Skip to main content

Main menu

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
Letters

NHS Health Check: national evaluation findings and implications

John N. Newton and Katherine Thompson
CMAJ January 30, 2017 189 (4) E172; DOI: https://doi.org/10.1503/cmaj.732012
John N. Newton
Chief Knowledge Officer, Public Health England, London, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Katherine Thompson
Deputy National Lead, NHS Health Check and Blood Pressure Programme, Public Health England; on behalf of the NHS Health Check Expert Scientific and Clinical Advisory Panel
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Responses
  • Metrics
  • PDF
Loading

Governments around the world are committing to primary prevention strategies to reduce the impact of cardiovascular disease on premature mortality, as recommended in evidence-based guidance,1–3 but there is uncertainty about the design and effectiveness of delivery programs.

Chang and colleagues4 report an evaluation of the National Health Service (NHS) Health Check program, adding to existing reports5,6 of low program coverage in the early years but broadly equitable take-up across socioeconomic and ethnic groups. The new data show a small absolute reduction in modelled 10-year cardiovascular risk from a health check (from 6.7% to 6.2%), and that attendance was associated with significant decreases in blood pressure, body mass index and total cholesterol (but not in smoking). Prescribing of statins and antihypertensive medication increased but was still disappointingly low, even in high-risk patients.

The small size of the modelled reduction in risk remains a cause for concern, even if the study might have underestimated risk reduction due to missing or incomplete data and limited period of follow-up. The authors suggest the program falls short of “performance targets” but we would point out that uptake is now 49%7 — more than double that reported in this study. The existing economic analysis did not show that 75% coverage was required to achieve cost-effectiveness as the authors imply.

Available evaluations show that vascular health check programs can identify large numbers of individuals at high risk. The challenge is to ensure that those patients receive effective and coordinated follow-up care to reduce that risk.

We agree that it is essential to continue to evaluate overall impact using more recent and complete data. Research is also needed on implementation to establish best practice and further improve program performance.

References

  1. ↵
    Cardiovascular disease prevention public health guideline. London (UK): National Institute for Health and Care Excellence; 2010. Available: www.nice.org.uk/guidance/ph25/resources/cardiovascular-disease-prevention-1996238687173 (accessed 2016 May 20).
  2. Cardiovascular disease: risk assessment and reduction, including lipid modification. London (UK): National Institute for Health and Care Excellence; 2015. Available: www.nice.org.uk/guidance/cg181/resources/cardiovascular-disease-risk-assessment-and-reduction-including-lipid-modification-35109807660997 (accessed 2016 May 20).
  3. ↵
    Package of essential non-communicable (PEN) disease interventions for primary health care in low-resource settings. Geneva: World Health Organization; 2010. Available: www.who.int/nmh/publications/essential_ncd_interventions_lr_settings.pdf (accessed 2016 May 20).
  4. ↵
    1. Chang KC,
    2. Lee JT,
    3. Vamos EP,
    4. et al
    . Impact of the National Health Service Health Check on cardiovascular disease risk: a difference-in-differences matching analysis. CMAJ 2016;188:E228–38.
    OpenUrlAbstract/FREE Full Text
  5. ↵
    1. Chang KC,
    2. Soljak M,
    3. Lee JT,
    4. et al
    . Coverage of a national cardiovascular risk assessment and management programme (NHS Health Check): retrospective database study. Prev Med 2015;78:1–8.
    OpenUrlCrossRefPubMed
  6. ↵
    1. Robson J,
    2. Dostel I,
    3. Sheikh A,
    4. et al
    . The NHS Health Check in England: an evaluation of the first 4 years. BMJ Open 2016;6:e008840.
    OpenUrlAbstract/FREE Full Text
  7. ↵
    Public health outcomes framework: NHS Health Check profile. London (UK): Public Health England. Available: www.phoutcomes.info/ (accessed 2016 May 20).
PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 189 (4)
CMAJ
Vol. 189, Issue 4
30 Jan 2017
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
NHS Health Check: national evaluation findings and implications
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
NHS Health Check: national evaluation findings and implications
John N. Newton, Katherine Thompson
CMAJ Jan 2017, 189 (4) E172; DOI: 10.1503/cmaj.732012

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
NHS Health Check: national evaluation findings and implications
John N. Newton, Katherine Thompson
CMAJ Jan 2017, 189 (4) E172; DOI: 10.1503/cmaj.732012
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • References
  • Responses
  • Metrics
  • PDF

Related Articles

  • Impact of the National Health Service Health Check on cardiovascular disease risk: a difference-in-differences matching analysis
  • The authors respond to “NHS Health Check: national evaluation findings and implications”
  • PubMed
  • Google Scholar

Cited By...

  • The authors respond to "NHS Health Check: national evaluation findings and implications"
  • Google Scholar

More in this TOC Section

  • Highlighting obesity as a risk factor for endometrial cancer
  • Hepatitis B vaccination for Canadian children: time for an adult conversation
  • Codesigning a public health approach to preventing firearm-related suicide deaths with rural communities
Show more Letters

Similar Articles

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions

Copyright 2021, Joule Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

Powered by HighWire