Only two out of every five adults called in for an ‘NHS Health Check’ actually took up the invitation in the latest blow to the multi-million scheme GPs have labelled ‘a waste of time and money’.
NHS Health Checks see every adult in England aged between 40 to 74 without a known health condition called into their GP for a series of tests every five years, with family doctors paid up to £40 for each one they carry out.
Tests include height and weight measurements, blood pressure, blood sugar, and general questions about health like smoking status, alcohol consumption as well as family history of conditions like heart disease.
Patients are then given results, which in the case of cardiovascular disease, are expressed as a score from low to high of them suffering an event like heart attack or stroke within the next decade.
They are then given general advice such as improving diet and exercise and, if needed, referred to specialist services like smoking cessation.
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Only two out of every five adults called in for an ‘ NHS Health Check’ actually took up the invitation in the latest blow to the multi-million scheme GPs have labelled ‘a waste of time and money’ (stock image)
But critics say the £165million-per-year scheme is a ‘waste of time and money’ as these checks should be carried out through routine appointments anyway.
Studies assessing the scheme have also found it only has a marginal impact on health outcomes, only preventing one heart attack or stroke every 10 years per some 5,000 people who attend.
The latest data on the scheme, for the 2023/24 financial year, shows it is also becoming increasingly unpopular with patients.
Despite a record 3.6million people being invited to take part that year , only 1.4million people did, about 40 per cent of the total.
This is a significant decline in turnout compared to the almost 50 per cent of the 2.8million people invited a decade ago having an NHS Health Check in 2013/14.
Dr Dean Eggitt, a GP from Doncaster, said in its current form the NHS’s midlife MOTs were ‘a waste of time and money’.
‘The way NHS Health Checks are conducted means it is likely to be a fruitless endeavour,’ he said.
‘We’re looking at the right problems, we’re screening populations for things we can and should help with…but the haphazard and solution-less way that’s being done is unlikely to help the population.’
He said that while in principle the NHS checks were looking at the right things and provided an opportunity to reach out to some patients, the execution of what the NHS did with that data, such as issuing general health advice, was flawed.
‘When we intervene with these patients we know we can buy them quality and quantity of life, and it’s the right thing to do,’ he said.
‘But if we’re going to screen people who are ill and not actively do something about it whilst we have the opportunity, what was the point in screening?’
‘This is where the execution fails, we’re not successfully tying up screening with a system that can then solve the problem.’
Dr Eggitt said part of the problem was that GPs simply didn’t have the time to do these type of checks proactively as part of routine care.
‘We need a return to old-fashioned general practice where the clinicians in your local GP surgery have the time to look after the whole person and not just the problem (they walk in with),’ he said.
‘We need to provide general practice with the resources to go back to old-fashioned holistic care.’
He said one general example of the wrong approach was smoking cessation.
Whereas previously family doctors could simply give patients who wanted to quit nicotine patches they now often have to go through a third-party smoking cessation service, creating unnecessary bureaucracy which lead to patients not singing up.
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Dr Eggitt added this third party outsourcing was often a problem in the NHS Health Check system.
He claimed it led to patients switching off when contacted as they didn’t recognise the provider and, much like smoking cessation, creating further barriers to meaningful health interventions.
‘By farming out the screening to an outside company we’re introducing more steps we’re prohibiting patients from getting the solutions to their problems.’
Senior GPs have also previously been highly critical of the NHS Health Check.
Former head of the Royal College of GP’s (RCGP), Dr Clare Gerada, previously labelled them a pointless exercise for family doctors.
‘GPs have always known these checks were a waste of time that should be spent treating people who are actually sick,’ she told The Times.
Her comments were on the back of a 2016 Imperial College London study which found the checks only prevented one cardiovascular event, like a stroke or heart attack, in following 10 years, for every 4,762 people who attended.
Other studies have suggested NHS Health Checks also have no significant impact on reducing deaths or hospital admissions.
Dr Gerada also previously described them as having ‘No benefit in terms of health from the mass screening of those who are well. Nor will it reduce the death rate from diabetes, heart and kidney disease.
In comments to the Health Service Journal she said that the checks identified ‘risk factors not diseases’ which could inevitably be ‘abnormalities’ that lead to patients being unnecessarily prescribed drugs or causing worry.
‘We run the risk of putting people on unnecessary medication or worrying them unduly,’ she said,
‘At a time when the NHS is having to slash its budgets and GPs and practice nurses are already at breaking point as a result of rising workloads and dwindling resources, this is not the best use of time or money that should be spent on caring for people who are sick or at high risk of illness.’
Current head of the RCGP, Professor Kamila Hawthorne, said while NHS Health checks can be ‘useful’ in early diagnosis family doctors were right to raise concerns.
‘College members have valid concerns around over-diagnosis and resource capacity at a time when general practice is already stretched – these are concerns the RCGP has previously raised, and it is important they continue to be considered as the NHS Health Check initiative progresses,’ she said.
Health charities, however, consider the NHS Health Checks to be an important tool to help people avoid risk of preventable diseases and have bemoaned declining uptake.
Joanne Whitmore, senior cardiac nurse at the British Heart Foundation said: ‘It’s very concerning to see a decline in the number of people attending their NHS health checks.’
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‘Identifying and managing risk factors that can cause conditions like high blood pressure and high cholesterol is one of the most important ways of preventing heart attacks and strokes.
‘These checks save lives, so we would urge everyone to take up the offer of a free NHS health check.’
Emily Jones, client consulting director at the consultancy Broadstone, said declining uptake was ‘disappointing’ and could be down to a number of factors.
‘The decline in uptake could be down to time constraints, challenges in contacting or accessing the local GP practice, anxieties around what may be identified or simply a lack of awareness about the long-term health benefits of attendance,’ she said.
Responding to MailOnline enquires an NHS spokesperson said: ‘The NHS delivered over 1.4 million NHS Health Checks last year – almost a record high.’
‘These free mid-life MOTs are a superb way of spotting the early warning signs of potentially life-threatening conditions such as high blood pressure, heart disease or type 2 diabetes, so if you are between 40 and 74 and haven’t had your NHS Health Check, you should come forward and take advantage of an offer which could help you enjoy a healthier and longer life.’
The NHS comment about 1.4million checks being a near record high as correct however, the health service didn’t comment on this being the third lowest turnout in terms of a proportion of people eligible for an NHS Health Check.
Despite criticisms, and declining uptake, the programme has continued to be rolled out year after year as GP services have continued to buckle under patient demand.
The RCGP says the average number of patients per fully qualified GP is now 2,294, meaning each family doctor is now, on average, responsible for 154 more patients than five years ago.
Under guidelines GPs are told not to deliver more than 25 appointments a day to ensure ‘safe care’. But some doctors are reportedly having to cram in nearly 60 in every workday.
Struggling to access timely GP appointments also has knock-on effects to other aspects of NHS care like A&E, with patients unable to get their health issues seen at the primary level seeking help from emergency departments.
Many of the GPs currently working in the system are now retiring in their 50s, moving abroad or leaving to work in the private sector because of soaring demand and NHS paperwork.
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This exodus risks exacerbating the workload crisis, as the remaining family doctors have to take on more and more appointments, increasing the risk burnout.
Estimates have calculated that England needs approximately 4,000 more GPs to meet current demands, with this figure rising to over just 7,000 to meet the demands of a growing and ageing population in the next 12 years,
Patients are also reporting struggles to access their GPs in a timely manner.
Shocking data earlier this year revealed more than 3million patients had to wait at least three weeks to see their family doctor.
Separate figures also demonstrate how GP satisfaction in the England last year dropped to its lowest level ever recorded.
Data gathered by the Office for National Statistics showed only 71 per cent of patients in England reported a positive overall experience of GP services in 2023, a decline from 84 per cent in 2018.
The latest NHS data for May shows only 65.1 per cent of GP practice appointments were held face-to-face – compared to about 80 per cent before Covid hit.
Of these appointments, less than half (44.7 per cent) were with an actual GP.
