In the world of medicine, it’s a well-proven maxim that prevention is always better than cure. And if you can’t actually prevent something, detecting and treating it early is the next best thing.
But for both these to work, you need to have some kind of regular health check; a physical ‘MoT’ that will flag up any concerns or spot early signs of something which could become more serious. Most private medical schemes offer this kind of regular health check as part of a package, but many people are unaware that you can also get a regular ‘once-over’ on the NHS, if you are the right age.
Launched in 2009, the “NHS Health Check” is available once every five years to people aged between 40 and 74. Currently, about 1.5 million people take up this offer every year. As well as looking for any specific medical problems, the check is designed to give people an overall picture of the state of their health and what they can do to improve or preserve it.
The check includes assessing lifestyle risk factors such as diet, physical activity, smoking and alcohol, together with physical risk factors such as blood pressure, blood sugar and cholesterol. Together these risk factors contribute to cardiovascular disease and other conditions such as respiratory disease, dementia and some cancers.
But if it is available only every five years, and a relatively small number of eligible people take it up, how effective is the NHS Health Check in practise? That was the question asked in a new report published this month by Public Heath England’s Expert Scientific and Clinical Advisory Panel.
Examining the report, NHS England’s National Clinical Director for Cardiovascular Disease Prevention, Dr Matt Kearney, found it is generally encouraging. It clearly shows that the health check is helping in identifying previously undiagnosed high-risk conditions.
For example, over a five-year cycle around 700,000 people at high risk of cardiovascular disease will be detected, plus an additional 175,000 patients with high blood pressure (hypertension), 35,000 with type 2 diabetes and 11,500 with chronic kidney disease. In all these conditions there is strong evidence that early diagnosis and treatment substantially reduces the risk of life-changing events such as a heart attack, stroke and dementia.
But Dr Kearney also found areas for improvement highlighted in the report. Currently, only half of all patients invited for the NHS Health Check actually take up the offer, so increasing this poor take-up rate must be a priority if the check is to be fully effective. Of those who do take up the check, many are confused by the information they receive, especially their “cardiovascular risk score”. Simplifying this information is crucial in getting people to change their lifestyle to improve their health and reduce future risk.
According to Dr Kearney, the report also highlights significant variations in how well medical professionals follow up on the health check and any issues it raises. For example, in some areas patients would be routinely referred to ‘lifestyle services’ such as smoking cessation or weight management programmes if the health check showed it was appropriate for them, but this did not happen routinely in other areas.
Similarly, there was variation in the prescribing of statins for people with high cardiovascular risk or antihypertensives (drugs to lower blood pressure) for those with hypertension. Both in referrals for lifestyle support and in prescribing preventative drugs, GPs should be encouraged and incentivised to follow up on health checks in line with national clinical guidance, said Dr Kearney.
If you are in the right age group for a free NHS Health Check and feel you might benefit from one, ask your GP about provision in your area.