DH-commissioned analysis to cast further doubt on NHS Health Checks
Exclusive An independent evaluation of the Government’s flagship cardiovascular screening programme is set to raise more concerns about the programme’s effectiveness, according to the author of the report.
The analysis – commissioned by the Department of Health and led by Professor Azeem Majeed, head of primary care and public health at Imperial College London – looked at the national impact of the NHS Health Check scheme and is due to be published in the coming weeks.
The findings mirrored those from earlier local studies, which have consistently found low uptake of the checks – particularly among high-risk groups – and relatively poor follow-up of those that are picked up.
Professor Majeed told Pulse: ‘Essentially the uptake has been lower than predicted and take-up of statins is also relatively low in patients with high risk.’
A further publication – yet to be submitted for review but due out later in the year – gives more detail on the impact of the Health Check on the health status of patients identified as being high risk, such as how their risk factor profiles have changed over time.
Professor Majeed said this paper could mark a critical turning point the future of the programme – as a proper cost-effectiveness analysis will only be possible if the programme shows clear benefits in terms of clinical outcomes.
He said: ‘I think that is the big question about the Health Checks – whether the programme needs to be funded in this way at all, or the money could be better spent elsewhere.’
Another Department of Health commissioned study that was published recently showed that the programme had low pick-up rates and poor follow-up of high-risk patients – only one in 10 people who came in for assessment was actually at high risk of cardiovascular disease (QRISK2 or equivalent above 20%), and only a third of these people started taking statins.
And an earlier study from Professor Majeed’s group found the programme had had only a ‘modest’ impact on patients’ cardiovascular risk factor profiles.
Professor Majeed said he believed one reason the programme had not been successful was that it had not been sufficiently sold to GPs.
He said: ‘I think the programme wasn’t well publicised – so lots of people weren’t really aware of it, including professionals as well as the public.’
Dr John Ashcroft, GPSI in cardiovascular medicine and executive officer at Derbyshire LMC, said GPs were not being resourced to do the programme properly – and called for the programme to be targeted to high-risk groups, particularly to improve their uptake of statins.
Dr Ashcroft said: ‘The amount paid was never very much and it creates considerable work for practices that we are not paid for.’