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The NHS Health Check in England: an evaluation of the first 4?years

Robson, John; Dostal, Isabel; Sheikh, Aziz; Eldridge, Sandra; Madurasinghe, Vichithranie; Griffiths, Chris; Coupland, Carol; Hippisley-Cox, Julia


John Robson

Isabel Dostal

Aziz Sheikh

Sandra Eldridge

Vichithranie Madurasinghe

Chris Griffiths

Professor of Medical Statistics

Julia Hippisley-Cox


Objectives: To describe implementation of a new national preventive programme to reduce cardiovascular morbidity.

Design: Observational study over 4 years (April 2009—March 2013).

Setting: 655 general practices across England from the QResearch database.

Participants: Eligible adults aged 40–74 years including attendees at a National Health Service (NHS) Health Check.

Intervention: NHS Health Check: routine structured cardiovascular check with support for behavioural change and in those at highest risk, treatment of risk factors and newly identified comorbidity.

Results: Of 1.68 million people eligible for an NHS Health Check, 214 295 attended in the period 2009–12. Attendance quadrupled as the programme progressed; 5.8% in 2010 to 30.1% in 2012. Attendance was relatively higher among older people, of whom 19.6% of those eligible at age 60–74 years attended and 9.0% at age 40–59 years. Attendance by population groups at higher cardiovascular disease (CVD) risk, such as the more socially disadvantaged 14.9%, was higher than that of the more affluent 12.3%. Among attendees 7844 new cases of hypertension (38/1000 Checks), 1934 new cases of type 2 diabetes (9/1000 Checks) and 807 new cases of chronic kidney disease (4/1000 Checks) were identified. Of the 27 624 people found to be at high CVD risk (20% or more 10-year risk) when attending an NHS Health Check, 19.3% (5325) were newly prescribed statins and 8.8% (2438) were newly prescribed antihypertensive therapy.

Conclusions: NHS Health Check coverage was lower than expected but showed year-on-year improvement. Newly identified comorbidities were an important feature of the NHS Health Checks. Statin treatment at national scale for 1 in 5 attendees at highest CVD risk is likely to have contributed to important reductions in their CVD events.


Robson, J., Dostal, I., Sheikh, A., Eldridge, S., Madurasinghe, V., Griffiths, C., …Hippisley-Cox, J. (2016). The NHS Health Check in England: an evaluation of the first 4 years. BMJ Open, 6(1), Article e008840.

Journal Article Type Article
Acceptance Date Sep 28, 2015
Publication Date Jan 13, 2016
Deposit Date Apr 15, 2016
Publicly Available Date Apr 15, 2016
Journal BMJ Open
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 6
Issue 1
Article Number e008840
Public URL
Publisher URL
Related Public URLs


Robson BMJ Open 2016.pdf (988 Kb)

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