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NHS Health Check makes ‘modest’ but successful start

Study estimates 2,500 heart attacks and strokes prevented over five years

Adrian O'Dowd

Thursday, 14 January 2016

England’s NHS Health Check initiative has helped to prevent at least 2,500 heart attacks and strokes over the past five years, concludes the first major evaluation* of the scheme published online today in the journal BMJ Open.

The NHS Health Check programme, managed by Public Health England, is described as the first nationwide programme in the world to tackle prevention of heart attacks and strokes by offering a free check to eligible adults aged 40-74.

The check provides a personal review of behavioural factors – such as smoking, inactivity, harmful drinking and obesity – that increase the risk of developing a heart attack or stroke, and offers advice and referral to lifestyle services to support behaviour change, while also helping detect undiagnosed serious conditions such as hypertension, diabetes and chronic kidney disease.

The new study, led by Queen Mary University of London, is based on data from 655 GP practices with 1.7 million eligible people in the nationally representative QResearch database over the programme’s first four years – April 2009 to March 2013.

Their analysis showed that at least 2,500 people avoided a major cardiovascular incident over five years thanks to the check, estimated on the treatment of those at high risk being treated through statins.

The programme 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.

Researchers 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.

However, the authors said the number of eligible people having an NHS Health Check still needed to increase for the programme to reach its full potential.

Estimates carried out when the programme was introduced in 2009 showed the checks could prevent 1,600 heart attacks and strokes, at least 650 premature deaths, and over 4,000 new cases of diabetes each year, compared to the final figure of 2,500 cardiovascular incidents over five years actually prevented.

The most recent annual data from PHE shows that about 48% of all eligible people attend when invited to have the check.

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.

“We estimate that the programme could help identify 44,000 new cases of hypertension, 10,000 new cases of diabetes and 4,500 new cases of kidney disease in England every year.

“In the first five years of the programme, an estimated 2,500 people were also prevented from having a stroke or heart attack through treatments following their NHS Health Check.”

Professor John Newton, chief knowledge officer at PHE, said: “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.”

Ceri Jones, head of prevention and behaviour change at the British Heart Foundation, said: “These results are a real success story and show the life saving impact that health checks are having in helping people cut their risk of a heart attack or stroke. However uptake is too low.”

* Robson J, et al. The NHS Health Check in England: an evaluation of the first 4 years. BMJ Open 2016;6:e008840 doi:10.1136/bmjopen-2015-008840

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