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Pharmaceutical Services Negotiating Committee

EN15 NHS Health Check (Vascular risk assessment and management service)

In April 2008 the Department of Health (DH) published Putting prevention first. Vascular Checks: risk assessment and management which announced the development of a Vascular Risk Assessment (VRA) service across England for people aged 40 to 74 years. Two days after that announcement DH published its pharmacy White Paper, Pharmacy in England - Building on strengths, delivering the future, which highlighted the role of community pharmacy in the provision of VRA.

In April 2009 the Department of Health launched the public branding for the VRA programme - NHS Health Check.

More detail on the programme has been published in two Department of Health documents:

Putting prevention first- vascular checks: risk assessment and management - next steps guidance for primary care trusts (November 2008)

NHS Health Check: Vascular Risk Assessment and Management Best Practice Guidance (April 2009)

What is the aim of the programme?

The aim of the NHS Health Check programme is to offer a straightforward risk assessment for diseases affecting the vascular system, including diabetes and chronic kidney disease, to everyone between 40 and 74 years of age. It is expected that once fully implemented, the programme will prevent on average 1,600 heart attacks and strokes, and save at least 650 lives each year.

The longer term aims of the NHS Health Check programme are:

  • To reduce premature death from related vascular conditions including Coronary Heart Disease, Chronic Kidney Disease, Diabetes Mellitus, stroke, Transient Ischaemic Attacks and Peripheral Arterial Disease;
  • To reduce the incidence of these related vascular conditions; and 
  • To narrow inequalities in premature death from these related vascular conditions.

When did it start?       

The programme was introduced by PCTs from 1 April 2009; all PCTs must 'show some evidence of participation' with the programme during 2009.

PSNC expects a spread of activity across the country with the Spearhead PCTs, which have the most pronounced health inequalities, being likely to be the first to fully implement the programme. Many PCTs are already piloting the service and a small number have fully implemented a VRA programme that matches the national programme requirements. PCTs may initially choose to target specific groups of the population to be the first people to be offered the NHS Health Check, e.g. people living in deprived wards.

Template Enhanced service specification

PSNC has developed a template national Enhanced service specification for the NHS Health Check service, working collaboratively with the Department of Health's Vascular Team and the Medicines, Pharmacy and Industry Division. The template service specification provides a starting point for the development of local service specifications by LPCs and PCTs.

To download a copy of the service specification click on the links below.

NHS Health Check service specification (Microsoft Word)

NHS Health Check service specification (PDF)

PSNC support for LPCs and community pharmacists

In February 2009 PSNC organised a series of seminars on VRA for LPCs across England in order to support them in making a bid for a pharmacy based VRA service in their local area.

Alongside the seminars PSNC published guidance, in three parts, for LPCs. The guidance contains a wealth of information and links relating to VRA, setting up the service, standards, assessment of costs, and much more. As this is a working resource for a new and evolving Enhanced service and the documents contain a large number of embedded links to other resources, they are only available in electronic format via the links below. The documents will be updated on a regular basis during 2009.

Part 1 of the guidance contains background information to support LPCs' preparation prior to developing a local VRA service.

Part 2 supports LPCs with making the case for a VRA service commissioned from community pharmacy. It provides a step by step approach to making a bid. Not all steps may be relevant in your area, depending on local circumstances.

This section has a linked template PowerPoint presentation that will help LPCs to highlight the added value that community pharmacy can bring to the delivery of a VRA service.

Part 3 of this guide contains guidance on the use of a financial spreadsheet to assist LPCs in developing an effective bid.  The spreadsheet can be downloaded here. The introductory presentation on how to use the spreadsheet delivered by Mike Dent (Head of Finance) at the LPC seminars can be downloaded here. Queries on the use of the spreadsheet should be directed to

A copy of the PowerPoint presentation used at the LPC seminars can be downloaded here.

If you have any comments on this guidance or suggestions on how it may be improved please contact

Useful resources and websites

PSNC dinner flyer for Vascular Checks (March 2009)

Department of Health

Putting prevention first. Vascular Checks: risk assessment and management (April 2008)

Putting prevention first- vascular checks: risk assessment and management - next steps guidance for primary care trusts (November 2008)

NHS Health Check: Vascular Risk Assessment and Management Best Practice Guidance (April 2009)

NHS Health Check leaflet for people invited for a check and template invitation letter (April 2009)

NHS Health Check information on NHS Choices website

Other resources

The Handbook for Vascular Risk Assessment, Risk Reduction and Risk Management (University of Leicester)

A selection of case studies and other support material is available on the NHS Improvement website

The PSNC services database contains details of a number of pharmacy based VRA services. LPC members should log in to the Members' area to access associated documents such as Service Level Agreements for the featured services.

The PharmOutcomes system can help community pharmacies provide services like this more effectively and make it easier for commissioners to audit and manage services