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Independents' Day

Health checks evidence to be reviewed after scheme falls 'well short' of targets

Public Health England has said it will review the evidence behind its NHS Health Checks programme after a Government-funded evaluation of the scheme found it has fallen ‘well short’ of performance targets.

The Imperial College London study of almost 200,000 patients found that only one cardiovascular event – such as a stroke or heart attack - was avoided every year for every 4,762 people who attend a health check.

The study was funded by the Department of Health and published in the Canadian Medical Association Journal this month.

It found there had been ‘poor initial planning’ of the programme, and ‘inadequate engagement of health care professionals’ and raised ‘concerns’ about the scheme as a whole.

Public Health England said it would ‘review the emerging evidence of the programme’ in the light of the damning evaluation.

The NHS Health Checks scheme has been riven with controversy since its rollout in 2009, with GPs saying the scheme was a ‘waste of money’ and was failing to reach those who were more likely to benefit.

The study compared patients who attended a NHS Health Check with those who didn’t and found only a ‘modest impact’ on absolute CV risk, equating to a reduction of 0.21%.

Similarly small effects were found on individual risk factors, with a –2.51 mm Hg reduction in systolic blood pressure a 0.27 reduction in body mass index and a 0.15 mmol/L reduction in total cholesterol, between groups.

Researchers also found that only 21% of the eligible population attended a health check; the DH had originally said that it would need 75% coverage to be cost-effective.

The study concluded: ‘The Health Check program failed to meet all of these targets, with only 21.4% coverage, and only 39.9% of high-risk patients receiving statins. The performance of the Health Check program has fallen well short of national and international performance targets for cardiovascular risk assessment programs.

‘These findings are concerning, given that the program is being delivered in the context of a universal health care system with well-developed primary care and high penetration of electronic medical records.’

Professor Azeem Majeed, a GP and principal investigator, said: ’For the NHS Health Check scheme to be effective, it needs to be better planned and implemented – our work will help highlight how this can be done.’

Jamie Waterall, national lead for NHS Health Check, Public Health England, said: ‘It is important that we review all emerging evidence for this programme. PHE has an established expert group which will look at the findings of this study.

‘The largest national evaluation of the programme shows that the NHS Health Check could have prevented 2,500 heart attacks and strokes in its first five years due to clinical treatments following the check.

‘We know that more people could benefit from the check and we are working with local teams to deliver the best possible service.’

A previous study, led by researchers from the Queen Mary University and published in BMJ Open, claimed that the scheme was a ‘remarkable success’ that has prevented at least 2,500 heart attacks and strokes in England over the past five years.

Readers' comments (16)

  • Surprise surprise!!

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  • Yup, this one and that one and that one etc
    Put monkeys in charge and you get ....

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  • Much like Antenatal classes, the most vulnerable groups don't attend !! The only solution is for GPs to initiate attendance & I can't see that happening as they never have done ! Perhaps it should be made a condition of registration with the GP to be a success ?

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  • During the last three years my wife and I, a none GMC registered qualified GP and a team of voluntary HCP's from our church members, and supported by our local council, have been undertaking public screening "events" in our local community (Height, Weight, BMI, Body Fat, BP, Oximetry, Blood Glucose, Lung Function and Life Style Analysis).

    Following screening the participants are given a one on one consultation with a GP or a Hospital Consultant (Internal Medicine) or Pharmacist who review and advise on outcomes.
    Since starting out 3 years ago we have "screened" over 1000 members of the public, many of them under 40 years of age, and of which just under 5% have had to be referred to their GP for further investigation, mainly in regards to concerns about CV and/or diabetes related issues.

    Most participants were unaware of their underlying conditions and several have returned to events to thank us for the service we have provided, explaining that we had been correct in our observations and that they were now under medical supervision.

    Obviously as a voluntary organisation we do not have the numbers of participants to provide a "sound" statistical analysis, but to say that health checks are a waste of time needs further consideration.

    Interestingly the only negative comments we have experienced have been from "passing" local GP's who where surprised that we were providing the service on a free of charge basis.

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  • At f... last- catching up with something they have already got right in Europe- they took heed of the scientific evidence indicating health checks not only a waste of consulting time, but on analysis of said evidence cause more harm than benefit!!!

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  • Presumably published in Canada out of embarrassment?

    And what are the resultant on-costs to the system in wasted capacity from statin-cough-recycle and from resultant harms?

    Just give us the cash without strings.

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  • Professor Azeem Majeed, a GP and principal investigator, said: "For the NHS Health Check scheme to be effective, it needs to be better planned and implemented" ....................Yes , and a realistic budget would help that in order to recruit the staff to do your data collection....prior to GP Land being handed over/ sold to the Private sector, by the Politicians!

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  • English GPs spent thousands of pounds of their own money during the 1990s running nurse led clinics that followed the 'Oxford Protocol'.

    The nurses and (very fit middle class) patients that turned up enjoyed the whole process. The subsequent reviews showed that very little was achieved.

    How much dosh to we have to waste to learn the same lessons again and again?

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  • Need to camp out in our most deprived areas and collar them via the GP to make a difference, but the worried well use up the resources and those in denial are aware of their bad habits but are fatalistic about old age and their chances of making it.

    It is only when they have a scare that there might be a change in some of their attitudes, unfortunately it is often too late to reverse the damage.

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  • Put the money back into the global sum and let us do our job properly

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