a control group who did not receive training. Practitioner understanding and confidence were measured before and up to 10 weeks after the workshop and was also explored through semi-structured interviews post-training.
Victoria said: ‘The training workshop covers a number of areas including risk perception, tools to communicate risk to patients and overcoming barriers to risk communication as requested by practitioners in interviews conducted prior to the development of training content.
‘The findings showed that our training significantly improved practitioners’ confidence and understanding of CVD risk, compared with the control group. Follow-up interviews also showed that they altered the way they delivered health checks as a result.’
Victoria was invited to deliver the training to commissioners and trainers in London in November and at the ‘Cardiovascular Disease Prevention Conference 2019’ as an introductory workshop. Both sessions received very positive feedback and has resulted in several changes to training provision in local authorities based in the South East. The team are also in discussions with Public Health England regarding the practitioner resource pack, developed based on the training content, as part of a digital project to improve the Health Check journey.
Nicky Saynor, Health & Wellbeing Manager, PHE South East, said: ‘Commissioners in the south east wanted a bespoke train-the-trainer version of the workshop to maximise its reach. The session was extremely well received and had clear impact – and many of those who attended have now begun to enhance their training with more in-depth masterclasses. This will help to ensure those providing checks have the confidence and skills to maximise impact of the “teachable moments” created when communicating future risk of heart attacks or stroke.’
Since the pilot, the free training resource pack has been requested by NHS Health Check teams all over the country, councils and universities. Oldham Council also asked for further training of new staff.
Victoria added: ‘NHS Health Checks are all about prevention –it is really important for patients to think early rather than addressing health issues when it’s too late. However, while prevention is important to reduce the pressure on the NHS, it can be difficult for primary care to prioritise NHS Health Checks given the huge demands of treating existing conditions in our ageing population.
‘Our training provides practitioners with tools to help improve patient understanding of CVD risk communication in NHS Health Check.’
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