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Tories to review 'evidence base' for vascular screening
18 Jan 10
The vascular screening programme could be scrapped as part of a wide-ranging review of public health programmes conducted by the Conservative Party if they win the forthcoming general election.
In a statement that has shocked leading cardiovascular GPs, a party spokesperson told Pulse they planned an evidence review of all NHS public health programmes and would halt those – such as the vascular checks scheme - without an adequate evidence base.
The spokesman said: ‘All public health programmes that receive taxpayer's money will be continuously evaluated and reviewed to ensure that they are evidence-based, cost-effective and producing identifiable public health benefits.
‘We will be looking to evaluate the evidence for the vascular risk assessment programme rigorously as part of this process.’
The spokesperson went on to say vascular checks was likely to be one of the first victims of the cull as Mr Lansley ‘didn’t think there was much of an evidence base for the programme.’
The announcement comes days after Pulse revealed the cost of the scheme varied widely in different parts of the country, with some screens costing as much as £700 per patient.
Leading cardiovascular experts said they were shocked by the move. Professor Mike Kirby, professor of health and human sciences at the University of Hertfordshire and a GP in Radlett, said the announcement would be ‘demoralising’ for GPs who were doing good work.
‘You put a lot of effort, thought and training into it. Rather than being hasty, we should look at the good things that are happening and see if we can do things more cost-effectively.'
‘It seems odd when the Tories want to include more preventative medicine in QOF - why spend money there and then take it from probably the world’s biggest prevention project?’ he added.
Dr Terry McCormack, former chair of the Primary Care Cardiovascular Society, admitted the programme had ‘cost more than it should’ but there was plenty of indirect evidence it can work.
‘It will have been a great waste of effort if the scheme is scrapped in its infancy and I would encourage Mr Lansley to consider adopting a simplified scheme rather than throwing it out altogether,’ he said.
Readers' comments
Hear hear, scrap all these wasteful programmes and scrap the managers that go with them.
The difficulty is the 'cost-effective'. There is a transition cost to move from a disease reactive service to a health promotion one - both work streams have to run in parallel with the benefits of a proactive approach showing up as a reduction in the disease reactive costs decades later. We have squandered the largest investment in the NHS ever on a 'plurality' of disease treatment providers and formation of pseudomarkets. The money would have been better spent on increased capacity for proactive health promotion and primary prevention through the existing providers. I predict it will never be 'cost effective' by an 'in year break even' accountancy process to undertake any type of screening no matter how extensive the expected benefit in decades to come.
What scheme? There is no sensible uniform and adequately resourced workable scheme. It was left to individual PCTs to organise the 'piss up in the local brewery' with widely varying results. A decent well thought out scheme negotiated with the GPC might be far more cost-effective.