Programme design and recruitment
This section provides answers to frequently asked questions about the Our Future Health programme design and recruitment processes.
The information in this section is provided to help researchers design and conduct studies using the data resources of the Our Future Health programme.
The programme aims to provide two main resources for health research:
a prospective observational data set for research
a research platform with participants who can be re-contacted for translational research (available in the future)
Design of the Our Future Health programme
What are the objectives and rationale of Our Future Health?
The Our Future Health programme aims to help people live longer, healthier lives through better prevention, earlier detection and improved treatment of diseases. It will speed up the discovery of new methods of early disease detection, and the evaluation of new diagnostic tools. This will help identify and treat diseases early when outcomes are usually better. The specific aims of the programme, as described in detail in the Our Future Health Protocol (external link), are to:
build a research resource that generates and links multiple sources of health and health-relevant information from millions of people in the UK
conduct genotyping on a custom genotype array using the donated blood sample from each consented participant
calculate personal disease risk information for participants by combining both genetic and non-genetic information
recontact sub-groups of participants generally for additional surveys, samples, and recontact studies
facilitate recontact studies which invite participants based on health risks and other characteristics
make available the baseline plasma samples stored in our biobank for discovery and validation of predictive biomarkers for diagnostic and prognostic algorithms
Building such a large resource with linkage to health-related data and enabling feedback and recontact, will provide the foundation for a new generation of discovery and translational research.
What is the setting of Our Future Health?
Our Future Health aims to recruit up to 5 million adults (aged 18 years or over) living in the UK. Most participants are resident in England, but people from all four UK devolved nations (England, Scotland, Wales and Northern Ireland) have joined the programme. The main mode of recruitment was direct invitation via a letter, but joining the programme is open to all adults living in the UK, whether they have received a direct invitation to join or not.
Following small-scale pilots in 2021, the initial pilot roll-out of community-based recruitment began in July 2022 in England only and full study recruitment in England started in October 2022. We have since expanded community recruitment across England and started recruitment in Scotland since June 2024, and in Wales since September 2024. Since July 2023, participants have also been recruited via the NHS Blood and Transplant services (NHSBT).
We chose to start community recruitment in geographical areas in England that have high levels of deprivation and the highest ethnic diversity. This was to maximise opportunities for individuals of historically under-represented groups to take part in the programme. These areas included the West Midlands, Greater Manchester, London and West Yorkshire.
What is the study design of the Our Future Health programme?
Our Future Health is a prospective, observational cohort study of the general adult population of the UK. It is a non-probability sample, obtained through open, volunteer-based recruitment. The programme aims to support a wide range of observational and translational health research studies.
We gather personal, health and lifestyle information from each participant through an online, self-completed baseline health questionnaire, and at an in-person clinic visit. At the clinic visit they are also asked to provide two blood samples which are processed to extract plasma, buffy coat and DNA. The extracted DNA is used to obtain participant genotypes, and remaining sample components are stored at -80°C for future analysis. We also use the information that participants provide to link their data to other health-related data sets such as medical records.
Participants have also given consent for us to recontact them, for example to invite them to take part in further or repeat data collections, or other embedded studies such as clinical trials.
Participants can withdraw their consent at any point. They can choose to leave existing data in the programme or ask us to destroy all data and samples not already used or in active use as part of a research study.
How does the clinic appointment and sample processing work?
Participants book their in-person clinic appointment at a location, date and time of their choosing. At the 15-20 minute appointment, we collect several health-related measurements including height, weight and waist circumference, blood pressure, heart rate and rhythm, and blood samples (2 x 6 ml EDTA tubes). Between 2022 and 2024, the appointment also included a point-of-care cholesterol test.
Where can I find information on the data available for this release?
For further information on the current release see the data dictionary and Data releases section. You can find our data dictionary on the Data and cohort page of our website (external link).
The current release includes data collected from our baseline health questionnaire, data from the genotyping array, linked health data, data collected in clinic during Our Future Health appointments, and data relating to participant geographies. In the future, Our Future Health will release additional data types including other health-related data linkages, and data from additional questionnaires and exposure instruments.
How have we addressed potential biases in the design and conduct of the programme?
Our Future Health aims to recruit a cohort that reflects the UK population in terms of age, sex, ethnicity, socioeconomic status and geography.
Eligible adults can choose whether or not to consent to join the programme. We aim to minimise selection biases and to support recruitment of populations who are historically underrepresented in health research by:
offering a large number of in-person appointments across a wide range of geographical locations.
allowing participants to book the appointment at a date and time that is convenient (including weekends)
sending reminders for people who have consented to join to complete questionnaires
improving public awareness of the programme through our invitation and media strategies
offer reimbursement (£10 voucher) to participants who completed the questionnaire and donated a blood sample at their appointment to recognise their time and effort (since December 2023)
We also aim to support researchers in reducing selection biases in their research by providing, in due course, sampling weights and statistical code. This will improve the accuracy of statistical inferences and enable weighting back to the populations of the UK, England, Scotland, Wales or Northern Ireland (as appropriate to the analyses).
Another form of selection bias may occur if we lose contact with some participants (loss to follow-up). This right-censoring would mean we are unable to contact them to ask them to complete additional questionnaires or to request other health-related information. We can maximise follow-up for health outcomes by linking to accurate and comprehensive electronic health-related databases across the UK.
Information biases could also affect research conducted using the Our Future Health resources. These biases could be due to measurement or reporting errors, and missing data. The baseline health questionnaire aims to partly mitigate these biases by providing a broad, robust, and harmonised approach to exposure assessment which:
collects historical health information (not limited to the beginning of an electronic database)
aligns with other recent large prospective cohorts and validated instruments, where possible
We have also designed the Our Future Health Illumina genotyping array to maximise parity of performance for different ethnic groups, minimising any population-specific biases in genotyping data quality. Both the imputation backbone and custom content were designed using cross-population, imputation-aware selection strategies, which directly assessed imputation performance between UK ancestral population groups.
What ethical approvals have been granted for the programme?
On 29 March 2021, we received ethical approval from the Cambridge East NHS Research Ethics Committee (ref: 21/EE/0016) for a period of 5 years.
Read more about ethics and governance of Our Future Health in the How we’re governed section on our website (external link).
Recruitment of Our Future Health participants
What are the eligibility criteria for programme participants?
Our Future Health is an open, volunteer-based research programme. All adults (ages 18 years or older) who live in the UK can join Our Future Health through our website. Participants do not need a direct invitation to join the programme.
How do we invite participants to join the programme?
Most participants joined the programme via community-based recruitment. The main route of recruitment was through postal invitations, either addressed to a person (via DigiTrials operated by NHS England) or to all adult residents in the household (via non-personalised letters).
For the NHS DigiTrials route, Our Future Health identified the number of eligible adults within an approximate 5-mile radius of an Our Future Health clinic (2.5 mile radius for London clinics) using an extract from the Personal Demographics Service (PDS) by postcode sector, age group and sex. If needed, we widened the radius to a maximum of 10 miles. Based on the capacity of the clinic, we requested NHS DigiTrials to send an appropriate number of invitations to a random selection of eligible adults within the radius. NHS DigiTrials then used name and address data that they hold to send the selected adults a postal invitation to join the programme on our behalf. At no stage in this invitation process did Our Future Health have access to any identifiable or individual-level data.
For the non-personalised letters, Our Future Health used the Royal Mail’s Postcode Address File (PAF). We took a similar approach to the NHS DigiTrials route, with a sequential series of randomly selected addresses within a clinic-specified mile radius, the maximum of which was 10 miles for less densely populated areas and depending on appointment capacity/availability, until we had eventually invited all adult residents in that area to join the programme. Postal invitations were mailed out using an external mail service.
All postal invitations included a code, special link or QR code to register on the Our Future Health website. This informed us that they were part of our community recruitment efforts and told us the version of invitation text that they had received. However, not all participants entered a code, used a special link, or scanned a QR code, if they had one. Recruitment is open to all website visitors eligible to join the programme, even if they haven’t received a formal invitation.
Other recruitment routes:
email invitation via NHSBT – we invited participants registered with the NHS Blood and Transplant Service (NHSBT) via email to join Our Future Health and provide a blood sample at their next routine blood donation appointment
pilot activities of the programme in 2021 – we invited participants during routine blood donations in partnership with the NHSBT, or by email in partnership with the National Institute for Health and Care Research (NIHR) BioResource from their ‘general population cohort’
ongoing pilots to establish the most effective combination of engagement, community partnerships and presence at key locations or events, to improve rates and diversity of recruitment
members of the Boots pharmacies customer loyalty programme – these participants joined after receiving an emailed invitation from Boots about the opening of Our Future Health clinics in selected Boots stores
SMS from general practice - patients receive an SMS from their registered general practice on behalf of Our Future Health and in partnership with iPLATO (myGP app) and uMed
pharmacy2U customers – patients who lived close to selected clinics received email invitations from the online pharmacy, on behalf of Our Future Health
ongoing pilots of targeted advertising and recruitment at external events or in specific communities
Information on the route of recruitment for each participant is not included in the data release.
How has Our Future Health expanded community-based recruitment across the UK?
Community-based recruitment to Our Future Health involved sending invitation letters to residents within a certain distance of the site of one of our clinics. We tested community-based recruitment in a pilot study from July to September 2022 and expanded from October 2022. In the subsequent scale-up of community-based recruitment, we increased appointment capacity, provided venue mobility, and increased geographic accessibility to participants. By the end of January 2023, we had opened a total of 28 venues with over 135,000 in-person appointment slots available across England.
In March 2023 a new phase of recruitment started, in which we further increased the number of venues across England using two providers: a community pharmacies (Boots Pharmacies) and a healthcare delivery partner (Acacium Group). From mid-2023, most clinics were open 7 days a week.
Boots Pharmacies provide static in-person appointment venues in Boots stores. From July 2022, 10 Boots venues were opened in England, with additional Boots venues being opened on a regular basis. To date there have been 112 Boots venues across England, 9 in Scotland (since June 2024), and 5 in Wales (since September 2024). We aim to open Boots venues in Northern Ireland in 2025.
Acacium Group provides static in-person appointment venues as well as mobile venues at convenient locations (shopping centres and high streets) in England. The mobile venues change location roughly every 2 to 8 weeks, based on the size of the local community. From July 2022, 7 static and 4 mobile venues were operating in England. To date there have been 19 static venues and 272 locations with mobile venues operating in England.
How has Our Future Health expanded recruitment in partnership with the NHS Blood & Transplant?
In June 2023, NHSBT (NHS Blood & Transplant) started sending email invitations to their blood donors, inviting them to join Our Future Health and provide a sample for the programme at a future blood donation appointment. The first 4 blood donation teams started collecting samples in July 2023 in England, with new locations opening each month in England. By June 2024 there were 80 blood donation teams collecting samples from blood donors who had joined Our Future Health.
How do participants provide data and samples to the programme?
Eligible adults can join the Our Future Health programme by completing the following steps:
visiting the Our Future Health website (ourfuturehealth.org.uk) for more information about the programme
registering on the website, reading the Participant Information document (PDF), and then reading and electronically signing the consent form to take part in the programme
After completing the consent process, participants can complete the baseline health questionnaire and book an appointment at one of the Our Future Health clinics to donate a blood sample and have their health-related measurements taken. They can book and attend an appointment either before or after completing the questionnaire.
At the appointment, staff will:
Confirm the participant’s identity.
Record the participant’s height, weight, blood pressure, heart rate and rhythm.
Collect 2 x 6ml EDTA tubes of blood.
Give participants written information on these measurements at the end of the appointment.
Please note that we only collect blood samples and not the additional health-related measures from participants who are recruited via NHS-BT. Between 2022 and 2024, point-of-care cholesterol measurements (a finger prick test) were also taken during the appointment.
How are samples processed in the laboratory?
We transport the blood samples to our central processing centre. The processing includes centrifugation and extraction of plasma and buffy coat from each of the two 6mL EDTA blood samples.
DNA for genotyping is extracted from one of the buffy coats and is stored at -80°C prior to being normalised to a maximum of 100 ng/µl. Normalised DNA samples are genotyped on the custom Our Future Health Illumina beadchip array. The genotyping array assays approximately 700,000 genetic variants, including variants related to a wide range of health phenotypes, blood typing, and pharmacogenetics, clinically-relevant variants and variants to support imputation.
After processing, the following amount of samples are stored in our automated, -80°C biobank:
6 x 850 µl plasma vials
1 x 500 µl buffy coat vial
1 vial of residual DNA from the buffy coat extraction
Further information
Where can I find more information about Our Future Health?
You can find out more about the programme on the Our Future Health website (external link). You can get the latest updates there.
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