So I know I am healthy right? Well I am a dietitian so I think I know how to eat well. I base my eating habits on the Eatwell Guide, and make all my meals and snacks from scratch so I know what goes into my body. Its a bit of an obsession in fact but I like to think its a positive one. I spend 30 minutes in the gym 3 times a week and do 30 minutes of yoga on the other 4 days. I don’t drink, I don’t smoke. What do I do? Why do I need a health check?

Well I didn’t, or so I thought. I was offered an NHS Health check a few years ago but I declined as I did not want to waste the time of the NHS, another annoying member of the ‘worried well’ party. Since then I have been asked several times what my blood cholesterol is and the answer is I don’t know because it is not a test that is routinely done.

So what finally prompted me to make that call and ask the question? Well a few weeks ago I was in the midst of the #AllourHealth course. One of the modules is based around cardiovascular disease (CVD) and there is an opportunity to test your heart age. Small snag. You can’t fully complete the test unless you ‘know your numbers’. Hence the phone call.

The NHS health check experience is what prompted me to start this blog. So (be warned) my first post will be about my reflections and my challenge to promote positive change.

I rang my GP practice to find out that the NHS health checks only take place on a Saturday and the practice nurse could facilitate this. No problem, I booked the first appointment of the day and arrived in good time. The practice nurse was friendly (and apologetic for running a bit late as the computer was not loading properly). So down to the nitty gritty and the component parts of the check. Firstly the healthy diet check. ‘Do you eat your 5 a day?’ Yes I do but that is because I know what constitutes 1 portion. In my professional experience, not everyone does and they often think they are eating their 5 but, in reality, they are not. Strangely that is the only question about nutrition.

So onto exercise. Do I exercise? Obviously I have the text book answer (because I really do). Same for drinking alcohol and smoking (I don’t do either). The crucial question of weight next. There are no scales in the room so I suggest we use the electronic ones outside. I should mention at this point that I am underweight, and have been for a very long time, and struggle to gain weight. Surprisingly to me this is not mentioned. The focus of the check is to prevent CVD/Diabetes etc so overweight is at the forefront of the check. However, malnutrition (underweight) also increases risk of CVD and 3 million people in the UK¹ are at risk of malnutrition and treating the consequences costs more that obesity in terms of NHS budget (19.6 billion² compared to 6.1 billion³). This seems like a great opportunity to talk about malnutrition and give advice? I even read the booklet afterwards and only one line is devoted to underweight.

Blood pressure done and blood tests taken. I am told I will get the results in 3 days and the nurse thinks a letter will be sent to me to tell me if everything is OK. I am really keen to know the results, normal or otherwise so I can make informed decisions about how to manage my health.

Reflecting on this afterwards I also realise that, during the consultation I was not asked how I was feeling in terms of my mental health. As someone who practices mindfulness to manage my anxiety, low mood and insomnia, I consider that this was a missed opportunity to incorporate the principles of Making Every Contact Count (MECC).

So as I write this I still await my blood results so I can add them to my other results and calculate my overall risks. Don’t misunderstand me, the NHS Health check is a great idea which I think is ready to be improved. The whole experience has thrown up many questions that I feel need to be raised with its creators to ensure it can be used effectively to help prevent ill health and reduce the burden on an already struggling NHS.

What can we do?

1. Make the health check more accessible. Take it out into the community rather than make people go to it. Not everyone will make the time to book that extra appointment
2. Link the questions in the check more closely to MECC so we don’t waste the opportunity to really make every contact count.
3. Malnutrition needs to be identified, and given the same parity as obesity, as a public health problem.
4. We need to ensure that the people conducting the test are appropriately trained and ask the right questions and know why they are asking the questions. If it is not meaningful and patient-centred, word of mouth spread will not take place.
5. There needs to be a planned review to discuss the blood tests that will follow and what they mean for each individual. This is vital to ensure that people take ownership of their health and feel empowered to self care.

So what have I done so far? I have raised this with my Occupational Health department and am happy to report that these checks will be offered in the workplace in the coming months as part of the staff health and wellbeing package. I have also contacted the Programme lead for prevention in Health Education England to share my reflections and hope that I can offer support in the potential future of this check. I am blogging about this to encourage you to get an NHS Health Check if you are eligible, but be proactive during your session rather than passive. Question the results and the advice and you will get the most out of the experience.

Be happy, be healthy

References:

¹ https://www.bapen.org.uk/malnutrition-undernutrition/introduction-to-malnutrition?start=4

² https://www.bapen.org.uk/pdfs/economic-report-short.pdf

³ https://www.gov.uk/government/publications/health-matters-obesity-and-the-food-environment/health-matters-obesity-and-the-food-environment–2

I have several passions. Obviously my partner (and better half) of which more later I am sure. I love baking, but am also really interested in all things health related including the endless pursuit of happiness. So most of the posts you see here will be about those things – with the odd motorbike, cat and other random stuff…..