About the data
Where the data comes from
The data presented in Healthier Lives is drawn from data published for the public health outcomes framework (PHOF).
The PHOF sets out the vision for public health and has been developed in a way that supports local communities to identify opportunities to improve health. For more information about how each indicator is created or to download the data please visit PHOF.
How the data is presented
The data is organised into three categories:
- NHS Health Check: includes three indicators on the delivery of the programme
- Risk factors: includes six indicators on risk factors that are key contributors to cardiovascular disease
- Health outcomes: includes five indicators on health outcomes related to cardiovascular disease
NHS Health Check data
The NHS Health Check data, collected from all 152 local authorities in England, shows:
- Percentage of eligible people invited to have an NHS Health Check between April 2013 and March 2018
- Percentage of the eligible people who have had their NHS Health Check between April 2013 and March 2018
- Percentage of people invited to have an NHS Health Check having their check between April 2013 and March 2018
The eligible population is defined as all adults in England, aged 40-74, who are not currently being treated or monitored for a cardiovascular condition, such as heart disease or diabetes, between 2013 and 2018. For the majority of areas the eligible population for each area is based on mid-year population estimates for the latest year minus a 30% adjustment. For other local authorities the eligible population is based on the GP registered population.
The data shows cumulative percentages over a five year period (between 2013 and 2018), up to and including the latest quarterly data. There is a legal requirement for local authorities to make provision to offer the NHS Health Check to 100% of their eligible population over a five year period i.e. 20% each year.
Data on the third indicator does not necessarily show the same group of people that were invited and had an NHS Health Check. As the programme was being delivered before April 2013 it is possible that some people were invited before this date and had their NHS Health Check after April 2013.
For corrections to previously published figures, please see:
The risk factor data is from the PHOF and further explanation on how each of the indicators are calculated can be found on the PHOF website. The hypertension indicator is an exception to this, it has been take from publicly available data from the Quality and Outcome Framework for 2012/13 which is based on general practice records.
The risk factor data is from the PHOF and further explanation on how each of the indicators are calculated can be found on the PHOF website.
The colour scheme and how to interpret it.
We have calculated for each area whether they are statistically significantly different from the national average by comparing the 95% confidence interval for each indicator with the England value. We have coloured the map as follows:
- RED = the upper 95% confidence interval of the indicator is lower than the England value – we have labelled this “Worse than average”.
- AMBER = the 95% confidence intervals for the indicator contain the Enland value - we have labelled this "Consistent" with the national average
- GREEN = the lower 95% confidence interval of the indicator is higher than the Engalnd value – we have called this “Better than average”
Why does Healthier Lives present QOF data without taking account of exceptions ?
There are two valid methods to calculate QOF indicators. We have chosen to show the proportion of patients receiving the intervention because:
From a public health perspective we are more interested in the actual proportion of patients receiving the intervention, i.e. the proportion of all patients with this condition who were treated. The HSCIC (QOF FAQs, p.11) states "Percentage of patients receiving the intervention, gives a more accurate indication of the rate of the provision of interventions as the denominator for this measure covers all patients to whom the indicator applies, regardless of exception status."
We consider this to be the better comparable indicator because, while there are very good reasons why a patient might not be treated (such as terminal illness), a generous interpretation of exception rules can also be used to improve practice performance.
The tool is intended to highlight variation and encourage conversation about the causes of variation. We are not suggesting that every practice should, or can, achieve a 100% intervention rate for every indicator - clearly there are patients it would not be desirable to be included - however it is clear that there is unwarranted variation in exception rates and the data is not available for us to make adjustments.
Triangulation with other sources of primary care data such as the National Diabetes Audit (NDA) support this approach. For those QOF indicators which match NDA indicators, a higher degree of correlation was found with intervention rates than with achievement scores, so intervention rates seem a better measure of true performance.
In the tool you can compare indicators of one local authority to other similar areas. This benchmarking draws on the index of multiple deprivation and will show other local authorities in the same deprivation decile as the area you have chosen to compare.
Public Health England produces a range of resources and information to support local areas to deliver a high quality NHS Health Check to as many eligible people as possible.
- Best practice guidance on delivering the NHS Health Check is published each year and provides information on what the NHS Health Check should include
- Marketing and branding resources and guidance is available to support local communications and campaigns
- Programme standards support the delivery of a high quality programme that will maximise its impact on helping people to live longer, healthier lives
- Information governance and data flows guidance helps local commissioners to understand data processing requirements
- A series of case studies explain the approaches adopted by different areas to reach people at higher risk of cardiovascular disease
- The NHS Health Check Ready Reckoner demonstrates the estimated local health benefits of the NHS Health Check programme.