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Keep Well is one of NHS Scotland’s key delivery vehicles for reducing health inequalities. The programme was launched in October 2006 as part of the Scottish Government’s 2005 health policy ‘Delivering for health’. This policy listed a number of interventions focused specifically at tackling health inequalities. One of the major actions for primary care was the development of an Anticipatory Care Model targeting geographic communities of greatest need. The programme was expanded further through Better Health Better Care (2007) and Equally Well (2008). Today Keep Well’s policy alignment with the Healthcare Quality Strategy is achieved through its continued drive to deliver at the right time: mutually beneficial partnerships between patients, their families and primary care, and the most appropriate interventions and services relevant to that person’s need.

Aims

The Keep Well vision is 'to increase the rate of health improvement in deprived communities by enhancing primary care services to deliver anticipatory care'.

This will be achieved by:

• identifying and targeting those at particular risk of preventable serious ill-health (including those with undetected chronic disease)
• offering appropriate interventions and services to them
• providing monitoring and follow-up.

Keep Well checks

In the Keep Well programme, individuals aged between 40 and 64 living in areas of high deprivation are invited to attend a health check. The checks include screening for cardio-vascular disease (CVD) and its main risk factors, such as high blood pressure, cholesterol, smoking, diet as well as discussions around wider life circumstances such as employment and literacy. Further details on the health check are outlined in the Keep Well patient journey poster (poster for health professionals) - PDF [423 kb].

Keep Well areas

The Keep Well programme operates in all NHS Health Board areas throughout Scotland. From April 2012, the Well North programme will be coming under the banner of Keep Well.

Communities were initially selected for Keep Well by using the Scottish Index of Multiple Deprivation and focusing on NHS board areas with high concentrations of the 'most deprived 15%'. From April 2012, the target population will extend to carers, prison and homeless populations and individuals with an addition to substance misuse.

Find out more about population-based approaches which currently support the delivery of Keep Well.

Settings-based approaches

Keep Well has primarily focused on GP practices as the route to deliver targeted health checks. However, more recent alternative approaches have been tested to engage and deliver health checks to support the delivery of Keep Well. These alternative settings include:

• the testing of approaches in community pharmacies
• the Scottish Ambulance Service through a mobile paramedic model in remote and rural areas.

Find out more about settings-based approaches which currently support the delivery of Keep Well.

Mainstreaming of Keep Well: From April 2012

In May 2010, the Scottish Government announced its intention to mainstream the Keep Well programme of targeted health checks from April 2012.

The Keep Well Extension Board (KWEB) was established to assist with and oversee the planning of the detailed work necessary to develop delivery arrangements from April 2012.

Short life sub-groups of the Keep Well Extension Board were established to develop proposals and recommendations on specific aspects of the future programme. The sub-groups were:

• information
• models of service delivery
• population targeting
• evaluation and outcomes
• post 2012 GP arrangements.

additional sub-groups may continue to be formed throughout the planning process if required.

The future plans will draw on the valuable experience of delivering Keep Well to date. This work will also be informed by:

• learning from local and national evaluations
• existing evidence
• analysis of responses to the national Keep Well consultation document.

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Reviewed 7 March 2012