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NHS Health Checks set to miss cost-effectiveness target with just 40% uptake

Exclusive Only two in five eligible patients have attended their NHS Health Check in the past five years, meaning the programme will significantly miss its cost-effectiveness target.

Although 86% of eligible people were offered to attend the screening in the last five-year cycle, less than half (48.5%) of those patients actually attended, according to a Pulse analysis of NHS Health Check data available to date.

This left only 41.9% of the desired population who actually had their check since April 2013 – well below a 70-75% cost-effectiveness target – prompting public health experts to question whether the scheme should be scrapped.

Under the scheme, first introduced in 2009 and relaunched in 2013, GPs bring in patients aged between 40 and 74 for a check up every five years.

The aim is to spot early signs of stroke, kidney disease, heart disease, diabetes and dementia, but according to economic modelling by the Department of Health and Social Care and Public Health England, it would only be cost effective if it reached between 70% and 75% of the population targeted.

Head of primary care and public health at Imperial College London Professor Azeem Majeed, who carried out a DHSC-commissioned evaluation of the scheme, told Pulse: ‘The performance of the NHS Health Check programme has been disappointing and it is concerning to see the recent decline in attendance rates.

‘The programme either needs to be properly resourced and planned, or we need to consider whether the programme should be ended and we look at other ways of delivering cardiovascular disease and diabetes prevention.’

It comes after PHE said it would review new research in 2016, which revealed that out of nearly 5,000 people attending a health check, only one avoided a cardiovascular event.

The DHSC-funded study highlighted that ‘poor’ planning and ‘inadequate’ engagement with healthcare professionals had led to the scheme falling ‘well short’ of targets.

Associate Professor Jamie Waterall, PHE national Lead for the NHS Health Check programme, said: ‘Over 6.4m people have received an NHS Health Check over the past five years, making it one of the largest non-communicable disease prevention programmes of its type internationally.

‘A recent evidence synthesis completed by Cambridge University shows the programme is reaching deprived communities and resulting in more people receiving evidenced based risk reduction interventions. Given that local areas pay per health check, this is still likely to be cost-effective but we are working with local teams to increase the number of people accessing this service.’

A PHE spokesperson told Pulse the final figures for the five-year cycle are due to be published in June.

Note: This article was updated with a PHE comment at 10.15am on 26 March. PHE had initially declined to comment.

Five-year uptake of NHS Health Check screening

Uptake among patients called for screening:

2013/14 – 49%

2014/15 – 48.8%

2015/16 – 47.9%

2016/17 – 49.9%

2017/18 (to Q3) – 46.4%

Source: NHS Health Check


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