Case study

Stockport: 'Know your numbers’ blood pressure campaign

Getting people who haven’t had a recent blood pressure check to take a self-service test at a local health kiosk and then follow up with their GP if the reading is high.

Man having his blood pressure taken

As part of Stockport’s Hypertension Programme – ‘Know your numbers’, health kiosks were commissioned for 6 months (April to October 2014) at 7 sites across Stockport. The health kiosks allow individuals to measure their blood pressure, weight, body mass index (BMI), body fat content and heart rate.

Prior to the installation of the kiosks (April 2014) 12,948 adults over 45 were flagged on the GP system as they were without a recorded blood pressure reading taken in the last 5 years.

This systematic flagging will enable follow-up analysis of the main objective to increase by 11% those patients aged 45 to 75 years old registered with a Stockport GP never having blood pressure recorded in the last 5 years. Results are expected December 2014.

Specific read codes applied to general practice systems have made it possible to identify blood pressure readings taken at kiosks, as distinct from readings taken in practice or at other community events running in parallel.

The benefit of health technology situated in the community to support health campaigns is now recognised. Softer outcomes to date include:

  • enabling more adults to know their blood pressure reading
  • increasing overall the number of individuals who have a blood pressure reading recorded with their GP
  • getting those with raised blood pressure to take action to manage their hypertension

For additional information, visit http://stockportccg.org/blood-pressure-2/.

Contacts

Andy Dunleavy, Senior Public Health Advisor, Stockport Metropolitan Borough Council.

Dr Vicci Owen-Smith, Centre Consultant in Healthcare Public Health, Public Health England.

Region

Greater Manchester

Location

Stockport

Partner organisations

Stockport Council, NHS Stockport CCG, NHS Stockport Foundation Trust, Stockport Homes, CCG Locality Councils and Stockport Council Community Committees

Target population

Patients registered with NHS Stockport CCG and recorded as never having a blood pressure reading in the previous 5 years.

Aim

To reduce the number of patients without a blood pressure reading reading recorded in the past 5 years.

Programme structure

One month prior to the kiosks being placed in the community a data search for patients without a blood pressure reading recorded at all 48 Stockport general practices was undertaken. Data on patients without a blood pressure reading recorded in the last 5 years was analysed. In total a cohort of 12,948 adults over 45 were identified. These patients were subsequently flagged on the Stockport health record system.

Any person can use the kiosks free of charge for health tests at specific sites across Stockport. Sites were located at range of public sector buildings including community and NHS settings. Locations of high footfall in the town centre and the main NHS trust were selected alongside community buildings in most deprived areas.

All clients are provided with readings for blood pressure, BMI, body fat percentage, heart rate, QRISK score (risk of cardiovascular disease), heart age, lifestyle advice (links) and follow-up information regarding their blood pressure reading (via print, email or text message).

Stockport-registered patients can choose to enter their practice address details on the secure system server. The data is retrieved and provided on a monthly basis to each practice to input the blood pressure readings on their GP system.

Activity to date

In the 6 month pilot period, data from 9,745 interventions with a completed blood pressure reading at the 7 kiosk sites were analysed. In total 5,794 unique kiosk clients accessed their blood pressure reading. Blood pressure records of patients registered on Stockport GP practice lists were made available for practice managers to input on their GP system at all 48 practices across Stockport.

Data available to date shows that:

  • around 60% of clients with a recorded BP were in the target age range (45 to 75 years)
  • 28% of clients were recorded with a blood pressure reading above the threshold for hypertension
  • 41% of clients in the target age range (45 to 75 years) had pre-hypertension (blood pressure which is raised, but not high enough to classify as hypertension)

Outcome measures

  • Quality and Outcomes Framework (QOF)
    • Number of adults over 45 years with blood pressure reading in last 5 years.
  • CCG strategic aims
    • Strategic aim 5: ensure better prevention of disease and early identification of disease leading to reduced inequalities.
  • Public health outcomes framework 2013 to 2016
    • Domain 4: healthcare public health and preventing premature mortality
    • Objective: reduced numbers of people living with preventable ill health and people dying prematurely, while reducing the gap between communities
    • Indicator 4.4: mortality from all cardiovascular diseases (including heart disease and stroke)

Outcomes

Follow-up will take place between October and December 2014.

An analysis of changes in patients blood pressure reading or recorded status (recorded or unrecorded) for flagged patients will be analysed for all 48 Stockport practices.

Lessons learned and tips for others

  • people are attracted to health kiosks as a method of receiving health information
  • health technology is a developing area – don’t expect the providers to know exactly what you want
  • remember that changes made late to any specifications can be very expensive (both financially and with regard to resources)
  • plan the placement of kiosks carefully to catch the most footfall in your target population
  • keep partnerships alive to ensure there is a growing understanding of how technology can be used most effectively
  • ask the users – they know where things have gone well and less well
  • engage with staff at sites, they also know what’s working and are key to promoting with users

External evaluation

Commissioning support unit.

Peer-review publications are currently in progress.

Estimated NESTA rating: to be confirmed.

Published 18 November 2014