Rapid evaluation of NHS Health Check Online

Close up of hands holding a smartphone showing a digital health application, photo by Tadamichi/Adobe Storck

Photo by tadamichi/Adobe Stock

What is the issue?

Through early assessment of individual risk factors, the NHS Health Check Online (NHSHC) programme aims to prevent cardiovascular disease and assess the risk of developing other conditions such as type 2 diabetes. The programme invites everyone in England aged 40–74 who is not on one of the disease registers for vascular disease to a health check every 5 years. This involves assessment of a number of risk factors including lack of physical activity, smoking, obesity and alcohol intake, as well as blood pressure and cholesterol levels.

However, the uptake of the NHS Health Check programme has been lower than expected. To address this, a 2021 review of the NHSHC programme recommended the development of a digital offer, with the aim to increase accessibility, effectiveness and efficiency of health checks. Development is currently underway with a view to implement and refine the digital service and learn from the experience of implementation, initially in 3 local authorities. The proposed rapid evaluation is intended to inform design, refinement and early adoption of digital NHSHCs as well as further roll-out and broader digital transformation in primary care.

How are we helping?

The DECIDE centre will carry out a rapid evaluation to examine the development, implementation and use of the NHS Health Checks Online programme during the initial testing phase in three local authorities. The aim is to draw timely, transferable lessons that can inform and support wider roll-out and potential future evaluation.

More specifically, the evaluation will seek to:

develop a rich picture of the structures and support mechanisms underpinning successful adoption of digital NHSHCs.
surface and explore the numerous interacting influences on implementation and identify potential challenges for spread and sustainability.
provide an in-depth understanding of staff and service user experiences, including in comparison with in-person health checks.
examine uptake rates and explore economic costs and assessments of value of digital NHSHCs for services and service users.
capture and disseminate transferable learning for technology-supported care and its users, including wider roll out of digital NHSHCs and feasibility of larger-scale evaluation.

This evaluation will take a multi-site, mixed-methods (qualitative and quantitative) approach with three implementation case studies, in order to build a rich picture of adoption of Digital NHSHCs and the system-wide factors that influence and shape adoption. We will learn from the experiences of health system stakeholders (healthcare professionals, local decisionmakers, policy stakeholders) as well as service users and those who do not use digital health checks to learn about the diversity of influences on uptake and implementation, and both intended and unintended consequences. A key element will be to capture the challenges for those with complex support needs and issues associated with inequalities in access, use and support. The quantitative evaluation will focus on measuring uptake rates, adjusting for patient and practice characteristics, to understand what factors influence uptake. We will also explore feasibility of comparing patient uptake between digital and non-digital NHSHCs and explore the costs associated with Digital NHSHCs.