Health Checks in the Workplace and Community Settings.

Men’s Health Check, MOT

A health check MOT is an opportunity, delivered direct to men, to have a detailed review of their current health, to receive advice on health matters and to discuss any aspect of their health and well-being.

The concept of a health check as the equivalent of an MOT test for a motor vehicle arises from the partnership between the Men’s Health Forum and the publishers of Haynes vehicle maintenance manuals. Their publication ‘Man’ states:

“ In truth, men are far more likely to look after their cars than their own
bodies and whereas car MOTs are required by law, there is no such
equivalent for the driver. Women see their doctor twice as often as do
men and invariably much sooner in the course of any given condition. ”

The Haynes publication also emphasises that there are no health screening systems for men. Health checks are not widely promoted by GPs or health centres, or they appear as expensive options advertised by private health insurance companies.

Health of Men Initiative

The purpose of the H.O.M. initiative is to address men’s health inequalities across the Bradford Metropolitan District. This will be achieved by providing and co-ordinating services which:

‘Promote good health; combat and prevent ill-health and are accessible and attractive to men.’

Activities have been designed with the following core objectives in mind:-

* to raise awareness of health issues among men by providing accessible services and information to the local male population;
* to deliver services and information to men through innovative practices away from their traditional health settings;
* to encourage and facilitate health-enhancing activities and to improve health outcomes in the male population.

A health check MOT, undertaken by a member of HOM staff is a key component of the initiative. For a detailed review of the statistics which create the rationale for addressing male health inequalities, through MOT work, please see Appendix 1.

‘Man’ Haynes Owners Workshop Manual, The Practical Step by Step Guide To Men’s Health, Haynes 2002.


Government Policy

The context for the provision of health checks in the workplace is set out in the HM Government 2005 publication; ‘Health, work and well-being – Caring for our future’ A strategy for the health and well-being of working age people

This joint Department of Work and Pensions; Department of Health and Health and Safety Executive publication states that:-

‘ Our strategy for the health and well being of working age people is a crucial part of delivering on the Government’s commitment to improving the health and well-being of the working age population. This is a central element of our wider reform agenda and is set out in the Government’s White Paper ‘Choosing Health’.

The strategy emphasises that: ‘It has been estimated that absence due to sickness costs around £12 billion each year – with costs to the public sector representing around £4 billion.’

Local authorities, the NHS and other public bodies are encouraged to show leadership in this area and Investors in People UK has been given a remit to develop a new ‘healthy business assessment’ in conjunction with the Department of Health.

Among the action points for healthy workplaces the strategy identifies the following potential developments:-

‘establishing pilots to provide evidence of the effectiveness of promoting health and well-being within the workplace.’
‘promoting models of health improvement advice, including health trainers’

The HOM initiative clearly fits this action agenda.

The Benefits of Health Checks for the Community and the Employer

If we are to achieve targets for improvements in community health; reduce the rate of work related ill-health and reduce the number of working days lost due to ill-health then men need to be more pro-active in relation to their personal health care.

Time constraints, lack of flexibility in the availability of primary care and sometimes lack of awareness of available services limit men’s use of traditional health services. Only as men get older does men’s use of GPs and health centres begin to match use made by women.

The aim of the Health of Men MOT programme is to overcome these barriers, particularly for men of working age, by taking services direct to men, e.g. in the workplace, through initiatives planned with employers; or in a community centre/pub/barber’s shop; or in a Job Centre to target unemployed men.

The Health of Men MOT is not a substitute for services available from GPs and health centres. It is an adjunct to primary care services but with an emphasis on promoting self care through health awareness; by providing an opportunity for an unhurried consultation of 30 minutes or more as appropriate.

In the full health check MOT the consultation will be with a Registered Nurse.

The discussion will assist men to think pro-actively about their personal health. In addition they may be offered support programmes eg in weight-management or smoking cessation. For some men a referral to a GP for a follow-up consultation on a specific health issue may be appropriate. The MOT and any follow-up/referral are entirely voluntary and personal decisions made by the individual.

The information on health inequalities in Appendix 1 provides not only the rationale for providing services specifically for men but indicates how the HOM team can achieve the greatest community and employer benefits by focussing on:-

* Manual workers.
* Men who are over 50.
* Unemployed men.

Men living in neighbourhoods with a high level of deprivation and/or communities with specific health issues related to the ethnic origin of the male population.

The Benefits of Health Checks for the Individual

Health of Men MOTs were originally ‘health promotion advice’ which developed with a few simple checks e.g. on weight, as an opportunity for engaging men in a discussion about their personal health. This simple approach was, however, only relatively successful. Men seemed more attracted by an objective assessment, like a vehicle MOT.

Methods involved in assessing a client’s health now include assessment of body mass index; blood pressure; blood glucose and blood cholesterol. These formal procedures allow the HOM nurse to engage with the client in a wide ranging discussion on health and lifestyle issues such as smoking, alcohol consumption, family history of illness and risk factors, health eating ( including ‘5 a-day’), exercise and physical activity, weight reduction, emotional health and well-being, sexual health, erectile dysfunction, prostate and testicular awareness.

Tests are not undertaken to screen for specific illnesses, more as a way of providing the framework to address a number of issues. While the nurse may pick up adverse observations and then encourage the client to see their GP, the primary aim is to inform and educate. To empower men with relevant information and thus to enable them to manage their own health; to ‘self-care’, with the knowledge and confidence to access traditional health services, before they develop an illness.

Occasionally our work has been of significant and immediate benefit to an individual as illustrated in the following case studies:-

Case Study 1

A 55 year old member of staff of the Bradford MDC Parks Department took advantage of an MOT health check which was organised in work time. Although the man had no obvious symptoms a test showed that he had high blood pressure. He was advised to consult his GP and was subsequently found to have undetected hypertension and that his heart was enlarged. The member of staff said in comments reported on BBC On Line “ They said it could be a hereditary problem and I could have gone at any time. The health team probably saved my life and to be quite honest I only went for the tests by accident.”

More often the health check MOT will reveal potential rather than immediate concerns, as the following example illustrates:-

Case Study 2

A South Asian driving instructor undertook an MOT at the driving school. He was found to be clinically obese and both parents were diabetic. He therefore had a number of significant risk factors for diabetes but the health check found his blood glucose level to be within normal limits. The knowledge and understanding of these risk factors and the need to have regularly checks will be vital to enable the individual to self-care.



The Health Check MOT :

Health checks involve measurements, review and screening based on PACE or other professional guidelines. These provide the context for health assessment and the individual health discussion.