The National Audit Office has recommended that a review is conducted into the way that NHS Health Checks are provided for the prevention of cardiovascular disease, which costs the economy tens of billions of pounds every year.
In 2013, responsibility for commissioning health checks was transferred from the NHS to local authorities as part of the transfer of responsibility for some elements of public health. By doing this, a statutory requirement was put on authorities to offer health checks to all those who are eligible over a five-year period.
When this legislation was passed, the Department for Health and Social Care was not given the levers that it needed to influence local authorities’ performance. This then means that local authorities weren’t able to require general practices or other health providers to deliver those health checks, relying instead on voluntary agreements. Issues are then exacerbated when local authorities become unable to regularly access data to monitor the health check programme and ensure that checks are being delivered to those who are most at risk.
Considering these challenges, the National Audit Office has outlined a number of recommendations for improvement, with these including:
- Assessing whether local authorities are best place to deliver health checks
- Offering further incentives for the delivery of health checks to people at highest risk of cardiovascular disease
- Setting clear targets for the number of eligible people that who should attend health checks
Further to this, the Public Health Grant has reduced by 21% in real terms, from £4.48 billion in 2015-16 to £3.53 billion in 2023-24. During that same period, local authorities have seen spending on stopping smoking, obesity and physical activity reduced by 23% in real terms.
NAO Head Gareth Davies said:
“Each year thousands of lives are lost to cardiovascular disease, with billions of pounds spent tackling it.
“Health Checks can play a crucial role in bringing these numbers down, but the system isn’t working effectively, resulting in not enough people having checks. This is an unsatisfactory basis for delivering an important public health intervention.
“The Department of Health & Social Care needs to address the weaknesses in the current system for targeting and delivering Health Checks if it is to achieve the preventative effect it wants.”
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