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<p>The NHS Health Check is offered to all 40-74 year olds without existing disease
once every five years. The check assesses family history of cardiovascular disease,
smoking status, alcohol use, levels of physical activity, body mass index, cholesterol
and blood pressure and uses information on age, gender and ethnicity to identify an
individual’s 10-year risk of developing cardiovascular disease. Where the results
of these tests indicate that a person is at high risk of diabetes and chronic kidney
disease then additional diagnostic tests, specifically HbA1c or serum creatinine respectively,
are undertaken.</p><p> </p><p> </p><p> </p><p>Data on eligible population having an
NHS Health Check has been collected nationally since 2011-12. Of those eligible 7.1%,
8.0% and 9.0% had an NHS Health Check in 2011-12, 2012-13 and 2013-14 respectively.</p><p>
</p><p> </p><p> </p><p>Cost-benefit modelling estimates the cost of the programme
to be £332 million each year at full roll out, with the average annual benefit to
be £3.678 billion. The cost-benefits of the programme primarily arise from the opportunity
it presents to prevent 1,600 heart attacks and strokes, and save at least 650 lives
each year. It also offers the opportunity to prevent over 4,000 people a year from
developing diabetes and detect at least 20,000 cases of diabetes or kidney disease
earlier, allowing individuals’ health to be better managed and improve their quality
of life.</p><p> </p><p> </p><p> </p><p>The findings from this cost-benefit modelling
further suggest that the programme is cost-effective, with potential savings to the
National Health Service of around £57 million per year after four years, rising to
£176 million per year after 15 years. This equates to a cost per quality-adjusted
life-year of around £3,000, which is considerably lower than the National Institute
for Health and Care Excellence’s threshold.</p><p> </p><p> </p><p> </p><p>The Government
is committed to bringing ever-greater scientific and clinical rigour to the programme.
Public Health England has established an Expert Scientific Clinical and Advisory panel,
formed of eminent clinicians and academics, which keep the evidence under review and
have recently published research priorities for consultation.</p><p> </p><p> </p><p>
</p><p>The Cochrane Centre review does add to the existing evidence base, however,
its generalisability to the NHS Health Check is limited. The studies that the review
considers are old, predominantly published in the 1960s. They were also undertaken
on people from different age groups and the ‘health checks’ that they consider are
not directly comparable to the NHS Health Check. For example, the age of the studies
means that the majority were carried out before statins were introduced into primary
care.</p><p> </p>
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