Patient Information Notice: NHS Health Check Data Extraction

This information is for people who have received an invitation to an NHS Health Check.

Starting in June 2018, NHS Digital, acting on behalf of Public Health England (PHE), will be collecting information about the numbers of people who are invited to an NHS Health Check and either attend or do not attend. This information will be extracted in June 2018 using the General Practice Extraction Service run by NHS Digital.

How will this information be shared?
The data collected will be analysed by PHE and reports of the main findings will be available on the NHS Health Check webpage.

What type of data will be extracted?
We will be using patient records, to collect information about people who have been invited for and attended an NHS Health Check, and people who have been invited for but not attended an NHS Health Check since 2009.

Before it comes to PHE, all patient information will be pseudonymised in line with the Information Commissioner’s Office (ICO) Anonymisation Code of Practice.
This means that the identifying fields within the data such as, date of birth, NHS number and postcode details will be replaced with an artificial identifier. In this case a unique number. Therefore, PHE will not receive personal data.

PHE will be using information from records for patients aged 40-74 years (the age group that the NHS Health Check is aimed at), and people aged 18-39 years who have been invited for and/or attended an NHS Health Check. This will provide information about cases where people may have been invited and/or attended an NHS Health Check before reaching the eligible age of 40.

PHE is collecting data for four patient groups:

Group 1: registered patients aged 40-74 invited to an NHS Health Check only.
Group 2: registered patients aged 40-74 years who either commenced, completed (by a GP or third party), declined or did not attend an NHS Health Check.
Group 3: registered patients aged 40-74 years for whom an NHS Health Check was inappropriate.
Group 4: registered patients aged 18-39 years who have either been invited for an NHS Health Check and/or completed an NHS Health Check.

Each patient will be included in one of these four groups according to the information in their medical record.

A unique number will be created for each patient, which PHE can use to identify them instead of their personal details. This means any data used by PHE will be pseudonymised.

NHS Digital will collect the following information for each patient:
• NHS number (this information will not be passed on to PHE)
• date of birth (this information will not be passed on to PHE, though age at time of the extract will)
• postcode (this information will not be passed on to PHE)
• gender
• patient active status
• general practice code
• date patient registered with the general practice
• date of death (if applicable) (this information will not be passed on to PHE)
• ethnicity
• first language (and whether an interpreter was needed)
• country of birth
• carer status
• diagnoses for disabilities: such as learning disability, serious mental illness, blindness, severe deafness

NHS Digital will extract information that relates to the health conditions that the NHS Health Check programme seeks to prevent or diagnose:
• smoking status
• family history of coronary heart disease
• body mass index (BMI) score
• cholesterol level
• blood pressure
• physical activity levels
• risk of cardiovascular disease
• alcohol use
• tests for cardiovascular disease risk factors
• cardiovascular disease diagnoses
• information on the advice or other information provided to the patient such as advice around diet
• information on any medication prescribed for cardiovascular disease

Who is collecting the data and how is it collected?
The General Practice Extraction Service (GPES) at NHS Digital will extract the data from general practice (GP) patient records. NHS Digital will pseudonymise the information before passing it on to PHE.

Why is this information being collected?
PHE wants to use the information collected in order to monitor access to the NHS Health Check programme for different populations, as well as the number of people in different communities who are attending an NHS Health Check when they are invited. It will also help to measure how well the programme is being run across England and whether it is having an impact on the health of local people.

To date, this information has not been collected on a national scale.

The data will also be analysed to inform our partners and other professionals involved in the programme, including the Department of Health, commissioners and professional groups who provide NHS Health Checks, such as pharmacists.

If any statistics or reports using this data are published, PHE will observe Government standards that ensure that individuals cannot be identified from published data.

How will the data be used?
• to provide information on how the NHS Health Check programme is performing
• to show how the programme is performing in different areas of England
• to highlight opportunities for improvement in how we deliver the NHS Health Check programme
• in the future, PHE hopes to use this data to track how the NHS Health Check programme has made a difference to the long-term health of patients

What happens to the data when it is sent to PHE?
All confidential personal information such as NHS Number, date of birth and postcode will be removed, and a unique ID will be created. PHE will not receive any personal information.

In order to allow us to track how the NHS Health Check programme has impacted the long-term health of patients, at a later stage PHE might seek to link the information we are collecting with other information such as hospital records. It is anticipated that the linkage would be done by NHS Digital, using the unique ID to link records.

Who will the data be shared with?
We will be sharing our findings with local authorities and these will also be publically available. These findings will be aggregated, which means that data will be grouped together. No individual patient information will be shared or made publicly available.

How will this affect the patients concerned?
There will be no impact on patients from sharing the data, as no one can be identified from the information shown in our reports.

What if I do not want my data to be collected?
If you do not wish your data to be collected, please contact your GP to register a Type 1 opt-out. This is an objection that prevents an individual’s personal confidential information from being shared outside of their general practice except when it is being used for the purposes of direct care, or in particular circumstances required by law, such as a public health emergency like an outbreak of a pandemic disease.

NHS Digital will uphold Type 1 opt-outs in collecting these data from general practices (that is: any patients who have registered a Type 1 opt-out prior to the point in time at which this data collection takes place will not be included in this data collection).

A Type 2 opt-out is an objection that prevents an individual’s personal confidential information from being shared outside of NHS Digital, except when it is being used for the purposes of direct care. Type 2 opt-outs do not apply to this data collection as no personal data will leave NHS Digital.

You can read more about personal information choices online.

What is the NHS Health Check?
The NHS Health Check was launched in 2009. Since 2013, local authorities have been required to offer an NHS Health Check every five years to all adults aged 40-74 years. Adults aged 40-74 who have been diagnosed with vascular disease, prescribed statins or identified at high risk of cardiovascular disease are excluded from the programme, as they should already be receiving support to monitor and manage their condition.

The NHS Health Check is a free check-up of your overall health. It can tell you whether you’re at higher risk of getting certain health problems, such as:
• heart disease
• diabetes
• kidney disease
• stroke

If you are over 65, you will also be told the signs and symptoms of dementia to look out for.

As well as measuring your risk of developing these health problems, an NHS Health Check gives you advice on how to prevent them.

The risk level varies from person to person, but everyone is at risk of developing heart disease, stroke, type 2 diabetes, kidney disease and some types of dementia.

Your NHS Health Check can detect potential health problems before they do real damage.

PHE is responsible for national oversight of the NHS Health Check programme, and for supporting the organisations which run the programme locally to deliver high standards and reach as many eligible people as they can.

Further information
For further information, please see NHS Digital Website. This provides information on the Privacy Notice: NHS Health Check for adults aged 40-74 years