Does the NHS Health Check need a rethink?

The NHS Health Check has been around for nearly a decade now, so is it time for a pause and think?

There is no doubt that the NHS Health Check has been hugely beneficial in identifying otherwise undiagnosed cases of hypertension, diabetes, high cholesterol, and chronic kidney disease...etc. The true benefits may not be measurable until decades down the line in terms of reduced mortality and morbidity due to early diagnosis.

Having said that, there is room for improvement!

My biggest issue with the NHS Health Check is, for a starter, its name. It should really be called the NHS Cardiovascular Health Check. I often worry that patients may think that it means a clean bill of health for everything if they’re told the results are okay.
Compared to other health checks provided by private firms it is less comprehensive and less adaptable to age and gender. Interestingly the NHS Health Check does not comprise a urinalysis or screening for cancers, no PSA for men who may want it and no breast examination for women. This confirms my first point that it is solely a cardiovascular health check. I think there is a real missed opportunity here!
It does not contain a written report element. This is a big downside and one that could easily be corrected. One of my quality improvement targets this year is to create a basic feedback report to give patients. The current status quo is basically: you’re ok if you Q risk is less than 10%!

So what should the ideal health check look like?

To me, it should screen for sleep apnoea, sleep disturbances, stress, depression and impaired cognition in the relevant subjects. Ideally, it should offer cancer screening when indicated and why not spirometry in smokers and ex-smokers.

I’d love to hear what else you can come up with in building the ultimate health check!

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