The first major evaluation of the NHS Health Check in England has found that the programme is effectively identifying people at risk of developing a major cardiovascular incident such as heart attack or stroke.
It estimates that over the first five years it has prevented 2,500 cases due to treatment following the check. In addition, the programme is helping diagnose conditions commonly linked to cardiovascular disease, including type 2 diabetes, high blood pressure and chronic kidney disease.
The study, led by Queen Mary University of London, also found that those from the most deprived areas and black and minority ethnic groups, who are at greatest risk of cardiovascular disease, are more likely to attend an NHS Health Check. This makes a positive step towards tackling health inequalities in England.
The programme, managed by Public Health England (PHE), is the first in the world to tackle prevention of heart attacks and strokes by offering a free check to every adult aged 40 to 74 years. It provides a personal review of the behavioural factors, such as harmful drinking and obesity, that might increase the risk of developing a heart attack or stroke and offers professional advice on lifestyle change and treatment. It also identifies any new or undiagnosed serious conditions such as hypertension, diabetes and chronic kidney disease.
The study is based on robust data from 655 GP practices with 1.7 million eligible people in the nationally representative QResearch database. In addition to the 2,500 people avoiding a major cardiovascular incident, the programme has also successfully identified:
- A new case of hypertension in every 27 appointments
- A new case of diabetes in every 110 appointments.
- A new case of chronic kidney disease in every 265 appointments
- 14% of attendees referred to lifestyle interventions due to obesity, smoking, alcohol or blood pressure compared to just 6% of those who were referred through standard care.
- Six times more people with high alcohol consumption than those who do not attend, offering brief advice and support.
However, the number of eligible people having an NHS Health Check still needs to increase for the programme to reach its full potential. The most recent annual data from PHE shows that about 48% of all eligible people attend when invited. PHE is continuing to work with local authorities to help them deliver the programme more effectively and increase the numbers taking up their NHS Health Check.
The study also shows that there is still room for improvement. The latest evidence suggests the programme is most effective at targeting the older end of the eligible population (those aged over 60) and more work is needed to encourage uptake among the younger age group (aged 40 to 60). However, as cardiovascular risk increases with age, this evidence suggests that the programme is effective in identifying and providing an NHS Health Check for those with the highest risk and not just the ‘worried well’.
Professor John Newton, chief knowledge officer at PHE said: “It’s good to see the clear initial successes highlighted by this comprehensive and robust study of the NHS Health Check programme in its early stages. The evidence shows that the programme is working and working well for its target group, effectively reaching black and minority ethnic groups and people from deprived areas, who are most at risk of their condition being missed or diagnosed too late.
“While this study shows a positive start and the numbers attending their NHS Health Check significantly up in the past few years, there is still more to be done to improve numbers and ensure those that need help get referrals for follow up treatment – which ultimately saves lives.”
Study lead Dr John Robson from Queen Mary University of London said: “The NHS Health Check programme is the first of its kind anywhere in the world and our study demonstrates a modest but successful start... Uptake of the programme during the study period showed year-on-year improvement, but much still needs to be done as there is considerable scope for even better coverage.”
The results of the evaluation were published inBMJ Open(January 2016).
