NHS healthchecks ‘cost £450,000 for every life saved’

NHS health checks offered to over 40s are ineffective – and cost £450,000 for every life saved, research suggests.

The MOTs aims to help prevent heart disease, stroke, diabetes, kidney disease and certain types of dementia.

People aged 40 to 74 are invited once every five years to come to their GP surgery for checks on blood pressure, cholesterol, weight and questions about diet and lifestyle.

The national scheme, introduced by Labour in 2009, has been pursued by successive governments, but has been dogged by low take-up and concern about whether the money is well spent.

The NHS has said the checks will save 650 lives a year, prevent 1,600 heart attacks and strokes, prevent 4,000 people from developing Type 2 diabetes and detect at least 20,000 cases of Type 2 diabetes or kidney disease earlier.

The new study by the London School of Economics and the University of Liverpool, says that even if 1,000 lives were saved annually, it would be at a cost of £450,000 each.

The new study, published in the Journal of Public Health, said attempts to measure a patient’s risk of disease were not precise enough. Even when lifestyle advice was given, it rarely made any long term difference.

And researchers said common medications handed out to protect against heart disease, after the checks, had a minimal impact.

The scoring system to calculate risk of disease has “frustratingly low sensitivity and specificity for the individual patient”, the paper says, often missing more than one third of those at risk of heart attack and stroke.

In other cases, some patients may be given medication they do not need, the authors wrote.

Furthermore, giving people advice coupled with short-term behaviour changes “generally have little medium or long-term benefits”.

Preventive medications for blood pressure have only modest benefits, while statins to lower cholesterol “only have minimal mortality benefits in low-risk individuals”, they said.

Latest figures show less than half of eligible people take up the offer of healthchecks.

The authors, including Professor Simon Capewell, from the department of public health and policy at the University of Liverpool and Professor Walter Holland, from the London School of Economics, said many officials privately felt the scheme was not worthwhile, but felt pressure to support the national policy.

Highlighting previous research, they said: “health checks have been repeatedly shown to be ineffective,” suggesting the programme “denies strong scientific counter-evidence” that such schemes do not work.

The authors said health and council workers spent too much time promoting the checks.

“In spite of austerity policies, they are required to commit time and scarce resources to activities of debatable effectiveness and cost-effectiveness.

“This saps morale, particularly considering the substantial opportunity costs of failing to invest those scarce resources in alternative, more effective interventions.”

The authors said the £450m spent on the scheme could be better used spent in areas such as child health or promoting healthy food.

Such actions could halve early deaths for heart disease, they suggest.

“Many such policies are powerful, rapid, equitable and cost saving, for example, legislation supporting smoke-free public spaces or plain packs, alcohol minimum unit pricing, banning dietary trans-fats or slashing the daily dietary intake of salt or sugar.”

The researchers raised concerns that the checks were being promoted because health officials were more concerned with “political obedience” than scientific objectivity.

“We believe that many of our colleagues in the Department of Health, Public Health England and NHS England privately agree that NHS Health Checks are costly and ineffective,” they said.

“However, as civil servants they are obliged in public to ‘toe the party line’.

“Lacking an independent voice, they must be seen to support ministers even when the scientific evidence points in the opposite direction – they are obliged to see the Emperor’s clothes where none exist.”

Jamie Waterall, National lead for the NHS Health Check Programme, Public Health England said: “Two thirds of deaths under 75 are preventable, such as strokes and heart attacks, and the NHS Health Check aims to help people take action to prevent these diseases in a systematic and cost-effective way. Each component of the Health Check is evidenced and aligned with NICE guidelines.”