Patient-centred care: Patients’ experiences of and responses to the National Health Service (NHS) Health Check programme in general practice

Abstract

This thesis investigates patients’ experiences of and responses to NHS Health Checks, towards the goal of improving patient-centred care. The findings are based on analyses of semi-structured interviews with sixteen Darlington-based patients who had recently undergone an NHS Health Check. I analysed patients’ satisfaction with the NHS Health Check and their expectations about the models and types of care their GP surgery should provide. This analysis identified five aspects of the design and delivery of NHS Health Checks which did not meet patients’ expectations:
1. The NHS Health Check did not meet patients’ expectations for a general health check which would provide empathy and support for all of their health priorities and concerns.
2. Patients felt that eligibility to attend an NHS Health Check should be based on patients’ opinions about when they need or want to have a health check and that access to NHS Health Checks should not be restricted, through age-based criteria.
3. During the NHS Health Check, health was measured in ways that caused some patients discomfort, stress, or anxiety.
4. Patients did not think that all the measures of health used to define their bodies were relevant to their lives. Patients did not necessarily agree with, support, or believe in these definitions of their health.
5. Reliance on general advice about self-help, specifically with the letter of results, did not effectively support all patients to improve their future health outcomes. Some patients found the general advice did not apply to their individual circumstances.
The current format of an NHS Health Check does not adapt well to patients’ needs and preferences as individuals and the particular health measures and health outcomes which they think are most important. Improved patient-centred provision of NHS Health Checks may help to improve patient satisfaction.