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NHS Health Check programme ‘failing to reach highest risk patients’

The Government’s flagship cardiovascular disease prevention programme is missing people at the greatest risk who are at most need of help, a study in East London has shown.

Only one in 10 people who came in for assessment under the usual NHS Health Check programme was actually at high risk of cardiovascular disease (CVD), and only a third of these people started taking statins.

The study’s authors argue that the programmes should be targeted more at those most in need.

The researchers, led by Dr John Robson from Queen Mary University London, looked at how the first three years of the Health Check programme went in three boroughs of London – Tower Hamlets, City and Hackney and Newham.

The proportion of people attending their check-up went up over the three years, from 34% in 2009 to 74% in 2011.

Overall, 10% were at high risk as indicated by a 10-year risk of 20% or higher.

However, the researchers pointed out that two areas that pre-stratified people before inviting them in had higher hit rates than with the usual blanket approach – 14% of people were at high risk in Tower Hamlets and over 9% in City and Hackney, compared with 8.6% in Newham.

In addition, statin use was higher in Tower Hamlets, where GP practices formed ‘managed networks’ to help improve follow-up care of high-risk patients – 48% of people at high risk had prescriptions of statins there, compared with 23% in City and Hackney and 20% in Newham.

The researchers concluded: ‘Implementation of the NHS Health Check programme in these localities demonstrates limited success.

‘Coverage and treatment of those at high CVD risk could be improved. Targeting invitations to people at high CVD risk and managed practice networks in Tower Hamlets improved performance.’

BMJ Open 2015; available online 13 April


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