No evidence for GP screening plans, Government's advisors admit
By Nigel Praities
The Government's plans to screen for cardiovascular disease in general practice from next year have sparked a storm of controversy, with even its own advisors admitting to a lack of evidence for the plans.
Ministers and GPs have been locked in a war of words over the plans – first revealed by Pulse two years ago – with the BMA's reaction described as ‘hyperbole' by the Government.
Everyone aged 40 to 74 will be invited in for a vascular check under the plans, detailed by the Department of Health last week.
But there are fears systematic screening will swamp practices with workload. The BMA, which opposes the plans, claims practices will face at least 40 more appointments a week.
Health Secretary Alan Johnson dismissed that, insisting: ‘A total of 3 million patients will be screened a year, working out at about 7 appointments a week per practice.'
The checks will include questions on risk factors as well as measurement of blood pressure and cholesterol, with further tests for those assessed as at high risk of diabetes or chronic kidney disease.
Screening experts warned the impact of systematic screening on practices was unclear. Professor Mike Kirby, professor of health and human sciences at the University of Hertfordshire, whose funding proposal for a cardiovascular screening pilot was rejected by the department last month, said: ‘This is going to be a huge amount of work and needs to be introduced in a structured way. More pilots are needed.'
He said the £250 million budget earmarked for the scheme was unlikely to cover practices' costs.
Dr Surendra Kumar, a GP in Widnes, Cheshire, and member of the government's screening advisory committee, said he supported targeted screening but there was a hole in the evidence for screening the general population.
‘We know it is not evidence-based but the Government wants to do it and we need to make sure taxpayers' money is not being totally wasted,' he said.
Dr Tom Marshall, senior lecturer at the University of Birmingham, who has set up screening pilots in Sandwell and Solihull, said proposals to use pharmacists and even community groups to conduct screening could cause ‘considerable' problems.
‘If a faith-based group checks your blood pressure and recommends you need antihypertensive treatment, who is going to prescribe it? Do you have a clear pathway about how you refer to a GP?' he said.GP screening: no evidence for Government's plans GP screening: no evidence for Government's plans