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Health check programme is pointless says leading GP

RCGP head says money for health checks is wasteful

Adrian O'Dowd

Tuesday, 20 August 2013

The head of the RCGP has attacked the government’s drive for NHS health checks to be carried out by GPs as being a pointless measure that wastes public money.

Dr Clare Gerada (pictured), chair of the RCGP, said the NHS health check programme should be dropped and replaced with targeted interventions on people who really need help and medical attention.

Public Health England (PHE) took over responsibility for overseeing implementation of the NHS health checks programme in April with local authorities rolling out the programme to 20% of their eligible population each year over the next five years.

Under the programme for England launched in 2009, people aged 40-74 are offered a free health check with the intention of identifying conditions such as heart disease, stroke and diabetes by looking for risk factors such as high blood pressure and cholesterol.

However, Danish researchers from the Nordic Cochrane Centre have questioned the evidence base for this approach and in a study published last year looked at the health checks being offered in a number of countries, including some pilot trials in the UK.

They concluded in the study: “General health checks did not reduce morbidity or mortality, neither overall nor for cardiovascular or cancer causes, although the number of new diagnoses was increased.

“With the large number of participants and deaths included, the long follow-up periods used, and considering that cardiovascular and cancer mortality were not reduced, general health checks are unlikely to be beneficial.”

The researchers, writing in a letter published in today’s The Times newspaper said: “We could not find any beneficial effects of health checks, whereas they likely lead to unnecessary diagnoses and treatments.”

Dr Gerada, responding to the letter was quoted by the BBC today as saying: “Governments seem to be promoting this against good evidence. They [health checks] are not based on good evidence.

“They are pulling in an awful lot of people who have nothing wrong with them and the very people you would want to be dragging in do not attend."

Dr Gerada argued that the money spent on health checks would be better used by having targeted intervention, adding: “We should be focusing on the hard-to-reach groups instead and policies like plain packaging for cigarettes and minimum pricing for alcohol.”

Public Health England defended the effectiveness of NHS health checks and its medical director Dr Paul Cosford said: “Estimates carried out when the programme was introduced by the Department of Health showed that health checks could prevent 1,600 heart attacks and strokes, at least 650 premature deaths, and over 4,000 new cases of diabetes each year.”

In July, PHE, NICE, NHS England and the Local Government Association, published a statement on the evidence base behind the programme, he added, saying: “Our statement outlined that although we recognise that the programme is not supported by direct randomised controlled trial evidence, there is nonetheless an urgent need to tackle the growing burden of disease which is associated with lifestyle behaviours and choices.

“All elements of the health checks follow well recognised and evidenced clinical pathways approved by NICE and the existing relevant evidence, together with operational experience accruing on the ground, is compelling support for the programme.”

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