Opportunistic health checks in a retail environment.

Cardiovascular disease remains common and accounts for many deaths, but primary cardiovascular risk factors are consistently underdiagnosed in the UK. NHS health checks are being implemented nationally in the next five years, targeting those aged 40 to 74 years, and many primary care trusts have commissioned health checks to be carried out opportunistically as an outreach programme in public places to aid uptake and improve access. However, there is little published evidence on the effectiveness and subsequent follow-up rates in such a model. This service evaluation verifies the effectiveness of primary cardiovascular screening in a supermarket setting in south east London. Eight consecutive Saturday clinics were carried out at the entrance of a local supermarket offering opportunistic health screening including blood pressure, random glucose, body mass index and screening spirometry. The primary outcomes are rate of uptake of the service, the proportion of participants with previously undiagnosed cardiovascular risk factors that were identified from the screening, and the subsequent rate of follow-up. Over the eight-week period, 1024 participants (457 males, 44.6%; 567 females 567, 55.4%) undertook the screening. Four hundred and twenty-two participants (41.2%) required follow-up for abnormal readings. Of these, 325 (76.4%) were abnormal readings in participants with previously unknown disease (raised blood glucose, 95 participants (9.3%); raised blood pressure, 172 participants (16.8%); FEV1 < 80%, 93 participants (9.1%)). Using the NHS health check age range, 34.3% of raised blood pressure measurements and 38.9% of raised blood glucose measurements would not have been picked up. The cost per patient was £19, the cost per abnormal finding was £43.66. Opportunistic health screening targeting particular groups of individuals appears to be highly effective in identifying significant pathology. The main limitation of this pilot was that cholesterol measurement was not performed and therefore full cardiovascular risk assessment could not be offered.