The Health Check Questionnaire is used to help gather data on a patient's general health. Using the information gathered, clinicians can determine the most helpful subsequent steps e.g. video call.
Please note: This questionnaire is only available to users who are in an area that has purchased Accurx Plus.
💬 Enrolment SMS:
Once the patient has accessed the link, they will be prompted to enter their date of birth in order to access the questionnaire 📆
Questions
1. What is your smoking status?
Current smoker
Ex-smoker
Never smoked
2. How much do you smoke?
< 1 cigarette or equivalent per day
1-9 cigarettes or equivalent per day
10-19 cigarettes or equivalent per day
20-39 cigarettes or equivalent per day
40+ cigarettes or equivalent per day
3. Do you drink alcohol?
Yes
No
4. How often do you have a drink containing alcohol?
Monthly or less
2-4 times per month
2-3 times per week
4 or more times per week
5. How many units of alcohol do you drink on a typical day when you are drinking?
(A pint of beer is around 2 units. A medium glass of wine (175ml) is around 2 units. A single measure of spirits is 1 unit)
1 or 2 units
3 or 4 units
5 or 6 units
7 to 9 units
10 or more units
6. How often have you had 6 or more units if female, or 8 or more if male, on a single occasion in the last year?
(A pint of beer is around 2 units. A medium glass of wine (175ml) is around 2 units. A single measure of spirits is 1 unit)
Less than monthly
Monthly
Weekly
Daily or almost daily
7. Do you know your weight?
Yes
No
8. Please enter your weight in kilograms.
If you only know your weight in stone and pounds, please use this converter here.
The field for weight entry
9. Do you know your height?
Yes
No
10. Please enter your height in metres.
If you only know your height in feet and inches, please use this converter here.
The field for weight entry
11. Are you able to provide a blood pressure reading?
This will require you to have a recent blood pressure reading or a blood pressure monitor at home.
Yes
No
Information screen
Before you take your blood pressure reading:
Sit down comfortably for 5 minutes.
Wear loose-fitting clothing.
Make sure your arm is around the same level as your heart.
Make sure your arm is relaxed.
When taking your blood pressure:
Put the cuff on following the instructions which came with your blood pressure monitor.
Keep still and silent.
Other tips:
Take at least three readings, each two minutes apart.
Your first reading may be much higher than the next readings. If this is the case, keep taking readings until they level out and stop falling. Use this as your reading.
Please seek urgent medical attention if you develop any of the following:
Blood pressure is 180/110 or above (despite repeating it at least 2 times)
Chest pain
Changes in vision
Confusion
Severe headache
Here is a video from the British Heart Foundation on how to take your reading.
12. Please enter your systolic (SYS) blood pressure reading. This is the top reading.
(Picture of bp monitor with systolic reading highlighted)
The field for reading the entry
13. Please enter your diastolic (DIA) blood pressure reading. This is the lower reading.
(Note: This is NOT the pulse)
(Picture of bp monitor with diastolic reading highlighted)
The field for reading the entry
14. Has anyone in your immediate family been diagnosed with heart or circulatory disease, such as a heart attack or stroke?
(Your immediate family include your father, mother, brother or sister)
Yes
No
I don't know
15. About your family history of heart or circulatory disease
What condition was it?
Who had it?
Approximately what age were they diagnosed?
Free text field
16. What type and amount of activity is involved in your work?
I am not in employment (e.g. retired, retired for health reasons, unemployed etc.)
I spend most of my time at work sitting (such as in an office)
I spend most of my time at work standing or walking. However, my work does not require much intense physical effort (e.g. shop assistant, hairdresser, security guard, childminder etc.)
My work involves definite physical effort including the handling of heavy objects and use of tools (e.g. plumber, electrician, carpenter, cleaner, hospital nurse, gardener, postal delivery workers etc.)
My work involves vigorous physical activity including handling of very heavy objects (e.g. scaffolder, construction worker, refuse collector, etc.)
17. During the last week, how many hours did you spend on physical exercise such as swimming, jogging, aerobics, football, tennis, gym, workout etc.
None
Some but less than 1 hour
1 hour but less than 3 hours
3 hours or more
When they have submitted their answers they will be thanked for completing the survey and sent a confirmation SMS 👇
Response in the Accurx Desktop toolbar: Health Check Team 👇
Please then select the save to record button if you wish for these results to be saved to the patient's medical record 📚
SNOMED codes saved to record
The codes added are in bold and italics
The following codes are also saved according to the patient's response:
"What is your smoking status?"
"Current smoker" - Current smoker
"Ex-smoker" - Ex-smoker
"Never smoked" - Never smoked
[if chose 'Current Smoker' above]Smoking: "How much do you smoke?"
"Trivial smoker (<1 cigarettes/day or equivalent)" - Trivial smoker (<1 cigarettes/day or equivalent)
"Light smoker (1-9 cigarettes/day or equivalent)" - Light smoker (1-9 cigarettes/day or equivalent)
"Moderate smoker (10-19 cigarettes/day or equivalent)" - Moderate smoker (10-19 cigarettes/day or equivalent)
"Heavy smoker (20-30 cigarettes/day or equivalent)" - Heavy smoker (20-30 cigarettes/day or equivalent)
"Very heavy smoker (40+ cigarettes/day or equivalent)" - Very heavy smoker (40+ cigarettes/day or equivalent)
Smoking cessation advice given - This code is added for anyone who says they are a current smoker. We display a standard short bit of smoking cessation advice with link to nhs.uk/smokefree.
Self reported systolic blood pressure (Concept ID: 1162737008 / CTV3 2469)
Self reported diastolic blood pressure (Concept ID: 1162735000 / CTV3 246A)
Body weight - 27113001
Standing height - 248333004
BMI - 60621009
FAQs 👇
Why do you not include the ‘National Health Service Health Check invitation SMS’ SNOMED code?
We don’t add this code as the questionnaire can be used to collect health status information from patients who are not eligible for an NHS Health Check.
Did you know? Users can invite patients to an NHS Health Check using our NHS Health Check Invitation template. This template is linked to the NHS Health Check invitation SMS SNOMED code.