NHS Health Check - what are the barriers for healthcare professionals? by https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3 To what extent do these barriers affect the quality of delivery? Why do these barriers exist? What is the root problem? en-us 2021-09-14 14:14:28 UTC 2021-09-20 14:13:56 UTC hello@padlet.com BPG https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742226857 Having regular training with HCP's delivering HC's is an issue. We circulate the BPG and any changes to practices but co-ordinating training for staff has been a challenge. I think over time, without update training staff revert to the quickest and easiet way of getting the check done, which may mean PA and Alcohol Q's are skipped?]]> 2021-09-15 09:35:15 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742226857 https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742227156 Varies across different staff members. Particularly the clarity around what is involved in health checks, what is good practice and how to deliver them effectively]]> 2021-09-15 09:35:26 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742227156 Time for training can be a barrier when working with busy GP practices who have multiple focuses to contend with https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742227391 2021-09-15 09:35:33 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742227391 Varying levels of enthusiasm/support from practices for the programme - I wonder if this is partly driven by them not necessarily being informed of what happens to patients after the check e.g. if they were referred on, what was the outome https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742227635 2021-09-15 09:35:42 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742227635 areas who have aligned to MECC and behavioural risk factors have improved quality and uptake https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742227698 2021-09-15 09:35:44 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742227698 Knowledge of where to refer to following Health Checks https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742228226 2021-09-15 09:35:56 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742228226 https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742229409 Massive impact and there is significant variation]]> 2021-09-15 09:36:34 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742229409 https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742230187 What period does the training last and how often do you have to renew it? It would be good for all practices to refresh due to reduced delivery throughout Covid and you updating the material

]]> 2021-09-15 09:37:02 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742230187 Practice priority - financial viability compared to other services https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742230196 2021-09-15 09:37:03 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742230196 Lack of time which impacts on interaction between HCP and patient https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742230262 2021-09-15 09:37:05 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742230262 Time taken to complete follow up referrals or not knowing where to refer on to https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742231195 2021-09-15 09:37:36 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742231195 Skills and knowledge of the geographical area can be both a positive and a barrier. 'no one will ever change in this area, its its always been' . This can be the attitude of either deliver or client or both https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742231468 2021-09-15 09:37:47 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742231468 difficult conversations https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742231539 Discussing alcohol use may be considered difficult by some staff? potentially a lack of services or signposting options for those on the lower end of problematic use can mean its not considered a priority?

]]> 2021-09-15 09:37:48 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742231539 https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742231577 Not so much of an issue and has better scope for improvement]]> 2021-09-15 09:37:49 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742231577 I'm particularly keen to understand this element more for some C&M insight work on how to best support increased uptake of NHS HCs in target populations (e.g areas of high levels of deprivation, BAME communities, working age men). There could be some valuable learning from the vaccine hesitancy work undertaken in C&M HCP. https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742231887 2021-09-15 09:38:00 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742231887 https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742232414 Changes to the local "offer" for patients i an issue - some services decomissioned, some new services in place. Will be a level of awareness raising among staff of these changes at restart for H/C to gain buy in and be effective

]]> 2021-09-15 09:38:16 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742232414 May have referred before into other services, and / or given advice with no change for patient https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742232671 2021-09-15 09:38:24 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742232671 i wonder if there are some challenges regarding referral services and follow up appointments https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742232872 2021-09-15 09:38:31 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742232872 Of where to refer https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742233642 2021-09-15 09:38:58 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742233642 https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742234005 Does impact to a greater extent and staff need support to minimise this

]]> 2021-09-15 09:39:10 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742234005 Low uptake following onward referral to lifestyle support - could be down to the quality of the referral conversation? interested to hear how Gateshead getting on with this since they have integrated their lifestyle support as part of the offer - has this improved uptake? https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742234624 2021-09-15 09:39:30 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742234624 good training around behaviour change that is accessible, cost effective and available to GP practices would be invaluable https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742234999 2021-09-15 09:39:43 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742234999 https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742235004 There is a tendency to attract the worried well. If the programme doesn't incentivise  a concerted effort to attract population groups who are known to be at higher risk due to genetic predispositions & socio-economic factors - You can end up with a large disparity between the attendance to the checks and the benefit in terms of outcomes for those who have attended between practices. ]]> 2021-09-15 09:39:43 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742235004 Knowledge https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742235184 Knowledge is an issue in terms of correctly communicating risk to patients. The check list is relatively easy to complete for a full health check but the follow on conversation is where we see barriers i.e. the quality and content of it. In Knowsley we commission Inspira Health to support practices delivering HC's, they have recently delivered training to some new staff and Health diagnostics also provide 2 half day training days for staff .    ]]> 2021-09-15 09:39:50 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742235184 May see too many other compounding factors / social economic status of patient or engrained health behaviours https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742235490 2021-09-15 09:40:01 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742235490 https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742236119 This comes back to training and confidence. Finding time for primary care staff to attend training is challenging.
Perhaps we could look at some attendance at training by staff to be part of local contracts.]]> 2021-09-15 09:40:23 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742236119 https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742236624 We need better understanding about concerns around consequences. 

]]> 2021-09-15 09:40:38 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742236624 confidence to have difficult conversations about weight, alcohol, smoking status etc and how to address in such a short time scale https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742236724 2021-09-15 09:40:42 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742236724 https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742236898 Clarity on referral pathways for wellness service NDPP etc sometimes isn't there]]> 2021-09-15 09:40:47 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742236898 Own understanding of areas covered by the health check - not confident in giving advice https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742237027 2021-09-15 09:40:51 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742237027 Beliefs about capabilities https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742237652 Staff can get anxious about correctly delivering a health check especially HCA's]]> 2021-09-15 09:41:15 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742237652 Ability of patient to retain information could be a barrier https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742238022 2021-09-15 09:41:30 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742238022 Annual training (with local offer information) for staff delivering Health Checks. Practice templates with referrals embedded to support staff. https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742238998 2021-09-15 09:42:03 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742238998 How to unpick the impact of wider determinants - fear of opening a can of worms https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742239037 2021-09-15 09:42:05 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742239037 https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742239053 Has a huge impact as there is lack of belief around health checks motivating people to change their behaviour. Upskilling of staff around behaviour changes approaches will add value

]]> 2021-09-15 09:42:05 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742239053 Maybe assumptions on patient ability to change and sustain changes https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742239156 2021-09-15 09:42:09 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742239156 https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742239920 I do think staff are aware of the benefits of the check and the reasons why the service exists.
There may be a prioritisation made by staff for the more regular measures eg BP, BMI]]> 2021-09-15 09:42:32 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742239920 if you don't think you have the right capabilities, or no one is checking and supporting you in your delivery, this can be a huge barrier to the effectiveness of your work. More time and resources can overcome this. buy in from GP practices is essential. Maybe add more into the locality requirments. https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742240768 2021-09-15 09:43:06 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742240768 https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742243101 I'm not sure how much of a barrier this is. HCP's may do lots of work that they may consider the patient not to be fully buying into, they still complete the assessments etc ]]> 2021-09-15 09:43:52 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742243101 Beliefs about consequences https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742243735 Staff are not always confident that they have enough understanding of behaviour change, supporting this and why this is important in prevention . ]]> 2021-09-15 09:44:17 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742243735 Reason for not changing behaviour could be deep rooted and complex eg. linked to long term lack of employment. The need to include wider support within referral pathways for providers of HCs https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742243786 2021-09-15 09:44:19 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742243786 Orcha report highlights that BAME communities less likely to be offered digital health interventions but more likely to take them up when available.. a real opportunity to embrace digital NHS HCs and reduce inequalities? https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742246212 2021-09-15 09:45:40 UTC https://padlet.com/hannahsullivan5/ggui6aga5dnn9xk3/wish/1742246212