Special edition e-bulletin: NHS Health Check review and recommendations

Clare Perkins, Deputy Director, Priorities and Programmes Division, Public Health England.

In early 2020, the Secretary of State commissioned Public Health England to conduct a review of the NHS Health Check to identify ways in which the programme could be developed further to support the NHS prevention agenda, and particularly to reduce inequalities in health outcomes.

The review, which was chaired by Professor John Deanfield, highlights that the NHS Health Check is achieving many of its aims, and millions of eligible people have been assessed. It makes a series of recommendations to Government on how the programme could go further in preventing non-communicable disease. It also links to the “Build Back Better” commitment to “explore turning the NHS Health Check programme into a National Prevention Service so that people can access checks, supporting individuals to be healthier and access the right treatments.”

 It makes 6 recommendations that, if implemented, will transform the programme over the next ten years to maximise its impact. In addition to the recommendations, the review stresses the importance of restoring the existing programme following the disruption to services caused by the COVID-19 pandemic.

Recommendations are based on 3 objectives: to empower people with the knowledge, tools and support they need to manage their own health better; to reduce inequality in health outcomes; and to provide a portal to a wide range of wellness initiatives.

1. Build sustained engagement

This key recommendation is to move from a one off ‘check’ every five years to a longitudinal programme of dialogue, measuring and managing risk factors from early adulthood.

2. Launch a digital offer

The digital revolution in healthcare has the potential to transform its efficiency and effectiveness – making it more proactive and personalised, enabling the redirection of resources to those at greatest risk, boosting health outcomes and readdressing health inequalities.

3. Start younger

Even small reductions in risk factors, by adopting healthier behaviour from an early age, can dramatically reduce the lifetime risk of heart attacks and strokes, as well as other conditions.

 4. Improve participation

Increasing participation across the eligible population is key, as well as prioritising those at greatest risk, taking into account factors such as deprivation, ethnicity and geography. The use of digital solutions could help improve accessibility and delivery of the new NHS Health Check - boosting uptake and scale.

 5. Address more conditions

The Programme focuses on preventing cardiometabolic diseases, as these remain a major cause of morbidity and mortality; but there is an opportunity to broaden the range of conditions, aiming to treat people not just diseases.

 6. Create a learning system

Robust evaluation is essential to maintain quality and rapid incorporation of innovation so that the Programme will always be at the cutting edge; a new ‘learning system’ would collaborate with academic programmes in the UK.

The full NHS Health Check review report and supporting annexes have been published by the new Office for Health Improvement and Disparities, and can be accessed here.