GPs braced for 'enormous' workload from vascular screening

GP practices face a greater than expected rise in chronic care workload resulting from the NHS Health Check programme after research showed it will pick up more cases of vascular disease than first thought.

Dr Khunti: Practices offering the checks will take on huge chronic care burden (Photo: Pete Hill)
Dr Khunti: Practices offering the checks will take on huge chronic care burden (Photo: Pete Hill)

Prevalence of diabetes and CKD among eligible patients was found to be higher than had been expected by the programme's organisers.

The DH had predicted 20,000 cases would be diagnosed through the programme each year. Experts now expect at least 158,000 cases to be found, meaning practices will have more patients requiring chronic care than first thought.

Lead author and Leicestershire GP Professor Kamlesh Khunti welcomed the extra benefits to patient health. However, he warned practices that are yet to offer the checks to expect the same ‘enormous’ increases in workload as experienced by practices in pathfinder areas.

He told GP: 'Lots of GPs are seeing this. Those implementing the checks are picking up a lot of people with diabetes, CKD or a higher risk of cardiovascular disease. Personally, I think it's great for patients, but it is a lot a work.'

He added that some practices have opted not to take on local enhanced services, fearing they may not cope with the extra demands on their surgery.

Underestimated impact
The NHS Health Check programme aims to invite 3m people aged 40-74 for vascular checks each year to prevent thousands of cases of stroke, heart disease, diabetes and kidney disease.

Official figures recently showed the scheme is struggling to persuade patients to attend checks, while GP leaders warn practices may abandon them due to mounting workload.

In the research, part-funded by the DH, a University of Leicester team analysed data for 3,707 patients who participated in a screening study. These participants were eligible for the NHS programme, and about 24% were of South Asian descent.

Participants had an oral glucose tolerance test and were asked for details of smoking status, alcohol consumption and medical and family history.

This screening detected 172 cases of type 2 diabetes and 278 cases of CKD. A total of 363 patients had impaired glucose regulation (IGR) and 656 were at high risk of cardiovascular disease.

Over a third of all participants had at least one of these vascular risk factors.

Researchers estimated that if the NHS programme provided 1.4m checks a year, an uptake rate of 45%, it would detect at least 51,569 new cases of diabetes and 124,651 cases of IGR.

There would be 234,320 people placed at high risk of cardiovascular disease, and 111,265 cases of CKD would be found. Even more cases would be detected if uptake reached the DH target for commissioners, set at 75%.

Patient uptake of the national programme currently stands at 48%.

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