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18-02-2013 | Article

Time for a check up on Health Checks?

Although I am not usually given to praising politicians and senior NHS managers, I feel they deserve some credit for investing energy and resources in the NHS Health Checks programme - an ambitious initiative launched in 2009, with the aim of preventing cardiovascular disease, diabetes and kidney disease in the population by reaching every adult aged 40-74 years who has not already been diagnosed with these conditions.

When I discuss the scheme with patients they are often enthusiastic and most consider it "a good idea." The profession seems to be broadly in agreement with this.

However, despite its reasonable rationale and all good intentions, emerging evidence suggests that the impact of the programme has not been as good in practice as we might have hoped.

As reported by the Univadis Medical News, (click here) only "a third of high-risk patients accepted their invitation to an NHS health check during the first year of the programme," in a study focusing on a single London borough .

The findings contrast with Government expectations that uptake would be much higher, which could have major implications for the cost effectiveness of the scheme.

The authors suggest that money invested in this programme could be better used elsewhere, such as in population-wide initiatives to promote healthy lifestyles. These findings follow an earlier Cochrane review, also reported by Univadis Medical News (click here), which suggested that such health screenings have minimal impact on morbidity and mortality.

Based on the growing evidence against the scheme, is it time for a change in policy? If the balance of evidence suggests so this would release cash to invest elsewhere which, in these financially tough times, could be a sensible move.

This need not necessarily be a political decision, but could instead come from senior NHS management. Either way, we need clear leadership and decisions based on good quality evidence.

Best wishes,

Harry

Dr Harry Brown, editor-in-chief Univadis

By Dr Harry Brown