Well North leads the way

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NHS Western Isles is gaining a valuable understanding of the health needs of the Western Isles population aged between 40-69 and is successfully supporting people to access local healthcare services and make lifestyle changes that will reduce their risk of cardiovascular disease (CVD).

These are just some of the successes of the Well North Outer Hebrides (WNOH) Project, which members of Western Isles Health Board were updated on today at a Board Meeting in Stornoway.

WNOH was introduced in May 2008 to provide universal health checks to people aged between 40 and 69. The project has gone from strength to strength over the past two and a half years; leading the way in Scotland in the early delivery of the government’s cardiovascular health check target and being the first Board in Scotland to introduce instantaneous access to CVD and Diabetes screening test results through Point of Care Testing.

The government target for cardiovascular health checks specifies that people within the target age group (between 40 and 69) in locally deprived areas should receive health checks. NHS Western Isles however took a universal approach and offers screening to every member of the population that falls within the target age range - which equates to around 8,200 people. Already more than two thirds of people within that age group have received a health check (5,390 people by March 2011), which far exceeds initial local and national expectations.

“Nobody anticipated how successful the ‘Well North’ screening programme would be when it was first introduced in 2008,” said Chair of the Coronary Heart Disease and Stroke Managed Clinical Network, and Clinical Lead for Well North, Dr Dave Rigby. “The project recently reached the milestone of providing our 5,000th health check through Well North, which means that more than two thirds of those eligible for screening in the Western Isles have now received a health check. We hope to have seen the majority of the 8,200 target group within the next year. I doubt if there is another primary prevention initiative in the country that has achieved so much and had such a big impact on this age group.”

As part of the Well North project, individuals are given an overall health check and risk estimation score. If, following a health check, a client is found to be at a 20 per cent (or higher) risk of developing CHD in the next 10 years, measures can be taken (such as an increase in exercise) to prevent the disease forming. Clients at a 20 per cent or above risk are also referred back to their GP. Those in a slightly lower risk group will be offered support such as sports programmes in the sports centre or healthy eating advice.

The fact that Well North clinics are effectively ‘mobile’ and held in a variety of community venues to suit different individuals is thought to have been a key factor in the success of the project, coupled with the fact that individuals receive personal invitations, by letter or phone, to attend health checks.

Well North has also provided an ideal platform to target local alcohol issues; helping to prevent problems before they begin through Alcohol Brief Interventions (ABIs). ABIs typically take the form of short motivational interviews, in which the costs of drinking and the benefits of cutting down are discussed, along with information about health risks.

With a target to deliver 772 Alcohol Brief Interventions over a three year period (from March 2008 - March 2011), NHS Western Isles delivered more than double the target number (1643) by March 31 2011, with a large number carried out through the Well North project.

Health Promotion Manager Colin Gilmour explained: “Most of the people we screen and carry out an intervention with are able to consider reducing their consumption or patterns of drinking with our help, but because of the approach we occasionally are able to help people with existing alcohol problems but who have not come forward to existing services.”

NHS Western Isles Chief Executive Gordon Jamieson said: “I am delighted that here in the Western Isles we have made such excellent progress through the Well North Outer Hebrides Project to help tackle some key public health issues.

“This innovative project, which has been an outstanding success, helps to keep the local population as healthy as possible and the staff involved in its development and running are to be commended for delivering such a successful initiative.”