The NHS Health Check programme is ineffective and currently wasting £450 million a year, a new report by the London School of Economics and University of Liverpool has concluded.

The so-called NHS MOT was launched for the over 40s in 2009 to much fanfare, with claims that the scheme would prevent serious illnesses, such as heart disease and diabetes, as well as provide support and advice on both managing and reducing the risk of ill health.

However, according to the report, NHS Health Checks - a naked emperor?, published in the Journal of Public Health, the programme fails to deliver on both these objectives, and also “relies on weak concepts, denies strong scientific counter-evidence and ignores persistent implementation issues”.

The researchers assessed the scheme against each of the ten World Health Organisation Screening Criteria, and found it lacking in most areas, including: suitability - with the mismatch between predicted and actual events possibly approaching 50%; acceptability - with persistently low attendance rates; and effectiveness - with the researchers pointing to three decades of field research and actual measured outcomes has shown that screening has failed to substantially reduce death rates.

“At best modelling suggests that perhaps 1,000 deaths may be prevented”, according to the report, and it claims that preventing these deaths annually “could cost up to £450,000 per death avoided”. Moreover, it warns these costs “will obviously spiral substantially now that NICE have roughly doubled the number of potentially eligible people for treatment”. 

“These high costs are rarely acknowledged and often dismissed. They also make the much quoted NICE estimate of ‘around £3000 per QALY (quality-adjusted life-year)’ look rather fanciful,” it adds.

Under fire

Since its launch the Health Check has come under fire numerous times. Back in 2012, researchers from Denmark found that such schemes appeared to have no impact on either the number of overall deaths or those from cancer or heart disease. Some concluded that the programme was a waste of money, while others claimed that failures in its implementation have left thousands of patients undiagnosed.

The authors argue that the scheme is the result of “political obedience over scientific objectivity”, and are calling for public health decisions in the NHS to become independent of government. 

“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. 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,” the note.