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DH launches plans to ramp up CVD screening

By Lilian Anekwe

Exclusive: GPs have been ordered to ramp up their screening of patients for risk of cardiovascular disease, with the NHS set a target to assess three million people by April 2012.

New technical guidance on the NHS Operating Framework dispels doubts over the future of the programme, making clear that the Department of Health plans to push ahead with it. The guidance instructs PCTs to screen almost a fifth of all eligible patients in the coming year, with the DH to monitor the progress within each trust quarterly from this April.

Prior to last year's election, the Conservative party had promised to address vascular screening as part of an evidence review of all NHS public health schemes. But ministers appear to have now given the green light to the programme, which began in April 2009.

PCTs have been told to massively ramp up the uptake of vascular checks to ensure at least 18% of their eligible cohort have a health check by April 2012. However, no extra funding will be provided, as the document makes clear that funding has already been made available in PCTs' baselines.

It states: ‘The number of NHS Health Checks offered and undertaken should increase until 2012 to reflect phased implementation of the programme.

‘Thereafter, there should be a fairly stable number of checks being offered and conducted every year – nationally around 3 million offered and we estimate about 2.2 million conducted.

‘Full roll-out of the programme will be reached when PCTs are inviting at least a fifth of their eligible population every year as part of a five-year rolling programme. We would expect PCTs to plan for 2011/12 for a programme which will enable 90% of a fifth, or 18%, of their eligible cohort to have an NHS Health Check.'

Figures from the Office for National Statistics show that 21.8 million people are aged between 40 and 74 in England – 18% of this is 3.9 million, and when patients who have previously been diagnosed with a cardiovascular disease are excluded, the DH say this still leaves three million patients - or 20,000 per PCT.

But a Pulse investigation last year covering 25 PCTs found many were falling far short of this target. On average, trusts had performed slightly more than 6,000 screens each at an average cost of £68 per screen, although the cost in some trusts was as high as £720 per patient.

Professor Mike Kirby, a GPSI in cardiovascular disease in Letchworth, Hertfordshire, said: ‘Clearly having made the decision that this is the right thing to go we need to press on with it. The trouble is that commissioning groups have so much in their plate and theirs is so much controversy around primary prevention that over the last year I have definitely seen the will to do it diminish.

‘Commissioning groups are going to find this very challenging financially . We need a clear statement and guidance on what best practice is and what the recommend the best price per screen is.'

Technical Guidance for the 2011/12 Operating Framework The DH has dispelled doubt over the future of the NHS Health Check programme Vascular screening in numbers

21.8m eligible patients aged between 40 and 74 in England

20% proportion of eligible patients to be offered assessments annually under full programme

90% proportion of eligible patients to be screened under phased rollout
3.9m patients to be screened next year

Source: DH technical guidance for the 2011/12 NHS Operating Framework