Are the NHS Health Checks a waste of money?

By Benedict Jephcote
4th May 2016
In Depth
 
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‘Useless’, a ‘waste of money’ and ‘pointless’. These are some of the words and phrases that newspaper headlines have been using to describe the NHS Health Checks scheme for over 40s.

These are strong opinions, but how true are they?

The headlines follow a study appearing in the Canadian Medical Association Journal, which looked to evaluate how much effect the Health Checks scheme had in reducing risks of cardiovascular disease.

The scheme was initially rolled out in 2009 to improve early identification of people at risk of common long-term health conditions, such as type 2 diabetes, heart disease, stroke, kidney disease and dementia.

The study concluded that the health checks were associated with a modest reduction on cardiovascular risk.

Given that the Health Checks scheme costs the NHS around £300 million per year, the media’s argument is that the modest cardiovascular benefit is not worth the money.

Is the study doing justice to the Health Checks?

There are number of problems with the study.

One is that the results only compare risk factors of people who took the health checks with people who did not take the checks. The study does not make an attempt to investigate whether there was a benefit in those people at higher risk of the long-term illnesses.

Another problem is that the study only shows effects over a relatively short period of time. Take a diagnosis of diabetes as a prime example: if someone is diagnosed with diabetes, the benefits of an early diagnosis may take many years to show through. The study simply doesn’t take in enough years to give the Health Checks scheme a chance to show its benefits.

Lastly, a further problem with the study is that it doesn’t take into account the many ways in which an early diagnosis of these conditions can help people. An early diagnosis of diabetes can improve a person’s well-being and reduces the risk of many long-term health complications outside of cardiovascular health.

The power of early diagnosis

Whilst the checks may not be showing immediate benefits, the study cannot predict their true potential.

The NHS and the government would be well advised to hold fire on making any knee-jerk reactions to the Health Checks scheme as a result of this study.

The study showed that the health checks were particularly effective at improving early diagnosis of all the conditions and particularly for diabetes and hypertension (high blood pressure).

An early diagnosis of diabetes is very helpful towards reducing the risk of diabetes complications and giving people a realistic chance of managing their diabetes through diet with minimal diabetes medication or no diabetes meds at all.

How the health checks should be improved

As with many new initiatives, they’re as strong as their weakest part. If there’s one aspect about the health checks that may need reviewing, it’s what happens after a patient is diagnosed with one of the listed health problems.

Patients will also be given the standard lifestyle recommendations such as following a low-fat diet, which has been shown to have little effect on reducing heart disease rates.

Not only does the standard low-fat diet have little effect on heart disease rates, it is also a diet that has been consistently outperformed by lower-carb diets when it comes to improving diabetes control. Furthermore, low-carb diets allow patients to control type 2 diabetes with significantly less reliance on diabetes medication, and this means less exposure to side effects and other health risks.

So is it the fault of the Health Checks that heart risk factors are not improving after the checks, or is it the fault of the advice and treatment people are receiving? Also, are we giving enough time to assess the true benefits of the checks?

Let us know if you think the Health Checks scheme is a good thing or a waste of money.

What do you think?