'Health MOTs' no better than GP case-finding, suggests study

A flagship £300m NHS health screening programme does not detect any more cases of heart disease and diabetes than opportunistic case-finding by GPs and may be a waste of money, a study suggests.

BP checks: Health MOTs may be a waste of NHS funding (Photo: Jim Varney)
BP checks: Health MOTs may be a waste of NHS funding (Photo: Jim Varney)

The first study into the effectiveness of the NHS Health Check programme since it was launched by the DH in 2009 found it showed 'little benefit' over usual care in diagnosing chronic diseases.

Writing in the British Journal of General Practice, researchers from Public Health Warwickshire said the result questioned whether the programme represented best value for money.

The non-randomised study spanned three years and analysed data from 79 GP practices across Warwickshire, a mixed rural and urban county in the Midlands.

A total of 1,142 previously undiagnosed conditions were detected as a result of 16,669 NHS Health Checks performed during the study, a detection rate of 6.85%.

But despite this, researchers found no difference in the prevalence of diabetes, hypertension, CHD, chronic kidney disease or AF – the conditions the health check aims to identify – between intervention and control practices.

Nor was there an association between the proportion of the eligible population who received a check and prevalence of any of the five conditions.

No better than 'usual care'

Of the practices involved in the study, 38 offered and provided eligible patients with an NHS Health Check as part of an intervention group. The remaining 41 did not provide the health checks and were used as a control group providing ‘usual medical care’.

Researchers said the results implied health checks made no difference to the number of conditions diagnosed and were no better than ‘usual care’, in which GPs opportunistically test for conditions based on presenting symptoms or risk factors.

The NHS Health Check, originally introduced in April 2009, is touted as a ‘midlife MOT’ that aims to assess people aged between 40 and 74 years for their risk of developing cardiovascular disease, diabetes and other health problems.

The programme has been controversial, and many GPs are concerned that the checks only serve to divert resources away from people who are sick and towards the ‘worried well’.

It was rolled out despite a lack of evidence on whether the scheme, the first of its kind, would be of any benefit.

Wrong to 'sit back' and wait for results

But Public Health England, which has responsibility for running the scheme, has told GP that it would be wrong to ‘sit back’ and ‘wait another 10 to 15 years for a randomised controlled study to say whether or not we should do this’ when preventable conditions are known to be contributing significantly to poor health and early deaths.

The study's authors said although the results suggested there was ‘little benefit’ in the scheme, larger-scale studies were needed to corroborate the findings before action should be taken.

One limitation of the study was that the recommended uptake of the checks fell considerably short of national targets, from which the programme’s benefits have been estimated.

Over the three-year study, 13.6% of the eligible population received a check, when national targets should have seen 45% receive one throughout this period.

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