Multi-method study of a locally enhanced service to increase uptake of NHS Health Checks

  • Horwood, Jeremy (Principal Investigator)
  • Feder, Gene S (Co-Investigator)
  • Coghill, Nikki (Principal Investigator)
  • Riley, Ruth (Co-Investigator)
  • Montgomery, Alan A (Co-Investigator)

Project Details


NHS Health Checks is a national primary care-based initiative designed to estimate cardiovascular risk and to provide appropriate advice and treatment all patients aged 40-74. The aim of this study was to investigate whether attendance, uptake of treatments and reductions in risk factors are improved by the initiative, and equitable by socio-economic status and ethnicity. Researchers looked at routinely collected data from GP practices in Bristol between 2010 and 2014, assessing which patients followed up their invitation to attend an NHS Health Check. Over the data collection period, 31,881 invitations for an NHS Health Check were offered to eligible individuals and 13,733 checks were completed.

To examine the experiences of patients attending and healthcare professionals conducting NHS Health Checks, interviews were conducted with a purposive sample of 28 patients and 16 health care professionals recruited from eight general practices across a range of socio-economic localities.

Key findings

Slightly more women compared to men attended (53 per cent versus 47 per cent), and, from the target 40–74 age range, more patients aged over 60. People from the most deprived communities were less likely to attend than those from more affluent areas (39 per cent versus 47 per cent). The proportion of black, Asian and minority ethnic (BAME) people attending NHS Health Checks was lower than in Bristol’s overall population. However, ethnicity was poorly recorded by GP practices, particularly for those patients who didn’t attend an NHS Health Check. People with a high risk of heart attack or stroke were more likely to be prescribed a cardiovascular drug and referred to a behavioural lifestyle service such as smoking cessation, exercise or weight management. Patients referred to behavioural lifestyle management were more likely to be living in the most deprived areas.

Patients were motivated to attend an NHS Health Check because of health beliefs, the perceived value of the programme, a family history of cardiovascular and other diseases and expectations of receiving a general health assessment. Some patients reported benefits including reassurance and reinforcement of healthy lifestyles. Others experienced confusion and frustration about how results and advice were communicated, some having a poor understanding of the implications of their results. health care professionals raised concerns about the skill set of some staff to competently communicate risk and lifestyle information.
Effective start/end date1/02/123/02/15


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