Variations in the organization and delivery of the 'NHS health check' in primary care

J Public Health (Oxf). 2013 Mar;35(1):85-91. doi: 10.1093/pubmed/fds062. Epub 2012 Jul 24.


Background: To evaluate the organization of the new cardiovascular risk assessment programme, NHS Health Checks, in general practices.

Methods: All 99 general practices in two inner London boroughs were invited to participate in a cross-sectional survey by completing an online questionnaire.

Results: Data were analysed for 66/99 (67%) eligible practices. Training attended for delivering the Health Check included measurement methods (43%), delivering risk information (65%) and advising on lifestyle change (62%). The Framingham risk score was used by 66% of practices, the QRisk score by 12% and both by 8%. Advice given to patients identified as high risk was 'usually' brief at 26% of practices, advice was given verbally at 92% of practices, in written form at 74% and through interactive visual materials at 29%. Statins were 'usually' prescribed to high-risk patients by 34% of practices and antihypertensive drugs by 22%. The follow-up of high-risk patients was by means of a register with regular recall at 51% of general practices.

Conclusions: There is considerable diversity in general practices' implementation of the NHS Health Check. A formal quality assurance process may be required in order to optimize the implementation of the NHS cardiovascular risk assessment programme.

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / prevention & control*
  • Cardiovascular Diseases / therapy
  • Cross-Sectional Studies
  • Delivery of Health Care / organization & administration*
  • General Practice / organization & administration
  • General Practice / standards
  • Health Promotion*
  • Humans
  • London
  • Middle Aged
  • Primary Health Care / organization & administration*
  • Program Evaluation
  • Risk Assessment / methods
  • Risk Assessment / organization & administration
  • Risk Assessment / standards
  • State Medicine / organization & administration*
  • Surveys and Questionnaires
  • United Kingdom