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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)

  • The funding won't go into the global sum but will be lost to the public health/local authority budget and will be another cut for surgeries who already employ the staff.

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  • Pull the plug. Put NHS Healthchecks out of their misery. They have been a huge waste of time and resources and in my practice have made it much harder for sick people to get an appointment.
    11:51 I'm sure you mean well, but your anecdotal evidence proves nothing. I have found that churches are full of people who believe in various things, and you have found one that believes in health screening. Have the thousand people you screened had better lives than a thousand that you didnt? If you have no control group and no outcome measure you cant prove any benefit.

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  • looks good - evidence poor - outcome debatable- predictably dubious benefit as usual - which I knew before it started !

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  • I don't believe the concept is bad, but the implementation by the DoH was very poor sucking upto Gordon Brown and ignoring the work of the NICE group including some seminal work by Tom Marshall using the data held on GP systems to target the risk assessment.
    But the big problem scuppering it now is the "fear of statins/medication" whipped up by a dysfunctional UK press.
    The future however is with calcium scoring. The recent MESA study is most impressive.

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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 – our work will help highlight how this can be done.’
    ------
    1)..... When will this work and its conclusions be published?
    2)..... When will this work and its conclusions be implemented?
    3)..... What will / should, be happening in the interim?

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  • Martin Harris

    This is a target requirement on public health and local authority who took an interest and wanted to speak to us GPs. The response was love to help and overwhelmingly we're overwhelmed by workload.

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