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NHS health checks

The NHS Health Check (HC) programme was introduced in 2009 to reduce cardiovascular disease mortality and morbidity for all patients aged 40 to 74 years in England. Three recent studies programme are reviewed.

Impact of the National Health Service Health Check on cardiovascular disease risk: a difference-in-differences matching analysis .

The impact of the NHS HC programme on changes in modelled risk for CVD, individual risk factors for CVD, prescribing of relevant medications and identification of new diagnoses of vascular disease was assessed in this study.

Data were extracted on a random sample of 138,788 residents (with no previous diagnosis of CVD) aged 40 to 74 years registered with 462 general practices between 2009 and 2013.

Patients were categorised as either HC attendees or non-attendees.

Findings suggested a small but significant reduction in cardiovascular risk among HC attendees, equivalent to one additional cardiovascular event being prevented every year for every 4,762 persons who attend.

Attendees had significant reductions in blood pressure, body mass index (BMI) and total cholesterol. Attendance was associated with significantly greater prescribing of statins and anti-hypertensives.

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Impact of the National Health Service Health Check on cardiovascular disease risk: a difference-in-differences matching analysis.

The impact of the NHS HC programme on changes in modelled risk for CVD, individual risk factors for CVD, prescribing of relevant medications and identification of new diagnoses of vascular disease was assessed in this study.

Data were extracted on a random sample of 138,788 residents (with no previous diagnosis of CVD) aged 40 to 74 years registered with 462 general practices between 2009 and 2013.

Patients were categorised as either HC attendees or non-attendees.

Findings suggested a small but significant reduction in cardiovascular risk among HC attendees, equivalent to one additional cardiovascular event being prevented every year for every 4,762 persons who attend.

Attendees had significant reductions in blood pressure, body mass index (BMI) and total cholesterol. Attendance was associated with significantly greater prescribing of statins and anti-hypertensives. During the study period, CVD was diagnosed in 6.4% of attendees and 1.3% of non-attendees.

While results were statistically significant, they were clinically modest in terms of modelled risk for CVD, blood pressure, BMI and total cholesterol.

The programme only reached 21% of eligible adults, significantly below the 75% needed to make it cost-effective. Any future initiatives will need careful planning, implementation and evaluation to ensure appropriate use of resources.

Chang KC-M, Lee JT, Vamos EP et al (2016) Californian Medical Association Journal. 10.503 /cmaj.151201


Investigating the impact of ethnicity and gender and method of invitation on uptake of NHS health checks

Who uses NHS health checks? Investigating the impact of ethnicity and gender and method of invitation on uptake of NHS health checks.

This study aimed to identify whether there were socio-demographic differences in uptake of the NHS HC and examine the influence of method of invitation on uptake.

Data were extracted on 50,485 residents aged 40 to 74 years registered with all 30 general practices in Luton between 2013/14.

Findings suggested a local uptake rate of 44%; lower than the national average of 47%. Uptake was lowest among patients residing in the most deprived wards.

There was also lower uptake among people aged 40 to 49 years, people from ‘Any Other White’ or ‘Black African’ backgrounds, men from ‘Any Other Black’ background, and women from ‘Mixed White & Asian’ backgrounds. The effectiveness of invitation varied by gender and ethnicity.

A tailored approach to invitation according to population need is recommended, as is further research to ascertain the barriers to uptake and facilitators to engaging with diverse communities.

Cook EJ, Sharp C, Randhawa G et al (2016) International Journal for Equity in Health. 15, 13. 10.1186/s12939-016-0303-2


Can lay health trainers increase uptake of NHS Health Checks in hard-to-reach populations? A mixed method pilot evaluation

NHS HC uptake is poor in deprived areas where the risk of CVD is often greatest. This study aimed to evaluate the impact of a community-based HC programme delivered through lay health trainers in County Durham between January and June 2012.

A ‘mini-health MOT’ was offered to anyone over 16 years old in community settings such as workplaces and colleges. Those who were eligible for a HC were invited for another appointment. Evaluation methods included semi-structured interviews, focus groups and patient satisfaction questionnaires. Monitoring data were also examined.

During the study period, 774 individuals underwent the MOT, including 441 (57%) people aged under 50 years and 449 (60%) individuals from the most deprived wards.

Fifty-nine percent of eligible men and 33% of eligible women returned for a full HC.

Fewer people from derived areas returned than those from more affluent areas. Approximately half of those who received a full HC were identified as having a low CVD risk, while 42% had a moderate or high risk. The MOT service was well-received by participants.

Provision of HCs in non-healthcare settings increases their acceptability to those least likely to engage with standard screening programmes. However, the assumption that lay health trainers increase uptake needs further exploration.

Visram S, Carr SM, Geddes L (2015) Journal of Public Health. 37, 2, 226–233. 10.1093/pubmed/fdu041

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