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Patients snub vascular checks programme

By Lilian Anekwe

Exclusive: The Government's ambitious plans for its vascular screening programme are being undermined by funding cuts and ‘considerably lower than expected' uptake among high-risk patients, a Pulse investigation reveals.

GP cardiovascular experts warned the Department of Health's target to screen 3 million patients by April 2012 was ‘not realistic' – amid concerns that neither patients nor policy makers have been convinced of the programme's value.

An investigation into the NHS Health Check programme across 35 PCTs found funding was patchy and in many areas faced being stopped.

Only 27 of 35 PCTs that responded are currently offering LES funding for GPs to screen patients aged 40 to 74 for cardiovascular disease. Of these, 11 said they were planning to stop funding in 2011/12, or that funding was under review.

Earlier this month, Pulse revealed the DH's plan to ramp up uptake of vascular checks to ensure at least 18% of eligible patients would have one by April 2012. But our analysis shows many patients are shunning the offer of vascular checks.

More than 185,000 screens have been offered over the last year in PCTs that provided information, but fewer than 70,000 offers have been accepted – an uptake of just 38%.

An evaluation by researchers at Imperial College London, presented at the recent Society for Academic Primary Care London and South East meeting, found 44.8% of high-risk patients invited for a vascular check attended.

The researchers, who included Professor Azeem Majeed, professor of primary care at Imperial College London and a GP in Clapham, said: ‘Uptake of cardiovascular risk assessment and statin prescribing in high-risk patients was considerably lower than projected in the first year.

‘Targeting efforts, or reinvesting programme resources in strategies to reduce obesity, smoking or salt intake, may prove more cost-effective than mass screening.'

The DH's flagship scheme officially launched in April 2009, but some PCTs are still refusing to participate. One trust, NHS Milton Keynes, told Pulse: ‘We planned to introduce health checks in 2010, but this has been delayed. We will review the programme and decide whether these should be offered.'

Several areas plan to turn to alternative providers in a desperate bid to ramp up uptake of the screens.

Professor Mike Kirby, a GPSI in cardiovascular disease in Letchworth, Hertfordshire, said: ‘There can be benefits from primary prevention of cardiovascular disease but you have to wait 20 or 30 years. The managers in charge now won't be responsible then and people have begun to lose faith. I think the DH target is probably not realistic.'

GPs face an uphill struggle to meet the DH's vascular screening target GPs face an uphill struggle to meet the DH's vascular screening target Vascular screening survey

35 – Number of trusts that responded to Pulse's survey

27 – Trusts with LESs in place for vascular screening
11 – Trusts planning to review or cease LES funding
185,000 – Total number of screens offered
38% - Uptake of screens in eligible population

Source: Pulse survey of 35 PCTs