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NHS cardiovascular checks do not reduce health inequalities, study finds

The NHS Health Check programme does not reduce health inequalities and is not cost-effective, according to a study focusing on a city with high levels of deprivation and cardiovascular disease.

Researchers from the University of Liverpool and Liverpool City Council analysed the current NHS Health Check implementation in Liverpool and found that it is ‘neither equitable nor cost-effective’.

The study, published in PLOS Medicine, revealed that the current implementation was 'unlikely to become cost-effective before 2040'.

The team said that even if the programme met optimal Public Health England recommendations for uptake and prescribing, it might only become cost-effective from 2030 and would not improve relative health inequalities.

They also noted that as health checks are aimed at high-risk individuals, they should theoretically be more effective in an area with concentrated deprivation and CVD risk, like Liverpool.

As such the authors said that they ‘expect the effectiveness and cost-effectiveness of NHS Health Check—even considering optimal implementation—to be worse elsewhere’.

The researchers have argued that a more targeted approach towards the most deprived would likely reduce health inequalities by 2039, although this method would only reach cost-effectiveness by 2040.

Co-author of the study and health economist Dr Brendan Collins, from the University of Liverpool, said: ‘Combining Health Checks with upstream, structural policy measures around CVD risk factors such as tobacco, healthy food and alcohol would have a much greater effect.’

Local GP and Liverpool LMC secretary Dr Rob Barnett explained: ‘A lot of GPs and practices have felt that health checks are generally a waste of time, and they’ve not been seen as a high priority for practices.

‘I know that in some places where practices have really worked hard to encourage people to attend, they have attended, but it’s the amount of time and effort for picking up very little.

‘I think it would be a lot better if people within particular areas or people with particular problems were targeted, rather than a blanket invitation approach.’

This comes after Pulse analysis of NHS Health Check data revealed that only two in five eligible patients have attended their NHS Health Check in the past five years.

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