DNA testing could be part of NHS health checks under government plans

The DHSC has launched a review of NHS health checks, with a view to introducing a new system of tailored, targeted checks that could involve DNA testing.

DNA testing (Photo: Andrew Brookes/Getty Images)
DNA testing (Photo: Andrew Brookes/Getty Images)

Health checks are currently offered to everyone between the ages of 40 and 74. However the DHSC said a new evidence review will explore 'whether tailored programmes – depending on factors that could include [an individual's] age, where they live and their DNA – will be beneficial to preventing devastating diseases.'

The DHSC said it wanted to end the 'one-size-fits-all' approach and ensure patients were offered personalised interventions 'based on their risk, location and predisposition to diseases'.

However, the RCGP said it was essential that any new approach was subject to rigorous review and warned of the 'unintended consequences' of widespread whole genome DNA testing, which would increase workload for GPs and other health professionals.

The DHSC said the review would also look at the digitisation of NHS health checks where appropriate, whether a specific check-up for those approaching retirement age should be introduced and consider increasing the range of advice offered as part of the checks. The DHSC also intends to explore ways to maximise uptake.

It added that the proposed changes were 'part of a wider shift from blanket approaches to public health, to a modernised, future-proof system that takes risk or personal choices into account'.

DNA testing

RCGP chair Professor Helen Stokes Lampard said a more targeted, evidence-based approach would be positive, but she raised concerns about the impact of introducing widespread DNA testing.

'The college has already expressed its concerns around the unintended consequences of widespread whole genome DNA testing to determine whether a patient has a genetic disposition to certain conditions. While more targeted predictive genetic testing is an important step forward, there are many issues to be explored in this review,' she said.

'We need to consider, for example, the increased workload for GPs and healthcare professionals across the NHS as patients want to discuss their genetic results; the huge ethical and financial implications of suddenly knowing what health conditions you may be more susceptible to; and patients being worried about any health concerns that are identified but of dubious personal impact, or where nothing can be done to improve the prognosis.

'It is essential that any new approach to health checks is subject to rigorous evaluation to ensure its safety, accuracy, and benefit for patients’ health. We also need to ensure that for digital or online services being promised, GPs and their teams have the technological resources and training to manage these and prevent additional strain on a profession already facing such intense resource and workforce pressures.'

Targeted intervention

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.'

Public Health England chief executive Duncan Selbie said: 'Predictive prevention becomes ever more possible through genomics and the application of cutting edge behavioural science. NHS health checks have been phenomenally successful and this review is a great opportunity to make the next generation the most effective in the world.'

A review of the NHS health checks programme published in the British Journal of General Practice last year found that it had 'fallen considerably short' of its targets in its first decade. Originally, the DHSC envisaged that all 15m eligible patients would be invited for an NHS health check and that 75% would attend. But statistics from 2013 to 2018 show that 45% of eligible adults across England attended a health check.

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