The impact of NHS Health Checks on the prevalence of disease in general practices: a controlled study

Abstract

Background: NHS Health Checks is a national case-finding and vascular risk assessment programme in England. No research has been published to assess the impact of NHS Health Checks on the prevalence of chronic disease in GP practices.

Aim: To examine the impact of NHS Health Checks on the prevalence of hypertension, coronary heart disease (CHD), chronic kidney disease (CKD), atrial fibrillation (AF), and diabetes within practices, and compare this with usual medical care.

Design and setting: A non-randomised controlled study in a mixed rural and urban county in England.

Method: Thirty-eight GP practices provided NHS Health Checks over a 3-year period. Forty-one practices that did not provide Health Checks acted as controls. t-tests and multiple linear regression were used to assess the difference in prevalence of disease between intervention group and control group practices, and the impact of NHS Health Checks on this.

Results: Throughout the duration of the study, 1142 previously undiagnosed cases of disease were detected through a total of 16 669 NHS Health Checks. Despite this, there were no significant differences in the change to the prevalence of diabetes, hypertension, CHD, CKD, and AF in practices providing NHS Health Checks compared with control practices. Regression analysis did not demonstrate that there was any significant association between the proportion of the eligible population of a practice having completed NHS Health Checks and changes in the prevalence of the five conditions studied.

Conclusion: In practices providing NHS Health Checks, the change in the reported prevalence of diabetes, hypertension, CHD, CKD, and AF did not differ from that of practices providing usual care.

Keywords: cardiovascular disease; health checks; primary care; risk factors; screening.