The NHS Health Check, health outcomes and health inequalities in England

About the NHS Health Check programme

Cardiovascular disease (CVD) accounts for around a quarter of all deaths and costs £15 billion annually in the UK. The National Health Service (NHS) Health Check programme was introduced in 2009 in England to systematically assess all adults in midlife for cardiovascular disease risk factors. It is one of the first such programmes in the world and is a key part of England's preventative healthcare strategy.

Annual health benefits from the NHS Health Check


There are 55.9m people in England. Every year about 730k (1.3%) of them turn 40 and become eligible for an NHS Health Check.





Our source is a 2018 study commissioned by Public Health England that uses a micro-simulation model to assess the health effects of the NHS Health Check.

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What if 80% of those eligible received an NHS Health Check at least once in their lifetime?

+300 fewer premature deaths before 80 years old every year

+1,000 more people living free of CVD, dementia, and lung cancer at aged 80 every year

+7,500 additional QALYs every year

+6,500 extra years of life given every year

The NHS Health Check and health inequality

Reductions in health inequalities

The programme has a greater absolute impact on health for those living in the most deprived areas compared to those living in the least deprived areas. The programme is likely to contribute to more equal health outcomes.

Least deprived people

Gain in QALYs is 3.3 days

Gain in life expectancy is 2.8 days

Most deprived people

Gain in QALYs is 5.1 days

Gain in life expectancy is 4.4 days

What are health inequalities?

There are stark differences in health outcomes across the UK – with a gap of almost 19 years in healthy life expectancy between the most and least deprived areas in England. Inequalities in power, money and resources at local and national levels can make people’s daily lives more challenging. In turn, this can make people more vulnerable to poor health.

Determinants of health: Source: Dahlgren and Whitehead

What causes health inequality?

Social, economic and environmental factors influence people's physical and mental health. Because these factors are not equal for all people they lead to systematic variations across the social spectrum, usually creating a link between income and health. It's easy to assume that individual behaviour, genetics, and national access to free healthcare is what leads to good or bad health. However, the data clearly shows that there is a strong and persistent link between income and health outcomes (e.g. number of years spent in good health, and life expectancy).

Determinants of health include natural environment (air quality, green spaces, and housing quality), educational attainment (the gap between most and least deprived areas achieving 5 GCSEs A*-C is substantial), income (households earning below the minimum income standards was 29.7% in 2016), employment and access to employment, and crime (there has been larger increases in crime in deprived areas in recent years and it was a wide range of health effects.)

One of the greatest illustrations of health inequalities is the difference in life expectancy seen when travelling from the wealthy end of a tube line to the poorer end.

Tube map of health inequality

Current and historical performance of the NHS Health Check programme

50-75% was the initial target

the target uptake set by Public Health, showing the programme is currently failing. NCBI.

79.8% were invited

of those eligible for an NHS Health Check were invited to one in the 2015-2020. PHE data.

37.6% received a screening

of those eligible for an NHS Health Check received one in the 2015-2020. PHE data.

Calculate the costs and benefits of your patient recall for NHS Health Checks with our new calculator.

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