NHS announce review of mid-life health checks following limited uptake
The NHS is launching a review of its programme of free mid-life health checks following concerns over their impact and limited uptake.
The NHS Health Check programme is offered to adults in England aged 40 to 74 every five years to help spot early signs of Type 2 diabetes, stroke, kidney disease, heart disease and dementia.
Since its launch in 2009, less than half of the population have been found to take it up in most areas and its cost-effectiveness has been questioned.
The checks were described as “ineffective” and wasting £450 million a year in a 2015 report from the London School of Economics and the University of Liverpool.
And a 2014 review found that illnesses spotted during the checks could be “equally well detected” in standard care.
A study earlier this year found the checks reduced the risk of cardiovascular disease by a small amount, but that population-wide interventions would improve their effectiveness.
Announcing the review, the Department of Health and Social Care (DHSC) said the checks take place with “little attention” to patients’ individual risks.
These “one-size-fits-all check ups” will be replaced with checks that are “new, intelligent, predictive”.
The personalised check-ups will offer targeted advice and take into account age, risk factors and preferences.
For example, 40 to 49-year-olds, an age group where alcohol use is more common, could be targeted with drinking advice, while adults in their early 70s may be told how to lower blood pressure.
The review is part of a broader shift toward a modern, personalised health care system, the DHSC said.
Health Secretary Matt Hancock said: “Personalised, preventative healthcare is mission critical to the future-fit healthcare service we want to build.
“We must harness the latest technology and techniques to move away from the one-size-fits-all approach of the past.
“The review we are announcing today will be an important step towards achieving that, helping us to find data-led, evidenced based ways to support people to spot, manage and prevent risks to their health through targeted intervention.”
Over 14 million people have been offered an NHS Health Check in the last five years and almost seven million have participated.
The DHSC said uptake varies and it will explore how to maximise uptake so more people benefit.
It will also look at whether to roll out a specific check-up for people nearing retirement to help minimise future care needs.
NHS medical director Professor Stephen Powis said: “The time is right to take a look at whether NHS health checks could be targeted differently to prevent and tackle major killer conditions like heart disease, cancer and dementia.
“Taking a smarter, data-driven approach has potential both to give people the tools they need to improve and manage their own health, and to focus the time and expertise of NHS staff on those who need them most.
Dr Alison Evans, head of policy at Alzheimer’s Research UK, said: “The diseases that cause dementia, like Alzheimer’s disease, begin in midlife, decades before symptoms begin to show. Research has estimated that up to a third of cases of dementia could be down to lifestyle changes in our power to change.
“We strongly believe the NHS Health Check should continue to include vital information about dementia risk reduction for people aged 40 and older.”
Professor Helen Stokes-Lampard, chairwoman of the Royal College of GPs, said: “The college has questioned the benefits of blanket health checks for everyone over a certain age for a long time – so a more targeted, evidence-based approach is certainly a positive step forward.
“However, while the focus on only offering health checks to certain groups at risk of certain conditions is a move in the right direction – we need to ensure the methods used to determine who should be invited for one are properly thought through and based on rigorous evidence.”
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