Health inequalities scheme flagging as GPs shun 'charity work'

Between April and June this year only 2.7 per cent of eligible patients received a health check, designed to assesses people aged between 40 and 74 every five years for signs of heart disease, stroke, kidney disease and diabetes.

The national figure, published by the Department of Health, is well below the target of 18 per cent of eligible patients set out in the 2011-12 operating framework. Local figures range from none at 22 primary care trusts to 21.4 per cent at NHS Liverpool.

Some primary care trusts are reducing funding for the health checks. But board papers reveal that even where money is available, in some areas many GPs are opting not to provide the service.

For example, September board papers reveal only 26 out of 34 GP practices at East Leicester and Rutland clinical commissioning group have signed up to a local enhanced service to carry out health checks, despite additional funding being made available.

At West Leicester CCG, 33 out of 50 have signed up and at One Leicester CCG, 40 practices were not “providing any [health checks] activity” in the first quarter of 2011-12. A cluster-wide communications strategy is being developed for practices.

NHS West Midlands also calls the performance of NHS health checks “disappointing” in its September board papers, noting only five out of 17 PCTs achieved or exceeded their targets.

The programme was launched by former Labour prime minister Gordon Brown in 2009 and is due to be fully rolled out by 2012-13.

One CCG executive responsible for finance told HSJ the relative lack of funding available under the relevant locally enhanced service in his area meant health checks “could only be described as charity work”.

There was not “a shred of evidence that it is of any benefit on a population-wide basis” and many patients being screened were “asymptomatic”, he said.

Association of Directors of Public Health vice president Chris Packham said the programme would be more successful if it was better targeted at those with the greatest need. Areas that had focused resources in this way had experienced better sign-up among GPs, he claimed.

However, he doubted whether the NHS would be able to achieve the operating framework target this year and feared plans to make local authorities more responsible for public health may mean the programme is not even “given the priority it currently has”.

Strategic health authorities said the low take-up was being addressed in performance meetings and workshops with PCTs.