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Annual Health ChecksWhat the Public Health England
Learning Disabilities Observatory does
PRESENTERPublic Health England Learning Disabilities Observatory (PHELDO)
Our work on Annual Health Checks
• We have looked at how effective health checks are
• We monitor how many people receive health checks
• We have published guidance on annual health checks for people with learning disabilities
• Supporting NHS England in their programme of work on health checks
2 Public Health England Learning Disabilities Observatory LDT@phe.gov.uk
AHC Research Evidence
Our systematic review of evidence showed annual health checks consistently lead to1:• detection of unmet, unrecognised
and potentially treatable health conditions
• targeted action to address these health needs
3 Public Health England Learning Disabilities Observatory LDT@phe.gov.uk
1. Robertson et al (2010) IHaL, http://www.ihal.org.uk/gsf.php5?f=7274
AHC Research EvidenceA study in The Lancet showed GP practices in the ES had2:• increased rates of general and specific health
assessments• increased identification of co-morbidities• more health action plans and secondary care
referralsA more recent study3 found:• GP surgeries performing AHCs had a
reduction in preventable emergency hospital admissions over a two year period
• Non-participating surgeries had an increase
4 Public Health England Learning Disabilities Observatory LDT@phe.gov.uk
2. Buszewicz et al (2014). The Lancet Psychiatry,1, (7) 522-530.3. Carey et al (2017). J Epidemiol Community Health,71, 52-58.
Numbers of checks
5 Exploring the initial findings
27,011
58,919
73,068
86,13492,329 94,647
124,785116,522
133962
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000N
umbe
r of c
heck
s
Year
Checks (18+)Checks (14+)
Widened eligibility
NumbersCoverage Number of patients receiving a check as a
proportion of total number on the QOF learning disabilities register
Practice participation Proportion of practices performing at least one learning disability health check
Possible coverage Proportion of learning disability register patients with participating practice
6 Learning Disability Health Checks 2016/17
• Not all practices allow the learning disabilities health check data collection
• Data published by NHS Digital covers 6,828 of the 7,534 practices active in 2016/17
• We assumed all practices participating in the scheme allow collection• Denominator (number of people who should have had check) taken
from national QOF figures• This will overestimate because a proportion are under 14, but will be
less biased between areas in relation to practice participation.
Health Check management indicators
2014-15 2015-16 2016-17Coverage by QOF 49.4% 44.2% 48.9%Practice participation 75.9% 79.1% 82.9%
Register patients with participating practice 85.2% 87.6% 90.1%
Coverage in participating practices 48.6% 54.1%Coverage by age (participating practices): Age 14 to 17 28.1% 34.5%
Coverage by age (participating practices): Age 18+ 50.0% 55.4%
Practice reports patient refused check 1.4% 1.5%HAP completed 58.5% 63.7% 63.6%HAP declined 2.1% 2.0% 1.8%HAP not recorded 39.3% 34.3% 34.7%
7 Learning Disability Health Checks 2013/14
8 Public Health England Learning Disabilities Observatory LDT@phe.gov.uk
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
South WestLondon North West
WessexCheshire & Merseyside
Central MidlandsSouth Central
Greater ManchesterLondon South
Cumbria & North EastEast
EnglandNorth Midlands
LancashireYorkshire & Humber
West MidlandsLondon North East & Central
South East
Coverage by QOF - Sub-Regions
2016-172015-162014-15
Coverage by QOF by Sub-Region
Practice participation by Sub-Region
9
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Cumbria & North EastCheshire & Merseyside
Greater ManchesterCentral Midlands
North MidlandsSouth Central
EastWessex
South WestLancashire
EnglandLondon South
London North WestWest Midlands
Yorkshire & HumberSouth East
London North East & Central
Coverage by QOF - Sub-Regions
2016-172015-162014-15
Improving the update of AHCsWhat works -• Leadership, ownership and accountability• Good relationships with GP practices• Providing feedback• Working in partnershipFor further information see:
http://webarchive.nationalarchives.gov.uk/20160704171237/http://www.improvinghealthandlives.org.uk/publications/1168/Improving_the_Uptake_of_Health_Checks_for_Adults_with_Learning_Disabilities._Evidence_into_practice_report_no.6
11 Public Health England Learning Disabilities Observatory LDT@phe.gov.uk
Other guidance on AHCs• Health checks for people with learning disabilities:
including young people aged 14 and over, and producing health action plans:
http://webarchive.nationalarchives.gov.uk/20160704152058/https://www.improvinghealthandlives.org.uk/publications/1243/Health_checks_for_people_with_learning_disabilities:_including_young_people_aged_14_and_over,_and_producing_health_action_plans
• Making reasonable adjustments to primary care services: supporting the implementation of annual health checks for people with learning disabilities:
http://webarchive.nationalarchives.gov.uk/20160704165913/http://www.improvinghealthandlives.org.uk/publications/1224/Making_reasonable_adjustments_to_primary_care_services:_supporting_the_implementation_of_annual_health_checks_for_people_with_learning_disabilities
12 Public Health England Learning Disabilities Observatory LDT@phe.gov.uk
Quality of Annual Health Checks• We have just updated an audit tool that can
be used to look at the quality of annual health checks.
• It is designed to support GP practices, primary care liaison staff, health facilitators and health quality checkers to assess the quality of annual health checks.
• There is an easy-read version.
• See: www.ndti.org.uk/resources/useful-tools/quality-checking-health-checks-for-people-with-learning-disabilities
13 Public Health England Learning Disabilities Observatory LDT@phe.gov.uk
Quality of Annual Health Checks1. How well is the GP practice doing at performing the
AHC?
2. How well are we doing at identifying patients with learning disabilities?
3. How well are we doing at arranging for people to attend for a health check?
4. How well are we doing at putting reasonable adjustments in place to maximise the effectiveness of AHCs?
5. How well are we doing at arranging for and supporting the uptake of follow-up actions?
6. How well are we doing at improving our practices?
14 Public Health England Learning Disabilities Observatory LDT@phe.gov.uk
Contact details
15 Public Health England Learning Disabilities Observatory LDT@phe.gov.uk
The pictures in these slides are from Photosymbols: www.photosymbols.co.uk
Our old website has been archived but there is still lots of information there that you can use at https://tinyurl.com/ihalarchive
We now have a community of interest Knowledge Hub group Email LDT@phe.gov.uk for an invitation to join
LDT@phe.gov.uk
@ihal_talk
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