Doubts over 40-plus health checks

stethoscope Health MoTs check things like blood pressure and cholesterol

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Health checks offered to millions of people over 40 are a waste of time, says the UK's leading GP.

Dr Clare Gerada, chair of the Royal College of GPs, says the government is promoting its NHS Health Check programme "against good evidence".

Her comments come after The Times newspaper published a letter from Danish researchers criticising the programme.

The Nordic Cochrane Centre group found health MoTs did not reduce deaths.

In England, people aged 40-74 are offered a free health check.

Start Quote

We should be focusing on the hard-to-reach groups instead and policies like plain packaging for cigarettes and minimum pricing for alcohol”

End Quote Dr Clare Gerada Chair of the RCGP

The initiative, launched in 2009, is designed to spot conditions such as heart disease, stroke and diabetes by looking for silent risk factors such as high blood pressure and cholesterol.

Ministers have said the scheme could save 650 lives a year.

But Danish researchers are questioning the policy and say health checks have no proven benefits.

Under review

Their review, published in October 2012, looked at health checks offered in a number of countries, including some pilot trials in the UK a decade or more ago, though not the post-2009 programme.

It concluded that general health checks failed to benefit patients and could instead cause them unnecessary worry and treatment.

Dr Gerada of the RCGP shares these concerns.

She said: "Governments seem to be promoting this against good evidence.

"They [health checks] are not based on good evidence. They are pulling in an awful lot of people who have nothing wrong with them. And the very people you would want to be dragging in do not attend."

NHS Health Check

The NHS estimates, each year, the programme could:

  • prevent 1,600 heart attacks and strokes
  • avoid at least 650 premature deaths
  • prevent over 4,000 new cases of diabetes
  • detect 20,000 cases of diabetes or kidney disease earlier
  • The estimated cost per quality adjusted life year (QALY) is approximately £3,000

Source: Public Health England

She said the money involved would be better spent on targeted intervention.

"We should be focusing on the hard-to-reach groups instead and policies like plain packaging for cigarettes and minimum pricing for alcohol."

Barbara Young, chief executive of Diabetes UK, defended the programme saying: "Far from being useless, there is good evidence that, if properly implemented, it could prevent thousands of cases of Type 2 diabetes a year, as well as having a positive impact for heart disease, kidney disease and stroke.

"And while the £300 million it costs to run might sound like a lot of money, diabetes and other chronic conditions are expensive to treat. This means that once you factor in the savings in healthcare costs, the NHS Health Check is actually expected to save the NHS about £132 million per year."

The Department of Health says the NHS Health Check programme is based on expert guidance that is continually reviewed.

A spokeswoman for Public Health England said the existing relevant evidence, together with operational experience accruing on the ground, was "compelling support for the programme".

She added: "We are establishing an Expert Clinical and Scientific Advisory Panel that will provide oversight of the NHS Health Check programme.

"This panel will be responsible for reviewing emerging evidence and research needs. It will also promote future research, development and evaluation of this programme."

When the Danish research was published in 2012, the NHS Health Check sent out an eBulletin warning that the Cochrane conclusions had little if any relevance to the NHS programme.

The Cochrane authors responded rebutting the criticism and asked to have their reply published alongside. They say this was denied.

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