Ally Health and Hall Green Health’s Journey to Delivering on the Promise of Effective Health Checks
Alexandra Tory (Chief Growth Officer, Ally Health) and
Jamal Syed (Operations Manager, Hall Green Health)
In 2020, a report by the National Audit Office (NAO) found that the NHS health-check program was failing to reach its targets. According to the report, only 49% of eligible people in England received a health check between 2017 and 2018, which is below the NHS’s target of 75%. The report also highlighted significant regional variations in the uptake of health checks, with some areas achieving higher rates than others. This is an issue that has not been fully addressed in the UK as of 2023, and GP surgeries around the UK are tackling this issue in a variety of ways.
According to the report, there were several reasons for the program’s underperformance, including but not limited to: a lack of clear accountability for delivering the program, inadequate training and support for staff, and a lack of consistent and effective communication with the public. On top of all of this, the pandemic (the Covid-19 pandemic) also had a significant impact on the delivery of the NHS health-check program. During the pandemic, the health check program was not deemed a critical support service, so it was subsequently deprioritised within the NHS and the program suffered. More specifically in some areas of the UK, health check programs have been postponed or cancelled due to the pandemic, and staff have been redeployed into other areas of the healthcare system to provide their support where there is seen to be a greater or more pressing need. With that said, the health checks program is failing to reach targets across the board, but various practices such as Hall Green Health are doing their best to support patients and bring this prevention program back onto the agenda as a priority.
Due to the pressures within the NHS and Primary Care, Hall Green Health found themselves focusing their resources on the patients that were already diagnosed with long term conditions. They were keen to support patients earlier by increasing the access that their patients had to screening programmes, in particular the NHS Health Check Programme.
On top of the focus being given to patients who were diagnosed with long term conditions, a number of other urgent and critical patient needs were coming into the clinic, these urgent and critical care needs were also taking priority. Given staff resources were being put onto tackling these critical issues, rather than adding more capacity to the preventative (health checks) service, resources were often taken away. For example, while they had staff members who were trained to conduct the health checks, these individuals were often pulled into other phlebotomy clinics and domiciliary visiting, and thus the health check program was struggling to get the attention they desired. The practice was providing opportunistic health checks and running the occasional clinic when there was capacity. The practice felt they wanted to have a more dedicated focus on the health checks to provide more access to their patients and help drive down future health issues.
In Q4, 2022, Hall Green Health performed an in depth review of its health check programme and put together a plan to action. Jamal Syed (Operations Manager) took hold of delivering the program in a new way – he wanted to deliver an accessible program run by dedicated staff.
Hall Green Health specifically set out with the aim to structure the new health checks program in a way that was slightly unique to what had been done before. Up until now, the clinics had been run by in-house staff who often had competing priorities. By working with Ally Health, specific flexible working staff work was brought into the clinics to provide a dedicated focus. This meant capacity was not taken from the overstretched full-time nurse and HCA team already working at the clinic and allowed them to focus on the other practice priorities.
“Data shows that the average coverage of NHS health checks in the UK is only 35%, and forward-thinking patient centric practices like Hall Green Health are working to bring this number up as much as possible by bringing onboard solutions like Ally Health and others.
The NHS is dealing with its largest ever demand, programmes like the NHS Health Checks, allow practices the chance to provide preventive medicine and care rather than firefighting the challenging workload of existing conditions.” – Jamal Syed
Ally Health were brought in to provide flexible staffing to Hall Green Health for the group’s health-check initiative. More specifically, it was identified that a trained healthcare assistant – with the appropriate qualifications, training, and phlebotomy experience – was required to conduct the health checks. The flexible staff accommodates patients on certain days and times when Hall Green Health knows that patients are typically free and happy to come into the clinic for preventative appointments. This surge staffing on specific days and times, ensures that the health checks do not get unutilised or overridden as a dedicated member of staff is matched with the program.
How were these times and dates identified?
Jamal conducted research on appointment date/time preference ahead of the program start date by looking at the time patients typically attend the clinic for appointments and by pre-publishing availability to track when patients most frequently booked in. Looking at the cohort of patients that were eligible, it was clear that a large number of these were working age individuals with a busy schedule. As such the Hall Green Health team predicted that Fridays and Saturdays would be the most convenient days for patients to have their health checks conducted.
How were the clinics booked?
In order to raise awareness for the program, the practice had to communicate to patients ahead of the program start date. Jamal was able to identify patients who were eligible for the health check, and had not completed their health check. Given the profile of the eligible population, the practice wanted to test the method of allowing patients to self-book via a link in a text message.
The example message sent to eligible patients is shown below:
Our records show that you are eligible for a free NHS Health Check.
You can find more information about the Health Check at: https://www.nhs.uk/conditions/nhs-health-check/
Don’t delay, book today.
Hall Green Health
This messaging proved to be very successful through AccuRx. Hall Green Health was able to pre-book hundreds of appointments through the first message notification to patients. After the first announcement message, Hall Green Health has subsequently messaged other eligible patients to continue to pre-fill the slots made available with Ally Health’s practitioner.
Before the program’s official start date, to prepare the Ally Health practitioner for the specifics of the Health Check program, Hall Green Health required that the Ally Health practitioner visit the clinic ahead of the first day of work. Additionally, Hall Green Health provided the healthcare assistant with one morning of training, and once the real work began the clinic started with one day of reduced appointments. This ensured that the practitioner could comfortably provide the service to individuals as required and without being rushed or feeling overwhelmed at the program’s start. It also ensured that any teething issues could be ironed out without any negative experience for the patients.
With the support of Ally Health, the practice was able to offer an additional 40 NHS health check appointments per week by adding one dedicated practitioner to their cohort who could focus solely on the health check program in addition to sending out a handful of messages to patients in order to encourage appointment bookings.
More specifically, comparing Q4, 2021/22 and Q4, 2022/23, Hall Green Health saw an increase from 266 health checks completed to 533 completed. This increase of over 100% is a clear indicator of the success of the program changes implemented.
In addition to the overall utilisation of health checks increasing, the program, during Q4 2022/23, generated a revenue for the practice of £13,325. As Jamal says:
“We were able to improve a service by making it more accessible to the patients, less of a burden on practice staff and to increase the financial revenue of the programme.
We have provided a better service to our patients, obtaining up-to-date health information that will help us provide preventative medicine all while generating an income that will help us provide other services as well.”
The increased access to health checks and the convenience of being able to book appointments easily has allowed for better patient outcomes as 25 patients were diagnosed with hypertension and 21 with pre-diabetes and 7 individuals with Type 2 diabetes. These early findings of medical conditions, or in some cases elevated risk, within their patient population means the practice has a better understanding of what needs to be treated and what they need to keep a close eye on moving forward. This data and understanding allows the practice to prevent health deterioration in a more effective and efficient way across their whole cohort. Importantly, all patients who have gone through the health check programme have received advice regarding their health and wellbeing.
Around 3 months into the program, uptake of appointments – within the eligible population – was still positive and the Ally Health practitioner was able to complete up to 20 appointments per day (not including DNAs). However, the number of patients who were successfully contacted via text and email and attended their appointments started to plateau at the end of the 3rd month. Seeing this trend, the practice took the next step with the communication to patients, and sent out mailers to target the population who are eligible for the service but were less tech-enabled, and unlikely to have received the text message outreach messages.
Hall Green Health and Ally health are working together – using this health check programme and its success as a blueprint – to decide what other services can be effectively offered to patients.
What do other clinics need to do to work with Ally Health to set up this type of program?
For any other clinics interested in setting up this type of program within their practice, they can contact Ally Health’s co-founder Alexandra Tory directly to discuss their needs and receive support from trained health professionals to conduct NHS health checks. Ally Health offers other services through their flexible staffing solutions to accommodate the unique needs of clinics and their patients.
The program will take roughly 3 weeks to one month to set up, from the time that you get in touch with the Ally Health team.
Program set-up timeline (see below):
1.Get in touch with Ally Health’s Chief Growth Officer, Sasha Tory (Alexandra.firstname.lastname@example.org) to discuss their requirements and receive assistance in setting up the program quickly and efficiently.
2.Within 2 working days, Ally Health’s Chief Growth Officer will be in touch with you to arrange an initial meeting.
3.Within 3 weeks Ally Health will be able to match you with an appropriate member – or members – of our clinical cohort to service the contract.
4.Prior to the 1st day of work, the practitioner will be expected to conduct a 2-3 hour training session with the team onsite at the clinic.
a)This will be a free training session and the time will not be charged to you by Ally Health.
5.The first day of work will be done on a slightly reduced appointment schedule to ensure the practitioner is comfortable with the process and is caring for patients as you need.
6.From the second day onwards, your practitioner will be able to operate on a full capacity schedule.
7.Weekly meetings will take place to ensure feedback is given and the program is operating as and how you need.
NHS Health Check Programme. (n.d.). Retrieved from https://www.healthcheck.nhs.uk/