Variations in the organization and delivery of the 'NHS health check' in primary care.

BACKGROUND To evaluate the organization of the new cardiovascular risk assessment programme, NHS Health Checks, in general practices. METHODS All 99 general practices in two inner London boroughs were invited to participate in a cross-sectional survey by completing an online questionnaire. RESULTS Data were analysed for 66/99 (67%) eligible practices. Training attended for delivering the Health Check included measurement methods (43%), delivering risk information (65%) and advising on lifestyle change (62%). The Framingham risk score was used by 66% of practices, the QRisk score by 12% and both by 8%. Advice given to patients identified as high risk was 'usually' brief at 26% of practices, advice was given verbally at 92% of practices, in written form at 74% and through interactive visual materials at 29%. Statins were 'usually' prescribed to high-risk patients by 34% of practices and antihypertensive drugs by 22%. The follow-up of high-risk patients was by means of a register with regular recall at 51% of general practices. CONCLUSIONS There is considerable diversity in general practices' implementation of the NHS Health Check. A formal quality assurance process may be required in order to optimize the implementation of the NHS cardiovascular risk assessment programme.