Only 40 per cent of adults sign up for NHS midlife health survey aimed at preventing heart attacks… and GPs call for overhaul of ‘fruitless’ £165m-a-year plan
Only two in five adults who request an NHS Health Check actually take up the invitation, the latest setback for a multi-million pound scheme that GPs are calling a ‘waste of time and money’.
NHS Health Checks involves every adult in England aged between 40 and 74 with no known health conditions being called by their GP every five years for a series of tests. For each test they carry out, GPs are paid up to £40.
The tests include measuring height and weight, blood pressure and blood sugar levels, and asking general questions about health, such as smoking habits, alcohol consumption and family history of conditions such as heart disease.
Patients are then presented with the results. In the case of cardiovascular disease, these are presented as a score from low to high, depending on whether they have had an event such as a heart attack or stroke within the next decade.
They are then given general advice, such as improving their diet and exercise. If necessary, they are referred to specialist help, for example to stop smoking.
Only two in five adults who requested an NHS Health Check have actually taken up the invitation, in the latest blow to the multi-million pound scheme that GPs have called a ‘waste of time and money’ (stock image)
However, critics say the £165m-a-year plan is a “waste of time and money” as these checks should already be carried out through routine appointments.
Studies of the program have also shown that it has only a marginal impact on health outcomes, preventing only one heart attack or stroke per 5,000 participants every 10 years.
The latest data on the scheme for the 2023/2024 budget year shows that it is increasingly unpopular with patients.
Although a record 3.6 million people were invited to participate that year, only 1.4 million people actually did so, about 40 percent of the total.
This is a significant drop in attendance compared to the almost 50 per cent of the 2.8 million people invited a decade ago who had an NHS Health Check in 2013/14.
According to Dr Dean Eggitt, a GP from Doncaster, the NHS’s middle-aged MOTs in their current form are ‘a waste of time and money’.
“The way NHS health checks are conducted makes it likely to be a futile exercise,” he said.
‘We look at the right problems, we screen the population for things that we can and should help with… but the haphazard and solution-less way in which that is done is unlikely to help the population.’
He said that while the NHS audits were in principle looking at the right things and providing an opportunity to reach patients, the execution of what the NHS did with that data, such as providing general health advice, was flawed.
“When we treat these patients, we know we can give them both quality and quantity of life. That’s the right thing to do,” he said.
“But if we’re going to screen people who are sick and do nothing about it as long as we have the chance, what’s the point of screening?”
“This is where the implementation falls short. We fail to connect the screening to a system that can then solve the problem.”
According to Dr Eggitt, part of the problem is that GPs simply don’t have the time to proactively carry out these types of checks as part of routine care.
“We need to get back to the old-fashioned GP practice, where the doctors in your local GP practice have the time to look at the whole person and not just the problem they come in with,” he said.
‘We must give general practice the means to return to old-fashioned holistic care.’
He cited smoking cessation as a common example of the wrong approach.
In the past, GPs could simply give patients who wanted to quit smoking nicotine patches, but now they often have to call on an external service to help them quit smoking. This creates unnecessary bureaucracy, which means patients don’t sign up.
Dr Eggitt added that this outsourcing to third parties was often a problem in the NHS Health Check system.
He argued that it led to patients dropping out when approached because they did not recognize the provider. And, as with smoking cessation, it created further barriers to meaningful health interventions.
“By outsourcing the screening to an outside company, we introduce more steps and prevent patients from getting the solutions to their problems.”
Experienced GPs have also been highly critical of the NHS Health Check in the past.
Former head of the Royal College of GPs (RCGP), Dr Clare Gerada, previously called them a pointless exercise for GPs.
“GPs have always known that these check-ups were a waste of time that should have been spent treating people who were actually ill,” she said. The times.
Her comments followed a 2016 study by Imperial College London, which found that the checks prevented just one cardiovascular event, such as a stroke or heart attack, over the next 10 years, for every 4,762 people who followed the checks.
Other studies have shown that NHS health checks have no significant impact on reducing deaths or hospital admissions.
Dr. Gerada previously described them as “no benefit in terms of health from mass screening of those who are healthy. Nor will it reduce death rates from diabetes, heart disease and kidney disease.
In responses to the Health Service Journal She said the checks revealed “risk factors, not diseases” and could inevitably be “abnormalities” that lead to patients being prescribed unnecessary drugs or causing concern.
“We run the risk of prescribing people unnecessarily or causing them unnecessary anxiety,” she said.
‘At a time when the NHS is having to cut its budgets and GPs and practice nurses are already on the brink of collapse due to increasing workloads and declining resources, this is not the best use of time and money that should be spent caring for people who are ill or at high risk of becoming ill.’
The current director of the RCGP, Professor Kamila Hawthorne, said that while NHS health checks can be “useful” in early diagnosis, GPs were right to raise concerns.
‘Colleagues are right to be concerned about overdiagnosis and limited resources at a time when GP practices are already overstretched. The RCGP has previously raised these concerns and it is important that they are taken into account as the NHS Health Check initiative moves forward,’ she said.
However, health organisations see NHS health checks as an important tool to help people reduce their risk of preventable diseases, but lament the decline in participation.
Joanne Whitmore, chief cardiac nurse at the British Heart Foundation, said: ‘It is deeply worrying to see a decline in the number of people attending NHS health checks.’
‘Identifying and addressing risk factors that can cause conditions such as high blood pressure and high cholesterol is one of the most important ways to prevent heart attacks and strokes.
‘These checks save lives, so we urge everyone to take up the offer of a free NHS health check.’
Emily Jones, director of client consulting at consultancy Broadstone, said the falling adoption rate was “disappointing” and could be due to a number of factors.
‘The decline in attendance may be due to lack of time, difficulty contacting or reaching the local GP practice, concerns about what might be identified or simply a lack of awareness of the long-term health benefits of attending,’ she said.
An NHS spokesperson responded to questions from MailOnline: ‘The NHS carried out over 1.4 million NHS health checks last year, a near record number.’
‘These free MOTs in middle age are a great way to spot the early warning signs of potentially life-threatening conditions, such as high blood pressure, heart disease or type 2 diabetes. So if you’re aged between 40 and 74 and haven’t had an NHS health check yet, you should come forward and take advantage of an offer that could help you live a healthier, longer life.’
The NHS said 1.4 million checks was a record number, but the health service did not comment on the fact that this was the third lowest turnout in terms of the percentage of people eligible for an NHS health check.
Despite criticism and declining participation, the program continues year after year as primary care continues to struggle with increasing patient demand.
According to the RCGP, the average number of patients per fully qualified GP is now 2,294. This means that each GP is now responsible for an average of 154 more patients than five years ago.
Under the guidelines, GPs are not allowed to make more than 25 appointments per day to ensure ‘safe care’, but some doctors are reportedly having to squeeze in almost 60 in each working day.
If patients are struggling to get to their GP in time, it will impact on other aspects of NHS care, such as A&E. Patients are unable to access primary care for their health problems and are therefore seeking help in A&E.
Many GPs currently working in the system are retiring at the age of 50, moving abroad or into the private sector to cope with increasing demand and the administrative burden of the NHS.
This exodus threatens to worsen the workload crisis, as the remaining GPs have to make more and more appointments and the risk of burnout increases.
It is estimated that England needs around 4,000 additional GPs to meet current demand, with this number set to rise to over 7,000 over the next 12 years to meet the demands of a growing and ageing population.
Patients also report that they have difficulty contacting their GP in a timely manner.
Shocking figures from earlier this year showed that more than 3 million patients had to wait at least three weeks before they could see their GP.
Separate figures also show that GP satisfaction in England fell to its lowest level ever last year.
Data from the Office for National Statistics shows that only 71 per cent of patients in England reported a positive overall experience of GP care by 2023, up from 84 per cent in 2018.
The latest NHS data for May shows that only 65.1 per cent of GP appointments took place face-to-face, compared with around 80 per cent before the Covid outbreak.
Of these appointments, less than half (44.7 percent) took place with a real GP.
