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Study finds smokers less likely than others to attend NHS Health Checks



People who took up the Government’s national NHS Health Checks programme to check cardiovascular risk were much less likely to report smoking than those who didn’t participate in the scheme, according to latest research that appears to back up GP critics’ concerns that the scheme is widening health inequalities.

The study – reported in the Journal of Public Health – looked at the GP records of over 90,000 people who underwent risk assessment through the NHS Health Check programme between 2010 and 2013, compared with those of over 180,000 similar people with no record of ever having the NHS Health Check.

The proportion of current smokers in the NHS Health Check group was 5% lower than in the control group – 21% of men and 16% of women in the former group were smokers, compared with 26% and 21% of control group men and women.

The study’s authors said this suggested that ‘a higher proportion of non-smokers attended for health checks’.

The study found a higher rate of diagnosis of hypercholesterolaemia in both men and women, and hypertension in men, who underwent Health Checks, while the proportion of people on statins or antihypertensive therapy was also higher among the Health Checks group.

However, the authors cautioned that ‘the effectiveness and longer term outcomes of behaviour change approaches to risk reduction following a health check remain uncertain and require further research, leading to the development of more effective intervention strategies’.

The findings come after the RCGP called for the programme to be scrapped amid concerns from leading GP critics that it is diverting resources to the ‘worried well’ and exacerbating health inequalities.

Professor Azeem Majeed, from Imperial College London, whose independent evaluation has questioned the effectiveness of the NHS Health Checks programme, said the findings reflected these earlier concerns over health inequalities.

Professor Majeed said: ‘It is often the case with health checks that it is the healthier, more motivated people who attend.’

Public Health England relaunched the NHS Health Checks programme in 2013 with a commitment to reaching all fifteen million eligible people by 2018, and has defended its evidence base – although it is evaluating evidence on the scheme’s impact in order to refine the approach as it is rolled out.

J Pub Health 2015; available online 7 September