NHS Health Checks have no impact in reducing premature deaths, and this flagship of the NHS preventative programme therefore deserves to be scuttled, writes Professor David Mant in a recent BJGP editorial.
Professor Mant, Emeritus Professor of General Practice, Nuffield Department of Primary Care Health Sciences, suggests that the current programme of preventative health checks are unfit for purpose, inefficient at detecting disease and lacking adequate quality-assurance mechanisms to ensure that subsequent treatment is effective.
Professor Mant comments on three BJGP studies showing evidence to suggest the Health Checks, which screen people aged 40–74 for undiagnosed diseases, are unsuitable.
One study suggests that checks had little impact on the discovery of conditions such as hypertension, chronic heart disease and chronic kidney disease. Another found that the checks needed to be targeted more at potential risk groups. A third found that they fell short of recognised World Health Organisation screening criteria for cardiovascular disease.
Professor Mant writes that in general practice, the NHS should focus on secondary prevention, picking up the pieces when government public health and fiscal policy fails to deliver effective primary prevention.
“Secondary prevention certainly includes identification and management of patients with high blood pressure, high blood sugar, hyperlipidaemia, or renal insufficiency. It also includes advising people to stop smoking.
“Not everyone has the ability and motivation to self-care, but surely we should not only be involving patients in self-recognition of risk but should also be delegating to them as much as possible for its subsequent management. Patient self-monitoring may not only be more convenient for them; it may also be more effective.
"Let’s look forward to moving from health checks to facilitated self-checks, and for cardiovascular disease, to a more targeted, quality-assured, and evidence-aware programme.”
Read the full editorial in BJGP.
Health checks and screening: what works in general practice?
BJGP 2014 vol. 64 no. 627 493–494