Follow up from Risk Assessment/Screening

Context

Over the past decade or more community groups and projects have organised
and delivered health events or programmes whereby individuals can access a
range of health checks. Anecdotally feedback about referrals to GP following
health check events are that GPs do not like to be inundated with people
following a ‘random’ health check, to the intervention is valuable and provides
a useful service (this feedback was received from Practice Managers in West
Belfast at GP surgeries to whom clients were referred following the Healthy
Hearts in the West (HHW) Community Pharmacy Vascular Risk Screening
Programme).

Healthy Hearts in the West Tool Box – Follow up from Risk Assessment/Screening
Potentially ‘At-Risk’ Health Check Screening or Risk Assessment Results

The information below has been received from practitioners, academics and
the Public Health Agency; and reference has also been made to the National
Institute of Health and Care Excellence (NICE ) guidance. The following data
provide guidelines for referring individuals to their GP, as these health results
suggest that the individual is potentially at risk.

Body Mass Index (BMI)

 A BMI measurement over 28.5 is used to define ‘overweight’ and ‘at risk’
 A BMI over 30 is classified ‘obese’
 Note: 18.5 to 24.9 is the range for BMI target setting

Blood pressure / Hypertension

 Greater than 140 mm Hg systolic or 90 mm Hg diastolic
 Individuals with a reading greater than 180 mm Hg systolic may need same
day assessment. It may be appropriate to refer to out of hours GP service.
 Note: for readings of 140/90, it would be good practice to consider taking a
second reading during the check.

Blood Sugar Monitoring

 For a random sample health check; any level greater than 11.0mmol/l
 Following fasting, a value greater than or equal to 7.0mmol/l
 Note: a value above 5.5 mmol/l is an indicator of risk, but usually GP
intervention at this level is lifestyle advice.

Cholesterol
 As a broad guide, values greater than 5.0mmol/l
 Note: many screens for cholesterol would assess total/HDL ratio.

Consent for a follow-up enquiry

If a project intends to carry out follow-up interviews after a health check

assessment or screening, permission will need to be gained from the individual
at the time of the health check. The individual’s contact details (preferably a
telephone number) will also need to be recorded.

Healthy Hearts in the West Tool Box – Follow up from Risk Assessment/Screening
 The following wording is acceptable in terms of permission granted:

You have chosen take part in the Community Pharmacy Vascular Risk Screening
Service. The information gathered through this form is confidential and
individual respondents will not be identified from the information collected.
The data will be used to inform the development of the service.

As part of the evaluation we also seek permission to contact you in the future,
when you have completed the service, to monitor the long-term impacts on
your health and wellbeing.

By saying yes and giving us your contact details you are in no way obliged to
take part. You are free to change your mind at any time.

Please tick box

1. I confirm that I have read and understood the patient information

leaflet for the above service and have had the opportunity to ask 
questions.
2. I understand that my participation is voluntary and that I am free to
withdraw from the service at any time, without giving any reason, 
and without my medical care or my legal rights being affected.
3. I agree to the use of anonymised data for research and evaluation. 

4. I give my permission to be contacted in the future as part of the

evaluation and follow-up of the service and agree for my contact 
details to be shared solely for this purpose.
5. I agree to take part in the service. 

The individual’s signature is also required.

Follow Up Interview with Individuals referred to their GP

Building on the follow-up interview form developed for the PHA Farm Families
Project, HHW developed a form for use with individuals who were referred to
their GP following the health check.

Healthy Hearts in the West Tool Box – Follow up from Risk Assessment/Screening
 Risk Screening
Client Review Sheet
Follow Up Call to be made 4 weeks post Risk Screening
Pharmacy:
Gender: Male Female
Client ID number:
Date of Health
Check
GP registered Yes No
Yes No
Client advised to self-refer to GP
If no re GP, then no further action is
required
If yes then make follow-up telephone
call to client

Reason for GP Blood pressure Blood Sugar

referral
Cholesterol level BMI / weight
Other please state

Date of Call (attempt 1) Date of Call (attempt 2) Date of Call (attempt 3)

Case closed following three unsuccessful attempts

Outcome of call: GP Referral

Yes No Awaiting
Appointment
Client attended GP
If yes - Outcome
of GP Appointment

Overview of outcome from GP Appointment Yes No

Healthy Hearts in the West Tool Box – Follow up from Risk Assessment/Screening
Referred to Specialist Service
Review /Commencement of Medication
Health Promotion Advice Given
No Resulting Action by GP
Comments

Healthy Hearts in the West Tool Box – Follow up from Risk Assessment/Screening