Digitising the NHS Health Check
Reducing NHS cost and encouraging uptake
Overview
Tickertest (our white-label project name) is a self-initiated venture born from our recognition of a critical gap in the healthcare market. Backed by a strong business case, we developed this Primary Care SaaS product from the ground up. Over three years, we invested in its development, taking it from a concept on paper to a live trial with OHID in Cornwall.
The Background
Our web-based solution is a digitised version of the NHS Health Check. Before the COVID-19 pandemic, NHS Health Checks—introduced in 2009—were conducted in person every five years for adults in England aged 40-74. The goal was to engage this demographic in proactive health management, helping to detect potential health risks before they become serious issues.
Cardiovascular disease (CVD) affects approximately 5.9 million people in England, causing 24% of deaths—second only to cancer—and placing a multibillion-pound burden on the NHS. However, between 2013 and 2018, only 33.8% of eligible individuals participated in the Health Check programme. The pandemic exacerbated the problem. Millions at risk of CVD remained unchecked while NHS resources were stretched to breaking point, leading to an unprecedented backlog.
Project
Self-funded start up
Client
OHID (Office for Health Improvement and Disparities)
The Idea
In 2019, we identified that a digital NHS Health Check could significantly improve participation rates. Our solution assesses the risk of stroke, kidney disease, heart disease, and type 2 diabetes over the next ten years. It evaluates six major risk factors associated with early death, disability, and health inequality: alcohol consumption, cholesterol levels, blood pressure, obesity, physical inactivity, and smoking. Additionally, the test raises awareness of early signs of dementia.
A digital approach removes accessibility barriers, allowing people to complete the assessment from home, which is particularly beneficial for those with time constraints or limited mobility. For healthcare providers, the solution optimises resource allocation by flagging only high-risk cases for follow-up, leading to more effective care delivery, improved health outcomes, and reduced costs. We estimate that digital Health Checks could save the NHS in England £3 billion annually.
How It Works
GP surgeries send secure, invite-only login links to the target group via text, with the number and timing of invitations managed at their end. Users complete a simple, usability-optimised online questionnaire. There are three models of delivery: a fully automated version that includes a remote NHS lab-grade capillary blood test completed at home; a semi-automated model where blood tests and blood pressure checks are carried out at the GP surgery; and a hybrid model allowing users to choose between in-surgery testing or at-home blood tests.
Once completed, test results are sent to the GP via a dashboard, highlighting patients needing follow-up. More than 20 SNOMED codes are automatically written back into the patient’s electronic health record (EMIS/TPP/Vision), completing the process.
Public trial
In 2021, we conducted an acceptability study with Smartline, where 98% of participants expressed interest in using such a service. In September 2022, Tickertest was selected from a competitive shortlist to partner with OHID (UK Office for Health Improvement and Disparities), Cornwall Council, and the South West Academic Health Science Network for a public trial. Three GP practices in Cornwall participated, involving approximately 1,500 individuals. The trial aimed to gain deeper insights into the factors influencing uptake, including enablers, barriers, and health equity impacts.
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