In May 2015, we were very lucky to have Peter Sutcliffe join team TDC as local outreach co-ordinator for the citywide community health checks project. Peter’s role was to raise awareness amongst 40-74 year olds of their entitlement to a free 20 minute health check every 5 years – helping to assess their degree of risk of developing a range of illnesses.
Through the relationships Peter slowly built with Practice Managers over the course of his contract, he convinced more than one surgery which had previously never offered NHS Health Checks to start offering them (to the point of being some of the most prolific in the city). He also identified that the traditional letter invitation was not working to get people to attend NHS Health Checks and persuaded surgeries to try out a range of methods such as phoning, texting, targeting leaflet drops and setting up pre-arranged appointments to see what would motivate people to attend.
With the end of the project Peter has now moved on to pastures new. But before he left, we asked him to tell us what the project involved, the impact it made, and describes some of the challenges in encouraging people to take ownership of their own health.
“Virtually the first member of the public I offered an NHS health check to – at a street event – stared at me in a surprised, offended and slightly angry way and said ‘Why would I want a health check, I’m a vegan.’ I guessed then that it wasn’t going to be a simple job.
NHS health checks is a national screening programme for the over-40’s that is trying to prevent cardio-vascular disease (diabetes, heart problems, etc.) by testing people’s cholesterol, blood pressure, BMI and offering advice on lifestyle, diet, exercise and so on. Unfortunately, the numbers taking the check aren’t high, particularly in less affluent areas: so Public Health contracted TDC to try to get greater take-up, particularly in those areas, and I’ve spent the last 22 months fulfilling this commission.
Initially I thought my job would be coordinating resource taken out to different parts of the City but it soon became clear that the cost of nurses working in community centres was prohibitive and therefore limited – most of the checks had to be done in GP surgeries. So the work has consisted of organising odd days of checks in Moulsecoomb, Whitehawk, Hangleton, Craven Vale, etc.; but mainly trying to get into all the surgeries in the City to persuade them to prioritise checks over the thousands of other things they have to do; and convincing people to go and get checked. At both ends it’s been a bit of a struggle: if you’ve ever tried to either arrange a meeting with a practice manager or persuade a smoker to get some advice about giving up, you’ll know what I mean.
On the other hand, I’ve spoken to thousands of people around the City, at events, knocking on their doors, over the phone and that’s been fascinating, sometimes successful, sometimes frustrating – trying to talk about health checks to fans outside the Amex stadium before a match, in the driving rain, was a funny highlight.
With regard to health, I’ve learnt that people want very simple, straightforward communications – except when they don’t. Then they want much more detail. Similarly, people like someone to show an interest in them except that they often don’t like to be bothered.
Encouraging behavioural change often comes with great difficulties and despite reaching great numbers of people, the project never quite reached a tipping point – the point at which momentum took over and people were requesting healthchecks without any prompting.
Obstacles within our public health system certainly played a part in this – closing surgeries, difficulties in recruiting and retaining staff, the huge pressures to deliver on so many targets… My perception is that attitudes are changing slowly as people accept they need to be more informed about, and responsible for, their own health. And surgeries are accepting that they need to do more, and be proactive in inviting patients in.
Saying all this – and it’s important to be honest about the challenges in a project like this – I can think of dozens of people that I spoke to and organised a check for, who benefitted from their check. And if a single person avoided a serious illness because of my work, it has been worthwhile.”
If you’d like to find out more about the NHS health check programme – call your GP! And ask your surgery why you haven’t been invited for a health check! (Unless you’re under 40 or over 74 and already being treated for a cardo-vascular disease, in which case you don’t need one). Or perhaps even join your local Patient Participation Group and offer to help your practice manager to get everyone in your neighbourhood in for a check…