Standard operating procedure

Baseline & Cardiovascular Health Check Procedure

How [Organisation Name] completes an objective baseline and cardiovascular health check before starting weight-management medication and at appropriate intervals - measuring height, weight, body mass index (BMI), waist circumference where used, blood pressure and heart rate, taking a cardiovascular history and risk assessment, identifying red flags that require face-to-face assessment, an electrocardiogram (ECG) or referral, arranging baseline blood tests where clinically indicated, and acting on abnormal findings before any prescription is issued.

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What's inside

This standard operating procedure is fully drafted and structured, ready to brand and complete for your service. It covers:

  • 1. Purpose
  • 2. Scope
  • 3. Definitions and abbreviations
  • 4. Responsibilities
  • 5. Procedure
  • 6. Abnormal results and escalation - acting on findings
  • 7. Records
  • 8. Related documents
  • 9. Review and version control
  • 10. Disclaimer

Legislation & standards it maps to

  • Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 12 (Safe care and treatment)
  • Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 9 (Person-centred care) and Regulation 17 (Good governance)
  • General Medical Council, Good practice in prescribing and managing medicines and devices (2021)
  • General Medical Council, Decision making and consent (2020)
  • National Institute for Health and Care Excellence, Obesity: identification, assessment and management, NICE guideline CG189
  • National Institute for Health and Care Excellence, Cardiovascular disease: risk assessment and reduction, including lipid modification, NICE guideline NG238
  • National Institute for Health and Care Excellence, Hypertension in adults: diagnosis and management, NICE guideline NG136
  • Medicines and Healthcare products Regulatory Agency, the Summary of Product Characteristics (SmPC) for the prescribed medicine
  • Data Protection Act 2018 and the UK General Data Protection Regulation

Who it applies to

All prescribers (doctors, and nurse and pharmacist independent prescribers) at [Organisation Name] who assess patients for, or prescribe, weight-management medication, together with the registered nurses, pharmacists, healthcare assistants and trained clinical support staff who obtain measurements and observations, arrange and review baseline investigations, and support remote consultations, including any locum, bank or agency staff working in these roles.

Glossary

Plain-English explanations of the technical terms and legislation used in this document.

Adiposity
The amount of body fat a person carries, which affects their health risk.
Ambulatory blood pressure monitoring
Wearing a device that measures blood pressure automatically over a full day to give a more reliable picture than a single reading.
Anaphylaxis
A severe, life-threatening allergic reaction needing immediate emergency treatment.
Arrhythmia
An abnormal or irregular heartbeat, where the heart beats too fast, too slow or unevenly.
Atrial fibrillation
A common type of irregular heart rhythm that can raise the risk of stroke.
Baseline assessment
The set of measurements, observations, history and tests recorded before treatment starts, used as the reference point to judge later change.
Body mass index (BMI)
A figure worked out from a person's weight and height, used as one indicator of whether their weight is healthy.
Cardiovascular disease (CVD)
Disease of the heart and blood vessels, such as heart attacks, heart failure, irregular heart rhythms and strokes.
Cardiovascular risk assessment
A structured estimate of how likely a person is to develop heart or blood-vessel disease, based on factors such as blood pressure, cholesterol, diabetes and smoking.
Care Quality Commission (CQC)
The independent regulator of health and social care services in England.
Cerebrovascular disease
Disease affecting the blood vessels supplying the brain, which can lead to a stroke or transient ischaemic attack (mini-stroke).
Contemporaneous records
Notes written at the time of, or immediately after, an event so they are accurate and reliable.
Contraindication
A specific situation or condition in which a medicine should not be used because it could be harmful.
Coronary heart disease
Narrowing or blockage of the arteries supplying the heart, which can cause chest pain or a heart attack.
Data Protection Act 2018
The UK law that sets the rules for how organisations collect, store and use people's personal information.
Dose titration
Gradually adjusting the dose of a medicine up or down to find the amount that works best with the fewest side effects.
Electrocardiogram (ECG)
A simple test that records the electrical activity of the heart to check its rhythm and look for problems.
Estimated glomerular filtration rate (eGFR)
A blood-test calculation showing how well the kidneys are filtering waste from the blood.
General Medical Council (GMC)
The body that registers and sets standards for doctors in the United Kingdom.
General practitioner (GP)
A doctor based in the community who provides everyday medical care and coordinates a patient's wider treatment.
Glycaemic control
How well a person's blood sugar level is kept within a healthy range over time.
HbA1c
A blood test that shows the average blood sugar level over the past few weeks, used to check for or monitor diabetes.
Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
The regulations setting out the fundamental standards that providers of regulated health and care must meet.
Heart failure
A long-term condition in which the heart cannot pump blood around the body as well as it should.
Hypertension
Persistently raised blood pressure, which increases the risk of heart attack, stroke and other problems.
Impaired glucose regulation
Blood sugar levels that are higher than normal but not yet high enough to be diabetes, indicating an increased risk of developing it.
Lipid profile
A blood test measuring fats such as cholesterol, used to assess the risk of heart and blood-vessel disease.
Liver function tests
Blood tests that check how well the liver is working.
Medicines and Healthcare products Regulatory Agency (MHRA)
The UK body that regulates medicines and medical devices to make sure they are safe and effective.
National Institute for Health and Care Excellence (NICE)
The body that produces evidence-based guidance on treatments and care for the health and care system.
Near miss
An event that could have caused harm but did not, by chance or because it was caught in time.
Non-medical prescriber
A trained nurse, pharmacist or other registered professional, who is not a doctor, authorised to prescribe medicines.
Notifiable event
An incident a provider is legally required to report to the regulator, such as a death or serious injury.
Palpitations
An awareness of the heart beating fast, hard or irregularly.
Peripheral arterial disease
Narrowing of the arteries supplying the limbs, usually the legs, which can cause pain on walking.
Red flag
A symptom or finding that may point to serious underlying illness and that needs urgent assessment before treatment continues.
Registered Manager
The person registered with the regulator as responsible for the day-to-day running of a service.
Regulated activity
A type of care or treatment the law requires a provider to register with the regulator to deliver.
Remote consultation
An assessment carried out by video, telephone or secure online questionnaire rather than in person.
Renal function
How well the kidneys are working, often checked with blood tests.
Risk assessment
A structured check identifying what could cause harm and what is being done to prevent it.
Safeguarding
Protecting people's health, wellbeing and rights and keeping them safe from abuse, harm or neglect.
Stadiometer
A calibrated instrument used to measure a person's height accurately.
Standard operating procedure (SOP)
A written step-by-step instruction setting out how a particular task or process should be carried out consistently and safely.
Summary of Product Characteristics (SmPC)
The official document for a licensed medicine that sets out how it should be used, including its uses, cautions and required checks.
Syncope
Fainting or a temporary loss of consciousness, usually caused by a brief drop in blood flow to the brain.
Thyroid function tests
Blood tests that check whether the thyroid gland, which controls metabolism, is working normally.
Transient ischaemic attack (TIA)
A brief, stroke-like episode caused by a temporary reduction in blood supply to the brain, sometimes called a mini-stroke.
UK General Data Protection Regulation (UK GDPR)
The UK's main data-protection law governing how personal information is collected and used.
Urea and electrolytes
A common blood test that checks kidney function and the balance of salts in the body.
Validated device
A measuring instrument that has been independently tested and approved as accurate for clinical use.
Waist circumference
A measurement around the waist used alongside BMI to assess fat carried around the middle and the related health risk.

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