Merge pull request #135 from NHSDigital/lung-health-check-first-post

Lung health check first post

Author: ralph-hawkins

app/_layouts/product.njk

@@ -51,6 +51,7 @@
         "Select people for invitation"
       ] },
       { title: "Personalised prevention", services: [
+        "Lung health check",
         "Personalised prevention platform",
         "Smoking cessation"
       ] }

app/images/lung-health-check/2025/06/health-assessments-discovery/stage-03-diagram.png

@@ -0,0 +1,10 @@
+---
+layout: collection
+title: Lung health check
+description: Helping more of the right people access lung health checks.
+pagination:
+  data: collections.lung-health-check
+  reverse: true
+  size: 50
+permalink: "lung-health-check/{% if pagination.pageNumber > 0 %}page/{{ pagination.pageNumber + 1 }}{% endif %}/"
+---

app/posts/lung-health-check.md

@@ -0,0 +1,218 @@
+---
+title: "Health assessments discovery"
+description:
+  "Summary of a discovery exploring which health checks the NHS could offer as digital self‑assessments, and how to evaluate their potential."
+date: 2025-06-09
+---
+
+This discovery sought to understand whether the NHS could introduce additional health checks as a digital self‑assessment.
+
+Evidence strongly confirms that offering health checks to patients contributes to reducing health risks.
+
+However, we do not sufficiently understand what types of checks would provide the most benefit to patients if offered as a digital self‑assessment. It is also unclear if providing healthcare professionals (HCPs) with a choice between digital and in‑person assessments would add value.
+
+We also did not know which groups would benefit most from access to self‑assessments, or how to ensure disadvantaged groups were included appropriately.
+
+## Our goals
+
+We structured our work around 3 goals:
+
+### 1. Understand value and impact
+
+We explored whether increased access to digital assessments could improve outcomes and reduce costs without adding strain on primary care.
+
+### 2. Identify suitable use cases
+
+We evaluated five health assessments in depth using a 3‑stage framework, identifying where measurable benefits were most likely.
+
+### 3. Explore reusability and shared components
+
+We assessed the feasibility of building reusable, scalable digital assessment tools using existing NHS infrastructure and design patterns.
+
+## What we did
+
+To support our discovery goals, we conducted a range of research activities. These helped us identify opportunities, highlight gaps, and inform the development of our evaluation framework for assessing the suitability of different health checks for digital self‑assessment. Our research activities included:
+
+### Stakeholder engagement
+
+Interviews with experts in commissioning, policy, strategy, technical, governance, compliance, and clinical fields.
+
+### Spoke to experts
+
+Regular consultations with internal technical and clinical subject matter experts (SMEs). Explored clinical feasibility, safety, and what is likely to resonate with healthcare professionals. As well as considering technical possibilities and constraints. We also gathered insights from providers of health assessments, digital tools, and biometric tests.
+
+### Desk research
+
+We reviewed:
+- NHS health check online discovery and alpha reports
+- NICE guidelines
+- NHS and DHSC policy documents (for example, Core20Plus5, NHS Long Term Plan, Digital Prevention Strategy)
+- public health literature
+- independent pilot studies
+- past user research
+
+We used our research to design and refine a 3‑stage evaluation framework to assess the potential of digital self-assessments. This framework helps us evaluate:
+
+#### Desirability
+
+Does it provide value to users or meet system needs?
+
+#### Potential impact on health inequalities
+
+Could it improve access and outcomes for underserved groups?
+
+#### Suitability
+
+Is it appropriate for digital delivery and aligned with prevention priorities?
+
+#### Feasibility
+
+Can it be delivered effectively within current NHS systems and infrastructure?
+
+## What we designed
+
+Our main output from this work was the design and iteration of a 3‑stage evaluation framework to assess which health assessments are suitable for the Digital Prevention Services team to take forward.
+
+Using this framework, we evaluated a longlist of opportunities and recommended five health assessments to proceed into design and development.
+
+### Stage 1: Matrix analysis
+
+We developed a Matrix to measure and better understand the details of assessments in relation to ten key categories.  This process established whether the assessment in question is something we could take forward for further consideration. The evaluation criteria are consistent for each category and an overall conclusion is drawn for each as high, medium, low, or positive and negative.
+
+#### Ease of use
+
+1. Ease of use for non‑experts
+2. Special equipment required
+3. Commonly measured
+4. Time taken for test
+
+Scored – high, medium or low
+
+#### Reuse potential
+
+1. Data contributes to other assessments
+2. Test result stability (no Long‑term health conditions (LTCs))
+3. Test result stability (with LTCs)
+
+Scored – high, medium or low
+
+#### Digital Feasibility
+
+1. Feasibility of offering digital testing
+2. Risks of a digital offer
+
+Scored – high, medium or low
+
+#### Strategic alignment
+
+Alignment with either NHS, DHSC or wider government priorities
+
+Scored – high, medium or low
+
+#### Value for money
+
+Potential scope for NHS value for money if digitised
+
+Scored – high, medium or low
+
+#### Complexity
+
+1. Assessment method
+2. Amount of data needed
+3. Interpretation of results
+4. Digital clinical safety risk
+
+Scored – high, medium or low
+
+##### Population impact
+
+1. Assessment is universal for all adults
+2. Cohort aimed at
+3. Prevalence of condition being assessed
+
+Scored – high, medium or low
+
+#### Health inequalities
+
+Summarised impact on health inequalities
+
+Scored – positive or negative
+
+#### Cost
+
+1. Current or potential cost of processing the assessment
+2. Cost is accounted for by primary or secondary care
+3. Current cost to public user
+
+Scored – high, medium or low
+
+#### Benefit to user
+
+1. Reversibility of condition
+2. Provides new information about their health
+3. Behaviour change potential
+4. Assessment outcome
+
+Scored – high, medium or low
+
+### Stage 2: Suitability analysis
+
+Stage 2 examined if each health assessment:
+
+1. positively impacts health inequalities?
+2. is suitable for prevention?
+3. is suitable and safe for a digital version?
+
+For each of these questions, the health assessment needs to meet at least one of a selection of criteria to qualify for the next stage. More details of these criteria can be found on the [Mural board](https://app.mural.co/t/nhsdigital8118/m/nhsdigital8118/1741255574984/dd08373f33f49bdf1915efeab171af94b4ec2071?sender=u8ca06001054231a776328187).
+
+
+### Stage 3: Feasibility analysis
+
+Stage 3 examined how feasible it would be to offer a digital version of an assessment. All health assessments follow a similar high‑level process – Data submission, Data storage and evaluation, and onward action.
+
+In this stage we map the data points that would be required to fulfil the end‑to‑end assessment. These data points are then categorised into the following:
+
+![Service map diagram for Stage 3: evaluating health conditions using existing methods. Shows data flow from patient sources (wearables, NHS App, patient records) through evaluation processes to three outcomes: clinical next steps, non-clinical next steps, or no action. Green indicators show currently possible data capture methods, red shows gaps.](stage-03-diagram.png "Digital prevention service ecosystem map showing how patient data moves through NHS systems to determine next steps for condition management.")
+
+- Red – Not currently possible to capture, measure or evaluate
+- Green – Currently possible to capture, measure or evaluate
+
+If a data point is evaluated as red, it does not mean it will not be considered for further exploration – it allows us to see what is currently available, and what will need to be built to deliver an assessment.
+
+#### The assessments we tested
+
+After deciding on the best evaluation method for testing face to face heath assessments as a potential digital offering, we tested various health assessments against the Evaluation Framework.
+
+Below are the conditions we tested through our evaluation framework and were determined not suitable recommendations for alpha. In addition to these, we concluded that several other options were out of scope and so were ruled out before being assessed using the framework.
+
+- Chronic obstructive pulmonary disease (COPD) pre‑diagnosis
+- Severe mental illness (SMI) health checks
+- Assessment onto the smoking cessation whilst pregnant programme
+- Annual ‘follow up’ checks for adults who have undertaken bariatric surgery
+- Annual health checks for people with a learning disability
+- Dementia screening test
+
+We engaged with SMEs throughout the discovery, helping us to make an informed evaluation of each potential assessment and ultimately identify suitable use cases to take forward.
+
+### What’s next
+
+We concluded, there are several use cases identified as strong potential as a digital self‑assessment.  We recommended 5 high‑potential assessments with potential to advance to a design and development phase. These were:
+
+- NICE recommended annual BMI and waist checks for people with long term conditions
+- Digital weight management programme pre‑assessment
+- Vital 5
+- Lung health screening pre‑assessment
+- Annual asthma review
+
+To help us prioritise the chronology of what comes next, we compared all these assessments in terms of their benefits, impact and alignment with current policy. This gave SLT as much information as possible, in a consistent way to evaluate the best course of action.
+
+Once the priority health assessments are chosen, next steps include:
+
+- understanding the users and cohorts for each use case
+- prototyping and testing user journeys
+- refining clinical and technical standards
+- developing pilots
+- continuing research with end users and healthcare professionals
+
+Our [evaluation framework](https://app.mural.co/t/nhsdigital8118/m/nhsdigital8118/1748336228396/c6cd1e4416fe47ef96015eb2ee86a79a8db5a1a0) can be reused to guide future work in this space, supporting decisions about desirability, feasibility, and strategic fit for digital health services.
+

app/posts/lung-health-check/2025/06/2025-06-09-health-assessments-discovery.md

@@ -0,0 +1,5 @@
+{
+  "eleventyNavigation": {
+    "parent": "Lung health check"
+  }
+}

app/posts/lung-health-check/lung-health-check.json

@@ -121,6 +121,10 @@ module.exports = function (eleventyConfig) {
     return collection.getFilteredByGlob('app/posts/smoking-cessation/**/*.md')
   })
 
+  eleventyConfig.addCollection('lung-health-check', collection => {
+    return collection.getFilteredByGlob('app/posts/lung-health-check/**/*.md')
+  })
+
   eleventyConfig.addCollection('guide', collection => {
     return collection.getFilteredByGlob('app/guide/**/*.md')
   })