How useful are NHS Health Checks? What the evidence and GPs say

In the second part of our series on the NHS Health Check programme, Anna Colivicchi looks at their actual evidence base, as well as whether GPs find them useful in practice

Despite the longevity of the programme, the effectiveness of NHS Health Checks is still contested – and GPs are divided on their clinical value, especially considering the current pressures in general practice. 

Researchers who looked at the programme in 2020 pointed out the absence of ‘convincing’ randomised clinical trial evidence about the effectiveness the programme, which prompted scrutiny and questions around its delivery, uptake, impact and cost-effectiveness. ‘Concerns have been raised that delivery and practical implementation of such a programme presents a paradoxical risk of increasing health inequality if implemented in a way which does not systematically prioritise equity of access, outputs and outcomes,’ the researchers said.  

According to the results of a Pulse survey of over 900 GPs, 62% think that the checks are ‘useful’, with 11% saying that they are ‘very useful’. However, 33% said that they were ‘neither useful nor harmful’. ‘Anecdotally, they do seem to be quite a good way of picking up that cohort of patients, particularly middle-aged men, who otherwise don’t come to the doctor,’ Gateshead LMC chair Dr Paul Evans tells Pulse. ‘We do seem to find quite a lot of this cohort with hypertension or prediabetes or highly elevated lipids, or all of the above.’  

GP scepticism 

But many have told Pulse that they are unsure about the clinical impact of the checks. When the programme was first introduced, a lot of GPs saw it as a way for politicians to win over the public, rather than an evidence-based measure. 

Some GPs responding to our survey described the programme as ‘pretty useless’ due to the lack of clinical evidence and ‘poor funding’. ‘It is a pointless exercise,’ one GP partner said, mentioning a lack of access to tools to interpret the data as accurately as possible – for example, using QRISK3, rather than the older QRISK2.

Others said that on balance the programme is ‘probably more useful than not’ but that it might ‘not be the best use’ of very limited resources in general practice – although the survey found that nurses carry out the majority of the checks in 40% of practices, compared with 2% saying GPs.  

Several survey respondents mentioned that while the checks may ‘have a time and a place’ the admin created is a ‘burden’ and needs adequate capacity. ‘They help identify illnesses and actually make a plan,’ says South Staffordshire LMC chair Dr Manu Agrawal, ‘but they need to be funded properly. I know there are many GPs who don’t see value in them, because of workload issues and funding, and they wonder if the money is actually worth the time.’ 

GPs responding to our survey described the checks as ‘quite a lot of work’, but helpful when targeted at higher-risk individuals. ‘It doesn’t work as well when blanketly rolled out to everyone, as it uses up a lot of resources,’ said one GP.  

‘We spend a lot of hours chasing patients up to attend or return for blood tests,’ said another GP partner. ‘The unfortunate problem is that there is not enough national marketing on the importance of NHS Health Checks and also no patient responsibility.’  

Clinical evidence 

Clinical evidence is limited on the long-term impact of the checks, but a 2024 study measured the rate of new diagnoses in UK Biobank participants who underwent the NHS Health Check compared with those who did not.  

It found that in the immediate two years after the check, higher diagnosis rates were observed for hypertension, high cholesterol, and chronic kidney disease among health check recipients compared to their matched counterparts. 

In the longer term, NHS Health Check recipients had significantly lower risk across all multiorgan disease outcomes and reduced rates of cardiovascular and all-cause mortality. ‘The NHS Health Check is linked to reduced incidence of disease across multiple organ systems, which may be attributed to risk modification through earlier detection and treatment of key risk factors such as hypertension and high cholesterol,’ the researchers from the Universities of Oxford and Queen Mary concluded. 

Other studies have found that the programme is associated with improvements in health behaviours including smoking cessation, physical activity and diet, and with improved management of hypertension and hypercholesterolaemia.  

But, on the other hand, the programme has been criticised by researchers for not reaching everyone who would benefit, specifically in deprived areas (see the first piece in our series) – and other studies have pointed out that the programme’s effectiveness may have been limited not only by funding pressures, as our investigation has found, but also by a lack of follow-up and support for lifestyle changes.  

Earlier analyses of the programme also raised concerns around cost-effectiveness, arguing that the money could be better spent on more effective interventions, such as those targeted at child and maternal health, or strategies promoting healthy food.

A lack of patient awareness 

Researchers have highlighted that patients usually perceive the programme as a one‐time event, ‘without any structured follow‐up plan to ensure continuity of care’.  The 2025 study also found that some patients expressed ‘fear’ about attending the checks, rooted in the anxiety of potentially discovering health problems. ‘This fear created a barrier, as many felt that learning about an issue would force them to confront difficult choices or lifestyle changes,’ said the researchers. ‘Some preferred not to know if something was wrong, allowing them to continue their routines without the burden of a diagnosis. This avoidance of bad news was a common deterrent for participants.’  

According to Healthwatch, awareness of what the checks aim to help prevent is ‘not as good as it could be’. Their survey found that while most people were aware that NHS Health Checks help to prevent heart disease, diabetes and stroke, less than half were aware that they also aim to help prevent kidney disease and dementia. 

This was also echoed in our own survey, where several GPs highlighted a lack of patient awareness when it comes to attending the checks and how this might benefit them. Others said that the checks have not been as useful because they have ‘promoted health anxiety’ but not led to any significant lifestyle change. 

Healthwatch also pointed out that there is also limited behaviour change following an NHS Health Check. ‘When asked what difference the NHS Health Check had made, less than half of respondents told us they have a better understanding of their health,’ their report said.  

Impact of plans to add more conditions to the checks

GPs have also raised concerns that adding more conditions to the checks could dilute their purpose. When the Government announced the addition of menopause questions to the checks, Professor Azeem Majeed, a GP and head of the department of Primary Care and Public Health at Imperial College London, told Pulse that it may be more appropriate for other conditions to be addressed through QOF for a more structured approach, rather than being added to the checks. ‘There is a risk that including additional topics could dilute the checks’ focus and effectiveness and set a precedent for including other important – but non-cardiometabolic – conditions in the future,’ he said. 

Rather than adding more conditions to the checks, GPs said that these should ‘concentrate on those that need it’ and potentially lift age restrictions. ‘We need to get the right care to the right people, not care by numbers,’ said one Cambridgeshire GP.  

Regardless of specific clinical outcomes, one benefit of the programme has been highlighted over and over – from research, to Pulse’s own analysis and survey. The programme represents an opportunity to ‘set up a relationship with the primary healthcare team’, which may not otherwise happen. 

In our next piece on the state of the NHS Health Check programme, we will look at what experts think of the checks’ future.

You can hear more about our investigation into health checks on our most recent episode of Pulse in Focus: The podcast for GPs. Listen here.