While grateful to be receiving this free service, the fact that I only found out that I was eligible for it during a consultation on an unrelated matter suggested all was not well with the system. 

This disconnect between aspiration and practice on early intervention and prevention was highlighted in a new NAO report on cardiovascular health checks by the National Audit Office this month, which reveals only 3% of local authorities delivered a health check to all of their eligible population in 2023-24.

Even more shockingly less than half (11m) of the 23.5m to be invited for a health check in the last decade actually turned up! 

Since local government was given the statutory duty to commission NHS Health Checks in 2013, the Public Health Grant, used by councils to fund health checks and other health services, has fallen by 21% in real terms down from £4.48bn in 2015-16 to £3.53bn in 2023-24. During the same period, local authority spending on stopping smoking, obesity and physical activity, was down by 23% in real terms, from £340m to £262m (in 2023-24 prices).

The NAO report found a number of problems with the delivery of NHS Health Checks, including a lack of powers for the DHSC on assessment of local authorities (LAs) performance, LAs' inability to require GPs to deliver checks and a lack of data to monitor effective programme delivery. 

Clearly there remains much work to do if the Government is to deliver on its ‘three big shifts' aspiration of moving from sickness to prevention. 

By Lee Peart, Editor of Healthcare Management