Electronic instructions for use of NHS Health Check online

1. Instructions for use

These instructions for use detail all information that is necessary for proper operation of the Digital NHS Health Check product. 

1.1 Device name

Digital NHS Health Check.

1.2 Software version and release date

Version 1.5.3 released 17 April 2025.

1.3 Manufacturer

NHS England
7 and 8 Wellington Place
Leeds
West Yorkshire
LS1 4AP

1.4 Instructions for use version

Version 1.0 dated 31 March 2025.

1.5 Intended use

1.5.1 Intended use and device description

The Digital NHS Health Check (DNHSHC) product is a stand-alone software integrated within the NHS App and also accessible via the NHS.UK website. It uses the QRISK3 Algorithm to estimate an eligible individual’s 10-year risk of experiencing a heart attack, stroke, or developing certain types of dementia, and screening for type 2 diabetes in adults aged 40 to 74. It calculates risk based on physiological parameters and associated health questions enabling early identification of those at higher risk. This supports preventive healthcare by facilitating timely interventions and providing patients with information to help reduce their likelihood of developing cardiovascular disease.

1.5.2 Indications for use

The Digital NHS Health Check product is suitable for individuals who have chronological age between 40 and 74.

The individual must not have a pre-existing diagnosis of:  

• heart disease 
• chronic kidney disease 
• diabetes 
• high blood pressure (hypertension) 
• atrial fibrillation 
• transient ischaemic attack (TIA)
• inherited high cholesterol (familial hypercholesterolaemia) 
• heart failure 
• peripheral arterial disease 
• stroke 
• currently being prescribed statins to lower cholesterol 
• previous checks have found that you have a 20% or higher risk of getting cardiovascular disease over the next 10 years 

They must also not have the following contra-indicators:

• they are pregnant 
• they have been diagnosed with eating disorders , or think they may have one 
• they have had a limb amputation or were born with a limb difference
• they have a condition that affects their height

1.5.3 Patient target groups

Patients aged 40 to 74 where the patient has not had an NHS Health Check in the last 5 years.

Patients are not eligible if they have been diagnosed with a pre-existing condition as outlined in the below contra-indications, or meet one of the criteria points in the contra-indications.

1.5.4 Intended users

Intended users of the Digital NHS Health Check product are patients aged 40 to 74 years in England who do not met any of the listed contra-indications for the device.  

1.5.5 Contra-indications

The Digital NHS Health Check product is contra-indicated in those patients who are 24 years or younger or 75 years or older.

It is also contra-indicated in patients that have been diagnosed with:

• coronary heart disease
• chronic kidney disease (CKD), being CKD which has been classified as stage 3, 4 or 5 CKD within the meaning of the National Institute for Health and Clinical Excellence clinical guideline 73 on Chronic Kidney Disease, published September 2008
• diabetes
• hypertension
• atrial fibrillation
• transient ischaemic attack
• hypercholesterolaemia
• heart failure
• peripheral arterial disease
• stroke
• are being prescribed statins for the purpose of lowering cholesterol
• are being assessed, either through a previous NHS Health Check or through any other check undertaken through the health service in England, as having a 20% or higher risk of having a cardiovascular event during the ten years following the check

The Digital NHS Health Check product is not to be used by anyone who:

• is pregnant
• has had a limb amputation, or were born with limb difference
• does not meet the predefined height parameters (height must be between 139.7cm and 243.8cm)
• has been diagnosed with an eating disorder, or think they have one
• is unable to access the service in the English language, as the Digital NHS Health Check is only available in ‘English’ and users requiring translation services should access the NHS Health Check face-to-face

1.5.6 Training and qualification requirements

No special skills, training or knowledge are required to use the Digital NHS Health Check. Device is intended for use by laypersons.

1.5.7 Technical and compatibility requirements

Technical and compatibility requirements for using the Digital NHS Health Check online service including device compatibility, web browser compatibility, JavaScript and biometrics are detailed in the technical issues with the NHS App.

Details on how to download the NHS App or access it via NHS.UK on a web browser are included in NHS App homepage and the guidance on getting started with the NHS App.

1.5.8 Professional consultation

GPs are responsible for inviting their eligible patients to an NHS Health Check, which they may choose to complete via the digital channel.

On completion of the Health Check, all details are written back to the GP record.

The GP is responsible for an follow-up actions required after the completion of the Health Check.

1.6 Operating instructions

Accessing the service

Follow the instructions from your GP surgery in your invitation message to access the service online.

The NHS Health Check online is accessed via the NHS App or NHS.UK via a web browser.

The service can be accessed at any time by the following steps.

1. Log in to the NHS App.
2. Navigate to 'Services'.
3. Go into 'Other services' and click 'Get your NHS Health Check online'.

The first time you access the online service, you will need to agree to share your NHS login information with the service by clicking the 'Continue' button. This stops us having to ask you for your NHS details again, including your name, date of birth, NHS number and GP details. You will not see this message again when you are accessing the service unless there is a change to the data items being shared. If you chose not to share your NHS login information you will be presented with a screen telling you why you cannot proceed with your NHS Health Check online.

You will also need to confirm that you have read and agree to the NHS Health Check online terms of use by ticking the checkbox and clicking the Continue button. You will not be able to complete an NHS Health Check without agreeing to the terms of use. You will not have to agree to the terms of use again unless there is a material change that you should be aware of. The terms of use will contain links to all policy documents including the privacy policy, cookies policy and accessibility statement. These documents can be accessed at any time you are logged in to the service via the footer of each web page, or directly on the legal and cookies page.

Before you start

Before you start your first check, you will be given some information about items you may need to complete the check online.

We will ask you for some measurements. If you have the following items at home, have them nearby before you start:

• tape measure
• bathroom scales
• blood pressure monitor

You can still complete your NHS Health Check without these items.

You will have 28 days to complete your NHS Health Check questions, before you take your blood test. If you do not complete the questions within 28 days, your answers will be sent to your GP and deleted from the Digital NHS Health Check to comply with data protection regulations.

When your blood test results have been analysed, you will be sent a message via either SMS or the NHS App telling you that your results are ready to view online.

Checking eligibility

Last 5 years

We will ask you to confirm if you have completed an NHS Health Check in the last 5 years. If you select 'No' and 'Continue', you can proceed with the online check. If you select 'Yes' and 'Continue', you will be advised that you are not eligible to complete an NHS Health Check and given links to relevant NHS advice.

Pre-existing health conditions

Next, we will ask you to confirm if you have an pre-existing medical conditions that would exclude you from completing an NHS Health Check. If you select 'No', and 'Continue', you can proceed with the online check. If you select 'Yes' and 'Continue', you will be advised that you are not eligible to complete an NHS Health Check and given links to relevant NHS advice. 

These pre-existing health conditions include:

• heart disease
• chronic kidney disease
• diabetes
• high blood pressure (hypertension)
• atrial fibrillation
• transient ischaemic attack (TIA)
• inherited high cholesterol (familial hypercholesterolaemia)
• heart failure
• peripheral arterial disease
• stroke
• currently being prescribed statins to lower cholesterol
• previous checks have found that you have a 20% or higher risk of getting cardiovascular disease over the next 10 years

Extended exclusions

Next, we will ask you to confirm that you do not have an additional conditions that would exclude you from using the online service. This is because the online service uses automatic calculations. It cannot give you accurate results in these cases. If you select 'Yes' and 'Continue', you can proceed with the online check. If you select 'No', and 'Continue', you will be advised to contact your GP about completing a face-to-face NHS Health Check and given relevant NHS advice. 

These additional exclusion include if you:

• are pregnant
• have been diagnosed with an eating disorder, or think you may have one
• have a condition that affects your height
• have had a limb amputation, or were born with a limb difference

What to expect from an NHS Health Check online

Doing your NHS Health Check online means you do not have to make a GP appointment. The results are sent to your GP.

If you have have successfully passed the eligibility checks above, you will be provided with information about what to expect when completing your check online.

You will have to answer questions about your lifestyle, family history and entering height, waist and weight measurements.  If you own bathroom scales and a soft tape measure, have them nearby before you start.

You will also submit a blood pressure reading.  You can do this at a local pharmacy. You can also take a reading at home using a monitor.

You will then take a blood test.  We will send you a blood test kit to use at home. This involves making a tiny finger-prick cut to your finger. You collect a few drops of blood and return the sample free of charge to be tested

You will then be asked to confirm whether you can you complete your NHS Health Check online. If you select 'Yes' and 'Continue', you can proceed with the online check. If you select 'No' and 'Continue' you will be advised to contact your GP surgery and given relevant NHS advice.

Questionnaire

The questionnaire asks you about your:

• family history and personal details ('About you')
• physical activity
• alcohol consumption
• body measurements
• blood pressure

Your answers will be automatically saved when you click 'Continue'.  You will be asked to confirm your answers at the end of each section and can update them at any time until you have completed all sections.

Your answers will be used to calculate risk factors and to provide personalised recommendations to help reduce these risks and improve your health.

About you

Questions include gathering information about your:

• family history of heart attack and angina
• family history of diabetes
• sex at birth
• ethnicity
• smoking status
• postcode

These questions are used to help calculate your cardiovascular disease (CVD) risk score and heart age.

Physical activity

We will ask you questions related to your physical activity to determine how active you are.

These questions are taken from the clinically validated general practice physical activity questionnaire and answers are used to generate your physical activity results.

Alcohol consumption

We will ask you questions related to your alcohol consumption.

These questions are taken from the clinically validated AUDIT questionnaire and answers are used to generated your alcohol use score.

Body measurements;

You will be asked to enter the following.

• Height. This can be entered in either metric or imperial by clicking 'Switch to metric' or 'Switch to ft, in'.
• Weight. This can be entered in either metric or imperial by clicking 'Switch to metric' or 'Switch to st, lb'. 
• Weight measurement. This will be provided with some guidance around how to measure your waist, with a link to NHS guidance.  If you continue, you can enter your waist measurement in either metric or imperial by clicking 'Switch to centimetres' or 'Switch to inches' as required'.

Once you have answered the questions above, based on all details entered to date, you may be asked as question about your health symptoms, including:

• peeing more than usual
• feeling thirsty all the time
• feeling very tired
• losing weight without trying to
• itching around your penis or vagina, or repeatedly getting thrush
• cuts or wounds taking longer to heal
• blurred vision

If you answer 'No' and 'Continue', you can continue the check online.

If you answer 'Yes' and 'Continue', you will be given appropriate health advice and cannot complete your check online and we will send these details to your GP.

Blood pressure

If you have been able to continue with your Health Check online, you will be presented with screens for you to do the following.

• Check your blood pressure. You can get a free blood pressure reading at a clinic or pharmacy. You can also check your blood pressure with a monitor at home. We will provide a link to an online tool to find a pharmacy near you that offers a free blood pressure check. We will ask you to confirm whether you cannot take your blood pressure. If you select 'I cannot take my blood pressure reading' you will not be able to complete your check online and given advice. If you click 'Continue' you will be asked to confirm where you can get a blood pressure reading.
• Confirm where you can get a blood pressure reading. Where you take a reading will impact your results. We will ask you to confirm whether you are taking a reading either with a monitor at home or at a clinic or pharmacy by a healthcare professional. Once you click 'Continue', you will be asked to enter a blood pressure reading.
• Enter a blood pressure reading. You will be asked to enter your systolic and diastolic readings and given information about what these readings mean with additional advice on how to take an accurate reading.

If you have very high blood pressure, you will be asked to confirm your blood pressure reading. Once confirmed you will be given appropriate health advice and will not be able to complete your check online, and we will send these details to your GP.

If you have very low blood pressure, you will be asked to confirm your blood pressure reading. Once confirmed, you will then be asked if you have symptoms of dizziness or fainting. If you do, you will be given appropriate health advice and cannot complete your check online and we will send details to your GP. If you do not have symptoms, you can continue the check online.

If you have neither very high blood pressure nor low blood pressure with symptoms, you can continue your online check.

Once you have entered and confirmed your blood pressure readings your information will be saved. At this point you will no longer be able to update your answers.

You can then order a blood test kit.

Order a blood test kit

You will have 3 months to order and complete a blood test.

You will be presented with the following screens.

• Order a blood test kit. A blood test helps to spot early signs of problems like high cholesterol or Type 2 diabetes. The test is done by pricking your finger to get a blood sample. You send this back for analysis in a lab. We’ll send you the blood test kit by post.  If you click 'I do not want to take a blood test' you will not be able to to complete your check online and you will be provided with information about about how to contact your GP if you want to complete your NHS Health Check.  If you click 'Continue' you will be asked to enter delivery details.
• Find your delivery address. You can use the address finder to find the address you would like your blood test kit to be sent to or enter it manually by clicking 'Enter address manually'.
• Confirm your details. Once you have selected or entered your delivery address details, you will be asked to confirm your address and mobile phone number. You can change either of these by clicking the relevant link.
• Blood test ordered. When you confirm your details you will be told what happens next. This will include address details of where the kit will be sent to and what communications will be sent.

Your blood test kit will contain a cholesterol test and an optional diabetes test, if required based on the details you have entered previously.  This will be automatically calculated by the service.

Completing your blood tests

Once you have ordered a blood test kit, it will be delivered to your address, normally within 48 hours.

When you receive the kit, carefully follow the instructions provided to complete the test and return it to the lab

If there is a problem with your blood sample, the lab provider will communicate with you directly via the contact details you have provided, for example email or SMS.

In the event you have a problem completing the test or need help, follow the links to support provided in the kit and lab communications. You can also refer to blood test help and support.

Results

Once your results have been analysed and returned from the lab, we will send you a message. This will by either and SMS or NHS App message depending on your preferences.  This message will contain a link to the NHS Health Check online. On clicking this link you will be asked to log in to view your results in the NHS App.

Results overview

When you have logged back into the service, you will be presented with a summary of your results based on your previous answers and the results of your blood tests.

This screen will include the following sections.

• Heart age. This has been calculated using QRISK3. QRISK3 looks at risk factors like your blood pressure, cholesterol and if you smoke. It compares you with healthy people who are the same age, sex (at birth) and ethnicity as you.
• Risk of heart attack or stroke in the next 10 years. This has been calculated using QRISK3. QRISK3 looks at risk factors like your blood pressure, cholesterol and if you smoke. It compares you with healthy people who are the same age, sex (at birth) and ethnicity as you.
• BMI results. This has been calculated based on the height and weight you entered previously.
• Blood pressure. This is based on the value you entered previously.
• Diabetes risk. This is based on your blood tests result.  It will only be visible to you if you were asked to complete two blood tests.
• Cholesterol level. This is based on your blood test result.
• Alcohol use score. This is based on your previous answers and has been calculated using the clinically validated general practice physical activity questionnaire.
• Physical activity level. This is based on your previous answers and has been calculated using the clinically validated AUDIT questionnaire.
• Smoking status. This is based on your previous answers.

You will also be provided with some information about dementia.

For each of the risk factors you will be given appropriate, personalised high-level guidance.

You will be able to click on each risk factor to see more detailed information about what you can do.

This information has also been sent to your GP and will be visible in your GP record in the NHS App if you have the relevant access.

Results details

Each of the detailed results screen will provide more information, for example things you can start doing to maintain or improve your health, things you should stop doing, appropriate signposting to your GP, national services or NHS guidance.

Accessing help and support

Help and support can be accessed by either clicking the question mark icon in the NHS App or by clicking the help and support link in the web page footer.

Raising technical queries

Technical queries are raised through the NHS App contact us form. This should not be used for raising medical queries.

Providing feedback

At various points in the journey, you will be able to leave feedback by clicking the 'Help us improve this service' link.

Logging out and back in

You can log out of the NHS App by clicking your person icon at the top right of the header and clicking 'Log out'.

You can access the service at any time. If you log in after having previously completed some of your answers, you will be presented with a task list screen which provides an overview of what you have completed to date. From this screen you can navigate to the section you want to update to continue your NHS Health Check online.

Session expiry

If you are logged into the service but inactive for 9 minutes, you will be prompted to extend your session. If you do not extend the session within 60 seconds you will be automatically logged out of the NHS App. This is to protect your details.

Software updates

Software updates for the NHS Health Check online will be made automatically. You can find out what's in each release in the release notes. 

For details on NHS App updates, see NHS App technical information.

1.7 Warnings and notices

1.7.1 Warnings

This device is intended for use only as described in the Instructions for Use. Improper use may lead to inaccurate results or unintended consequences. Do not rely solely on this device for medical decisions and always consult a qualified healthcare professional for medical advice, diagnosis, or treatment.

This device should only be used by individuals who have read and understood these instructions. Misuse or use by unauthorised persons may lead to errors or misinterpretation of results.

The accuracy of the device’s outputs depends on the accuracy of the data entered by the user. This device does not detect all possible health conditions. If you experience symptoms of concern, seek immediate medical advice, regardless of the results provided.

Where a user enters a blood pressure reading which might be considered very high, or low with associated symptoms, or a user provides answers that indicate they might be at risk of type 2 diabetes, then their Digital NHS Health Check will be stopped and associated advice provided that should be followed.

This device is not a diagnostic tool and does not replace professional medical judgment. It is designed as a decision-support tool and should be used alongside professional advice. Do not start, stop, or modify any medical treatment based on the results of this software without consulting a healthcare professional. If you receive a result that seems inaccurate or unexpected, consult a healthcare provider before making any health decisions.

3.7.2 Limitations

This software has been designed, tested, and validated in accordance with applicable regulatory requirements, including UK MDR 2002 (as amended). Based on comprehensive risk assessment and performance evaluation, no significant limitations have been identified that would impact the intended use of this device when used as directed.

Users should ensure they follow all instructions for proper use and consult a healthcare professional if any unexpected results or concerns arise. The manufacturer continuously monitors product performance and will update this section should any limitations be identified in the future.

1.8 Reporting of incident to the manufacturer and competent authority

Should any patient face an adverse event related to the use of the Digital NHS Health Check product, the incident should be reported to both:

• the manufacturer (NHS England) via the National Service Desk on 0300 303 5035 or ssd.nationalservicedesk@nhs.net or the NHS Website Service Desk on 0300 303 5444 (8am to 5pm, Monday to Friday) or nhswebsite.servicedesk@nhs.net
• the Medicines and Healthcare products Regulatory Agency (MHRA) via the Yellow Card reporting site