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Avoiding a healthcare time bomb

Promote self-care by suggesting a free online NHS MidLifeCheck to patients.

As the UK population both ages and expands, we all know that the level of spending required from the NHS is not sustainable. So it is crucial to invest in new ideas which champion preventive healthcare.

This means moving 'upstream' to focus on the causes of poor health rather than just focusing on treatment. It means starting with the person not the disease - and looking at how lifestyles lead to poor health.

Ultimately, the responsibility for improving lifestyles lies with individuals and their communities. However, we must give patients the information and support they need to develop self-care skills in order to avoid a healthcare time bomb.

Healthy lifestyle
A survey commissioned by the DoH showed that despite half the adult population in England admitting they need to think more about leading a healthy lifestyle, the same people admit to spending a lot more time talking about getting healthy than actually doing it. And a third of adults said they would not even know where to start.

NHS MidLifeCheck is an online tool that turns this well-intentioned talk into action.

Having been involved in the NHS LifeCheck online programme from the beginning in 2006, I feel passionately that it is a significant step in the move towards preventative self-care.

NHS TeenLifeCheck - aimed at young people aged 12 to 15 - and NHS BabyLifeCheck - for parents and carers of five to eight-month-old babies - are already a great success, and NHS MidLifeCheck (www.nhs.uk/midlifecheck) launched in February 2010, has exceeded uptake expectations.

Multiple choice questions
NHS MidLifeCheck is aimed at adults over 40. Free, easy-to-use and confidential, the website guides users through a set of multiple choice questions on aspects of their life, such as diet, exercise, smoking, alcohol consumption and emotional well-being.

The results page produces tailored advice based on the users' answers and signposts them to further points of information on specific topics.

Users can create a personal plan, set goals, track their weight and sign up for free emails, texts or letters to help them along the way.

NHS MidLifeCheck is available from any computer with internet access and, therefore, patients can obtain information 24 hours a day, outside normal practice hours.

The service is non-judgmental and friendly in tone. It can gently nudge people in the right direction, reassure them that they're leading a healthy life, or advise them to seek professional help should it be necessary.

GPs can promote NHS Mid-LifeCheck in their practice and can confidently direct their patients to the website, with the knowledge that it is accurate, up-to-date and relevant to mid-lifers.

Patients can, if they are worried, bring a printout of their results into the surgery, but this is not what the site is about. NHS MidLifeCheck has been carefully put together to reassure users that there are many things they can do to help themselves.

There will be critics who suggest that the people who could benefit most from using NHS MidLifeCheck may not have internet access at home. But this is where GPs and other health and social care professionals can also help.

In my own practice we have set up a LifeCheck room with computers for patients to use when they visit. The response has been incredibly positive and there are many opportunities for practices to link MidLifeCheck with local initiatives.

Setting personal goals
More than 170,000 people have visited the NHS MidLifeCheck website so far, with many thousands also committing to setting specific personal goals.

Although any adult can use the site, its look and content has been designed with particular consideration for those from socially disadvantaged backgrounds.

This is in order to help address glaring health inequalities as identified in the Marmot Review report Fair Society, Healthy Lives (www.ucl.ac.uk/gheg/marmotreview) published in February 2010.

The NHS MidLifeCheck website also ticks many boxes in the list of public service agreements targets. Used well, it could be a powerful resource.

In essence, the service is an innovative way of reaching out to people who may not otherwise engage with health promotion services. And it delivers important information that users may not otherwise be exposed to.

It does not sermonise but instead offers people practical advice and support by providing a structure to use in planning for the changes they choose to make.

I believe that, if we encourage and empower individuals to take responsibility for actions which impact upon their own health and well-being, NHS MidLifeCheck could begin to shift the mindset of those who only look to their GP for solutions.

  • Dr Dixon is a GP in Devon, NHS Alliance chair and NHS LifeCheck programme board chair.
Fact file
  • NHS MidLifeCheck, which launched in February 2010, is part of a three-pronged LifeCheck service in England.
  • The other two parts are NHS Teen LifeCheck, aimed at teenagers aged 12-15 and launched in June 2009, and NHS Baby LifeCheck aimed at parents and carers of babies aged five to eight months and launched in August 2009.
  • The DoH has dedicated £5.8 million to help embed the service in 83 Communities for Health areas, concentrating on reaching the most socially disadvantaged groups.
  • Further information and resources on how to promote NHS MidLifeCheck to patients, including marketing materials, is available at www.lifecheckers.co.uk.


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