NHS Health Check Standard

The NHS Health Check is an important public health programme aimed at preventing non-communicable diseases (NCDs) among adults aged 40-74 in England. By promoting early awareness, assessment, and management of key risk factors, it targets conditions contributing to premature death, disability, and health inequalities.

With over 1.2 million annual appointments, the program relies on accurate data recording to ensure appropriate clinical actions and treatments are carried out. Currently, several clinical templates are used to record the information gathered during a health check. This information standard will ensure high quality, standardised data is regularly collected and can be used effectively to risk assess NHS Health Check attendees.

Current release

Version: v1.3.0
Standard model - Excel
> Release notes
Supporting documentation
Description/purpose
Implementation guidance
This document includes general implementation guidance for all PRSB standards. Detailed implementation guidance specific to this standard are included within the information model.
Business rules
Rules for implementation of the standard.
Final report
Describes the purpose, methodolgy and stakeholder engagement for developing the standard, along with the findings and recommendations for further work.
NHS Health Check Survey report
The online survey was part of the consultation approach in the development of the standard and came after detailed work on specific topic areas and a national workshop on the entire standard.
Safety case
Summarises the hazards which could result from implementing the standard.
Hazard log
Details the potential hazards from implementing the standard with their risk rating and mitigation.
Provenance data
Defines the information on who made a record entry and who carried out the activity, where and when.

From 01 January 2026, this standard will be owned and managed by NHS England and is made available for reuse or amendment under the Open Government Licence v3.0 (OGL 3.0). A review of the ongoing requirement for this standard will be undertaken by NHS England. Details on this and any update to the standard will be published on the NHS Standards Directory. If you have any questions or feedback relating to this standard, please email: england.standards.assurance@nhs.net.

 

About this standard

The PRSB has developed an information standard to ensure standardised data of high quality is regularly collected and can be used effectively to risk assess NHS Health Check attendees, together with a record of follow up actions (referrals, advice, signposting).

Benefits:

  • Reducing burden in terms of staff time for NHS Health Check commissioners, providers and IT suppliers.
  • Allowing accurate flagging of patients eligible for an NHS Health Check, therefore patients who would benefit for a check are invited in a timely manner. Patients not eligible are not called in un-necessarily.
  • Supporting high quality delivery of the NHS Health Check programme.
  • Appropriately informing clinical action, treatment and follow up of NHS Health Check attendees.
  • Ensuring local and national monitoring and evaluation of the NHS Health Check programme is based on high quality data.
 

Scope:

  • Adults and older adults aged 40 to 74 with no pre-existing cardiovascular conditions.
  • Scope includes recording of agreed actions, next steps and signposting.

Out of scope:

  • Annual physical health checks for learning disabilities.
  • Annual physical health assessments for those with severe mental illnesses.
  • Physical health checks in prison.
  • The development of personalised care and support plans (PCSPs).

Examples

To give a clearer idea of how the standard works in practice, PRSB have created scenario examples.

Endorsement

This standard has been endorsed by the following organisations:

Personalised care and support planning for people with severe mental illness

A review of a sample of current care plans, and the way they have been developed, may be helpful in identifying the priorities for this improvement. The PRSB Implementation Guide provides more detailed explanations about each element of the plan, including advice on how the planning process might be best conducted.
These questions might form a checklist for current plans to be compared with. 

1. Does the plan include an About Me section in which the service user, in their own words, can indicate the information they want to be available about their lives, their values, their interests, and priorities, available for all those who may care for them?
2. Is the approach to developing a care plan patient centred and engaging, allowing plans to be based on patient priorities goals, and aspirations, along with the actions they plan to take and the support that they will receive?
3. Is there space for a “formulation” to be recorded in which the person receiving care and the professionals who provide it, share and record the personal meaning and the origins of the person’s difficulties?
4. Are relevant procedures and therapies recorded?
5. Where relevant, are one or more contingency plans included for anticipatable disruptions, exacerbations, or deterioration, and do they include advice on what to do and points of contact for those called upon to respond?
6. Where relevant are additional supporting plans incorporated, (an example being an “educational and health plan” for someone with a neurodevelopment disorder)
7. Is a version of the plan available to a service user (if they wish to have it) in a form and format that they can understand and find to be of value?
8. How is a version of the plan available to the GP and other key parts of the health and care system?

Work conducted by PRSB and partners recently has looked specifically at the suitability of this approach to the development and documentation of care and support plans for people with Severe Mental Illness. This resulted in an updated version of the standard (v1.4), for use by any service and for any group of service users, but with some modifications to ensure that it meets the needs of this community. The approach to a patient centred process of identifying goals, hopes, and values, and the support needed to achieve them, is fully compatible with and can be conducted using, specific tools in use in mental health, such as DIALOG, DIALOG+, and ReQoL, for example. 

Where analysis indicates the need for improvement in the content and process of personalised care and support planning for patients with Severe Mental Illness, specific improvement projects should be instituted to co-design with service users and their representatives, and the relevant staff groups, new approaches, and documentation that would be of value in delivering improvement. The toolkit includes a range of existing resources that could be used to engage in this improvement work, including signposting to relevant existing approaches informed by patient experience-based design.

Moving to a single holistic plan

A review of a sample of current care plans, and the way they have been developed, may be helpful in identifying the priorities for this improvement. The PRSB Implementation Guide provides A key development, consistent with national policy on support for Personalised Care across all health and care sectors, is the move towards an individual with complex needs having a single, integrated, care plan, rather than a series of plans developed by different parts of the health and social care system in isolation of one another. For a patient with severe mental illness, the related concerns and challenges might form a very prominent part of such an integrated plan; many will also have concurrent health challenges and needs. The intention is that the relevant services work together to plan and wrap support around the patient and their family in an integrated way, rather than as a series of sequential or disconnected encounters in which the service user or their friends and family have to adopt the role of the integrator.

A starting point would be to agree priority groups of service users who may already have more than one care plan because they need care from more than one part of the system of health and social care. This could be initiated by looking at service users registered with some sentinel practices or PCNs. Alternatively, the approach might focus initially on people with defined co-morbidity or risk that entails collaborative care with agencies beyond specialist mental health services.

The focus here is on the process of care planning and agreement on what should be shared, rather than solely on the technology used;

1. What is the process to agree which professional will initiate care planning and act as the “lead point of contact” for the service user?
2. Will initial plans be agreed with the service user in joint consultations or sequentially? Where and how will they be conducted?
3. What will be the process to agree the elements of the plans which should be available to professionals and potential authorised users beyond the immediate care teams, (A&E services, Ambulance Services, Social services, etc.) with the service user’s consent?
4. How will elements of the plan be updated following consultations in a way which is proportionate, to allow contact and progress notes to be maintained by the service conducting the consultation, whilst avoiding unnecessary work for partners in care if there is no significant change to the personalised care and support plan?
5. What are the implications for workload, logistics, and administration arising out of these decisions?

The answers to these questions and others will best be elicited through focused joint working, grounded in real, or at least realistic examples. This will entail process mapping, and co-design with a range of professionals, service users, and families. Resources from the toolkit and outputs from the Simulation element of this project will be valuable. Some organisations would adopt an approach such as a Rapid Process Improvement Workshop, planned over several weeks and conducted over a number of sequential days, to develop prototype ways of working that could be tested in the field.

“If someone’s been working for a period of time, in a form of therapy, for instance, where there’s an agreed plan for the locality when they may present in an emergency situation … then it’s really important for us to be able to see that that information and be able to act appropriately according to that because, you know, there isn’t and there shouldn’t be a stock response to that. These plans are designed to be individualised and personalised.  All services should be giving that personalised approach to care wherever possible. And a standard such as [PCSP standard] definitely moves us closer towards being able to do that. [Not acting on agreed plans] is a key finding in terms of emergency responses over the years where responses have been inappropriate.” – Mental Health Nurse

“Following a particular plan that’s been put into place will result in much better outcomes and prevent the sort of poor outcome which would otherwise be leading to an unplanned hospital admission.” – General Practitioner