A Florey allows you to send a questionnaire out to patients to gather data. The Health Check Questionnaire Florey 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 Florey is only available to users who are in an area that has purchased accuRx Plus.


Content

Enrolment SMS

Hi/Dear NAME,

I'd like you to answer some questions about your general health. This helps us to manage your health and keeps your records up to date.

Thanks, SIGN-OFF



Please follow this link (link will autogenerate here).
You need internet on your phone (otherwise you can open the link on a computer or contact reception).
SENDER ID

First page of questionnaire

Hi NAME,

This questionnaire from your GP will ask you some questions about your general health. It should take no longer than five minutes to complete.

Are you happy to proceed?

This survey is operated by accuRx.

Questions

What is your date of birth?
Example 8 12 1988

  • DD MM YYYY

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.

  • 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.

  • 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.

  • Field for reading 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.

  • Field for reading 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

After submitting

Thanks for submitting this information to your practice.

What next?
Your practice will review this information in the next 28 days and be in touch if further action is required. Please contact reception if you need to speak to a clinician.

Smoking cessation advice
Smoking leads to health problems such as cancer, heart disease and strokes. The benefits of stopping smoking include: better health, more money and cleaner air for those around you!

Do you want to stop smoking? Here is some advice on ways to quit smoking, local services and general tips: nhs.uk/smokefree

Response in accuRx Inbox

Patient NAME has responded:

Questionnaire : Health Check Questionnaire

Smoking status : Current smoker

Smoking quantity : < 1 cigarette or equivalent per day

Drinks alcohol : Yes

Frequency of alcohol : 2-3 times per week

Typical units : 10 or more units

More than 6/8 (f/m) units in the past year : Monthly

Weight (kg) : 90

Height (m) : 2

BMI : 22.5

Systolic BP (mmHg) : 120

Diastolic BP (mmHg) : 90

FH circulatory issues : Yes

Circulatory history :

Physical activity at work : 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.)

Amount of physical exercise : 1 hour but less than 3 hours

SNOMED codes saved to record

The codes added are in 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.

  • Systolic arterial pressure - 72313002

  • Diastolic arterial pressure - 1091811000000102

  • Weight - 162763007

  • Height - 162755006

  • BMI - 60621009

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