Date Published: 24 October 2006

Health checks to combat heart disease in Scotland

A radical preventative care programme was launched today in North Lanarkshire.

Targeted at communities with the greatest health needs, the first Keep Well pilot will assess 45-64 year olds in Airdrie, Coatbridge and Wishaw for the risk factors associated with heart disease.

Those who may be at risk will be identified through local GP registers and invited to attend a health check looking at factors such as blood pressure, diabetes and cholesterol, as well as lifestyle issues such as smoking, diet, alcohol and weight management. For those who need it, treatment and services as well as regular monitoring and follow-up across a range of community providers will be available.

Launching the programme at Gartlea Community Centre in Airdrie, Deputy Health Minister Lewis Macdonald said:

" We are moving from a culture of treating ill-health to preventing it. This means targeting resources where they are needed most and designing services which are easier for the public to use.

_ Keep Well is a new and ambitious approach to engage with people who have not traditionally made best use of health services - reaching out to those who may be at risk and learning wider lessons for the NHS.

_ Using the GP register as a starting point, the pilot will target 45-64 year olds and, based on an initial health questionnaire and health check, refer on those who would benefit from further treatment or services. The evidence suggests this age group has the most to gain in improved health outcomes from short to medium term intervention.

_ But this programme isn't just about GP practices. It will seek to use services right across the community and try to find new and different ways of working with local people. Here in Lanarkshire, they are proposing to take case finding and risk assessment out into community centres in the evenings and at weekends.

_ This is the first of five Keep Well pilots. They will provide valuable evidence about how to make services relevant and accessible in areas of the greatest ill-health, and help to tackle the roots of health inequality."

John Howie, Health Improvement Programme Manager for Keep Well at NHS Health Scotland, said:

" At Health Scotland, we are committed to working with the Scottish Executive and other partners by supporting the Keep Well programme in its delivery and evaluation.

_ Keep Well provides a new and exciting opportunity for primary health care services to broaden their health improvement role in communities where health needs are greatest. By attending a Keep Well health check, people will gain access to a wide range of services, support and advice that will have a positive impact on their health.

_ With more people living for longer, this programme plays a major role in not only reducing the risk of ill-health but increasing the likelihood of better health in later life."

The North Lanarkshire Keep Well pilot will involve 34 GP practices, and has around 40,000 people in the target group. Each health check is expected to take around 30-40 minutes. Although the Programme will be GP practice led, it will link to a range of providers such as smoking cessation services, dieticians and the Counterweight obesity management service. The pilot is a partnership between NHS Lanarkshire and North Lanarkshire Council.

NHS Lanarkshire will target relevant patients principally by identifying, through the GP registers, those who smoke, have high blood pressure or diabetes and by making an assessment of those who are high risk for cardio-vascular disease (CVD) or chronic obstructive pulmonary disease (COPD). Funding of up to £2 million will be available for the North Lanarkshire pilot over two years. This is expected to be 'pump-priming' money to employ extra staff and free up extra time to review and redesign services.

It is the first pilot to go live from the five announced by Health Minister Andy Kerr in November 2005 (programme name now changed from Prevention 2010 to Keep Well). The others are located in Glasgow (North and East), Dundee, and Edinburgh, and are scheduled to start inviting people in for health checks in the next 2-3 months. The location of the pilots was decided by using the Scottish Index of Multiple Deprivation and focusing on NHS Board areas with high concentrations of the most deprived 15%. A decision about location and funding for a second wave of pilots is expected to be made later this year.

The aim of the programme is 'to increase the rate of health improvement in deprived communities by enhancing primary care services to deliver anticipatory care: identifying and targeting those at particular risk of preventable serious ill-health; offering appropriate interventions and services to them; and providing monitoring and follow-up.' This followed a commitment to provide such services in Delivering for Health, the Executive's long-term vision for the NHS.

National support for the pilots is being provided by NHS Health Scotland, ISD (Information Services Division) and the Scottish Executive. Health Scotland have commissioned national evaluation through the Primary Care Department of Glasgow University, and the programme will be overseen from the Executive's perspective by the Health Improvement Directorate and the Chief Medical Officer.

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