Times Online
Chris Smyth, Health Editor
Gerry Gajadharsingh writes:
A government requested study of almost 50,000 people into NHS health checks offered to millions of middle aged people found that only one in five of the over-40s bothered to turn up for the “midlife MoTs” and those that did barely cut their risk of disease. Every year about 1.3 million people are checked, with GPs paid for each one they carry out.
Even the GP’s know they are a waste of time and resources. Clare Gerada – a former chairwoman of the Royal College of GPs – said: “GPs have always known these checks were a waste of time that should be spent treating people who are actually sick.”
What we don’t know about the 80% of patients who did not “bother to turn up” was were they DNA (Did Not Attend), which is a huge waste of GP’s time, putting pressure on the already stretched GP appointment system, or did those patients also think the NHS health checks were a waste of time (as well as the GP’s).
I suspect that the parameters used to measure the patients’ “health” were inadequate or the GP’s ability to impart useful lifestyle improvements impaired by their lack of time with patients or their poor application/knowledge base to make it meaningful to patients. I know that a lot of clinicians and researchers accept that “lifestyle factors” plays a major part in many health conditions and they are also frustrated about the minimal impact they have in persuading patients to change. It would be interesting to know how much time is spent on disease prevention in medical undergraduate and GP postgraduate training. Maybe the NHS needs to invest in clinicians to help GP’s who have more expertise on this area, once Public Health Policy is updated. (My recent blogs have flagged up the lagging behind of current Public Health Policy (often by many years) compared to what clinicians (outside of the NHS) and research are providing and actually doing.
NHS health checks offered to millions of middle-aged people are a largely pointless waste of hundreds of millions of pounds, a government-ordered study has concluded.
Only one in five of the over-40s bothered to turn up for the “midlife MoTs” and those that did barely cut their risk of disease, the study of almost 50,000 people found.
Senior doctors have called for the health checks to be scrapped after finding that the £165 million-a-year scheme has to see 4,762 people to prevent only one heart attack or stroke.
People who had the health checks put on only a pound or two less than those who did not have one and had only tiny reductions in blood pressure and cholesterol levels, the study by Imperial College London found. They were also no more likely to quit smoking.
Public Health England has pledged to review the programme in light of the findings but insisted that trying to spot problems early was a sound principle.
Everyone aged between 40 and 74 is invited for the checks at their GP surgery every five years for tests of blood pressure, cholesterol, diabetes and kidney problems. The scheme has been dogged by controversy since its launch in 2009. Every year about 1.3 million people are checked, with GPs paid for each one they carry out.
Yet two years ago international experts warned that the health check programme “operates in direct conflict with the best available evidence” after analysis of 14 randomised trials of similar schemes found that they did not cut deaths or keep people out of hospital.
Health chiefs insisted that the NHS scheme was different and would be vindicated, but the analysis ordered by the Department of Health found only minimal benefits.
“It isn’t zero but it’s much smaller than the people who designed the programme hoped,” said Azeem Majeed, who led the study. “For any individual person the effects are so small that they wouldn’t notice them.”
He said that the scheme had not been designed rigorously enough and now needed to offer more consistent advice and find better ways of making sure people attended. “It needs a major overhaul and it needs to be run centrally rather than being left to each local area,” Professor Majeed said.
“Preventative healthcare is key to addressing the health challenges of the future. It is worth arguing for a bit longer to see if we can address the issues. If in a few years nothing much has changed then we’d have to question whether it should carry on.”
He looked at data on 138,788 people invited for checks at 462 GP surgeries, matching 29,672 who came for the check with the same number of similar people who did not. Over two years the heart disease risk of those who had the check fell by just 0.21 per cent, his team concludes in the Canadian Medical Association Journal.
Clare Gerada, a former chairwoman of the Royal College of GPs, said: “GPs have always known these checks were a waste of time that should be spent treating people who are actually sick.”