Health: Screening

(asked on 1st December 2014) - View Source

Question to the Department of Health and Social Care:

To ask Her Majesty’s Government what is their assessment of the Nordic Cochrane Centre review of the evidence base supporting the NHS Health Check Scheme.


Answered by
Earl Howe Portrait
Earl Howe
Deputy Leader of the House of Lords
This question was answered on 15th December 2014

The NHS Health Check is offered to all 40-74 year olds without existing disease once every five years. The check assesses family history of cardiovascular disease, smoking status, alcohol use, levels of physical activity, body mass index, cholesterol and blood pressure and uses information on age, gender and ethnicity to identify an individual’s 10-year risk of developing cardiovascular disease. Where the results of these tests indicate that a person is at high risk of diabetes and chronic kidney disease then additional diagnostic tests, specifically HbA1c or serum creatinine respectively, are undertaken.

Data on eligible population having an NHS Health Check has been collected nationally since 2011-12. Of those eligible 7.1%, 8.0% and 9.0% had an NHS Health Check in 2011-12, 2012-13 and 2013-14 respectively.

Cost-benefit modelling estimates the cost of the programme to be £332 million each year at full roll out, with the average annual benefit to be £3.678 billion. The cost-benefits of the programme primarily arise from the opportunity it presents to prevent 1,600 heart attacks and strokes, and save at least 650 lives each year. It also offers the opportunity to prevent over 4,000 people a year from developing diabetes and detect at least 20,000 cases of diabetes or kidney disease earlier, allowing individuals’ health to be better managed and improve their quality of life.

The findings from this cost-benefit modelling further suggest that the programme is cost-effective, with potential savings to the National Health Service of around £57 million per year after four years, rising to £176 million per year after 15 years. This equates to a cost per quality-adjusted life-year of around £3,000, which is considerably lower than the National Institute for Health and Care Excellence’s threshold.

The Government is committed to bringing ever-greater scientific and clinical rigour to the programme. Public Health England has established an Expert Scientific Clinical and Advisory panel, formed of eminent clinicians and academics, which keep the evidence under review and have recently published research priorities for consultation.

The Cochrane Centre review does add to the existing evidence base, however, its generalisability to the NHS Health Check is limited. The studies that the review considers are old, predominantly published in the 1960s. They were also undertaken on people from different age groups and the ‘health checks’ that they consider are not directly comparable to the NHS Health Check. For example, the age of the studies means that the majority were carried out before statins were introduced into primary care.

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