Piloting an undergraduate student-led health check service

There is a growing focus on the development of communication and clinical skills during undergraduate pharmacy programmes; this has been demonstrated particularly by the General Pharmaceutical Council’s recent consultation on initial education and training^[1]
. A health check service delivered by pharmacy students has shown benefits in the development of such skills^[2]
. This service can be successfully incorporated into the curriculum in the UK^[3]
.

During our exploratory work at the University of Bradford’s School of Pharmacy and Medical Sciences (SPMS), we identified that our pharmacy students had a strong desire for more practical learning experiences so that they may feel better prepared for their first day of professional practice^[4]
. Additionally, a consultation of SPMS staff agreed that students in third year and beyond should have the knowledge and skills to deliver the tests required for a health check^[5]
. Therefore, building on our previous work and valuable experience from Langran et al. at the University of Reading^[2]
,[3]
, we piloted a student-led health check service to the university’s community. The pilot service was delivered by six undergraduate pharmacy students as part of their self-selected research project.

The service, including standard operating procedures, was adapted from the NHS Health Check StARS framework^[6]
and work from the University of Reading. Following ethical approval, third-year pharmacy students attended two training sessions, each of which lasted for two hours:

• Practical skills training to perform health check tests;
• Competency assessment, which students were required to pass.

Students were also made aware of the risks associated with handling clinical waste, such as lancets used for finger pricking, and how to minimise these risks.

The student-led service was advertised on the university’s website in September 2018; it received high interest and all appointment slots were filled within three days.

The students worked in pairs over three days in October 2018 at the Digital Health Enterprise Zone at the main campus. This multidisciplinary facility houses physiotherapy and optometry public clinics, health promotion areas and digital diagnostics. The health check service was hosted within our medicines review hub, which has private consultation rooms. One or two supervisors (registered and practising pharmacists) were available at all times to offer advice to the students and review overall health check results.

Tests performed included height and weight measurement; body mass index (BMI) calculation; waist and hip measurements; body fat composition; blood pressure and pulse readings; physical activity and lifestyle assessment. Where appropriate, they also implemented the QRISK3 cardiovascular health risk algorithm. Supervisors performed cholesterol and blood glucose tests. Participants were able to opt out of any test. Students interpreted the results and discussed with supervisors, then offered lifestyle advice and health promotion literature and set healthy living goals with the participant. Each participant was provided with a personalised copy of their test results and asked to complete a feedback form.

A total of 38 participants — 28 staff members and 10 students from the university — used the service. More females (n=23) than males participated and the average age of participants was 40 years (range 20–62 years). Nearly 70% of participants (n=26) had not had a health check before, and 14 (37%) had at least one long-term condition. Health checks lasted on average 41 minutes (range 18–60 minutes).

All participants were offered tailored healthy lifestyle information and were encouraged to set a goal. Nearly all participants (n=37, 97%) were provided information on healthy diet and increasing physical activity owing to high BMI, high waist-to-hip ratio, and/or elevated cholesterol readings. No participant required referral to their GP.

The service was well received by the pharmacy students delivering the service, as well as the wider university community. The majority of participants (n=36, 98%) stated they were very likely to recommend the service to a colleague and would attend again if the service was run regularly on the campus (n=34, 89%). Many participants (n=33, 87%) stated they would make changes to their lifestyle owing to the health check. The pharmacy students valued the opportunity to test their advanced communication skills, including the principles of coaching, and apply their theoretical knowledge to practice through contact with real patients.

Participants recommended that the service would be improved with an easier booking process, clearer location signposting and more instructions before the appointment (for example, what clothes to wear).

We have demonstrated that students can deliver a health check service that is valuable to participants and contributes to the development of students’ confidence in undertaking clinical activities. Future work will focus on incorporating this service into our current pharmacy undergraduate programme, which would allow all students the opportunity to take an active role in service provision.

However, further considerations are required to deliver student-led clinical activities to local communities. These considerations include (but are not limited to) timetabling, supervision, and governance, including professional liability (appropriate insurance). Currently, there is limited guidance on student-led services and we should learn from other groups (such as physiotherapy, optometry and dentistry) who have successfully delivered student-led clinics to members of the public.

Kristina Medlinskiene and Justine Tomlinson, pharmacy doctoral training fellows, School of Pharmacy and Medical Sciences, Faculty of Life Sciences, University of Bradford,UK