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DH study finds NHS Health Checks had low coverage and poor follow-up

The Government’s national cardiovascular prevention programme reached only a fifth of its target population over the first four years, an independent evaluation of the scheme has revealed.

Less than 5% of patients were identified as high risk and only a third of these were receiving appropriate treatment, the Department of Health-commissioned report further showed.

The figures from the study, which looked at 509 GP practices across the whole of England that were running the NHS Health Check programme between 2009 and 2013, mirrored those of earlier, regional studies that showed poor uptake and follow-up of high-risk patients previously covered by Pulse.

Coverage was just 21% overall but varied markedly, with some practices having no patients attend at all, while others achieved over 70% coverage. Only one in 20 patients (4.6%) were identified as high risk (QRISK2 score of 20% or higher) overall - and only 33% of these were prescribed a statin after attending their check.

The study also underscored previous concerns about potential widening of health inequalities – with coverage significantly lower in Black African and Chinese populations than in White British.

The researchers said the findings question whether the NHS Health Check programme will deliver the population health benefits the Government has claimed it will.

They concluded: ‘Coverage of the programme and statin prescribing in high-risk individuals was low. Coverage was similar in deprived and affluent groups but lower in some ethnic minority groups, possibly widening inequalities.

‘These findings raise a question about whether recommendations by WHO to develop CVD risk assessment programmes internationally will deliver anticipated health benefits.’

Public Health England relaunched the programme in 2013 with a commitment to access all fifteen million eligible people over the next five years and to evaluate evidence on its impact in order to refine the approach as it is rolled out.

However, critics of the evidence base have called for it to be scrapped altogether. This included the RCGP, which recently said the scheme should be halted until a robust trial of the approach was completed.

Prev Med 2015; available online 8 June

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Readers' comments (2)

  • Shocking.

    (not)

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  • This calls in doubt the whole process.
    Most of the benefit of the health checks will be the prescribing of statins to those at high risk.
    If such a small portion of those called in are assessed as high risk, then something is wrong with the risk assessments or more likely the high risk patients are not attending, and jsut the worried well.
    And then such a small portion of those at high risk take a statin. How many will then be taking a statin in 2 or 3 years time?
    And how many will take a statin when there risk is deemed only moderate risk ie 10-20%.
    It needs to be in the QoF, like hypertension, but even then probably will not have the impact that it deserves. It looks like we will have to move to calcium scoring.
    Costs more, but more accurate, and patients take their meds (also change their lifestyle more)

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