The NHS Health Check and mortality: do they help people live longer?

Today, we’re speaking to Dr Jasjot Saund, a public health registrar based in London. Title of paper: Association of the NHS Health Check with all-cause mortality: a longitudinal cohort study in primary careAvailable at: https://doi.org/10.3399/BJGP.2025.0451The NHS Health Check (NHS-HC) has been shown to improve detection and management of surrogate markers of health, such as blood pressure and cholesterol. The long-term impact, however, is less evidenced, with mortality reductions seen in a UK Biobank cohort and no mortality reduction seen in a Cochrane review of general health checks, including those outside the UK. The current study added real-world evidence from a diverse UK urban population, and a 15-year study period. Survival analysis of GP electronic health record data shows reduced mortality in those who attended an NHS-HC compared with those who did not. These findings should be interpreted cautiously given the observational nature of the study design.TranscriptThis transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.Speaker A00:00:01.440 - 00:00:58.570Hi and welcome to BJGP Interviews. I'm Nada Khan and I'm the senior research editor of the Journal. Thanks for taking the time today to listen to this podcast.In today's episode, we're talking to Dr. Jazjot Sound, a public health registrar based in London.We're here to discuss the paper she's recently published here in the BJGP titled Association of the NHS Health Check with All Cause Mortality, A Longitudinal Cohort Study in Primary Care. So thanks very much for joining us here today, Jazja.It's really great to talk about this work and I think just before we get into the study itself, we know that NHS health checks are something that most GPs will probably be very familiar with, but maybe we don't always stop and think about the evidence behind them. So, just to start off, I wonder if you can explain to us a little bit about, about what the NHS Health Check program is actually designed to do.Speaker B00:00:59.050 - 00:02:16.370Yeah, absolutely.So the NHS Health Check program was rolled out in 2009 and it's essentially a population level preventative initiative, focusing particularly on cardiovascular disease, but potentially wider as well.And so it's specifically targeted at people who are between the ages of 40 and 75 and who don't already have a, a cardiovascular disease or a known cardiovascular disease. And I think that's really important because it's targeting people who are potentially at risk or have undetected disease.And what this means is, so ultimately the health check itself, it consists of a check that's usually undertaken by primary care, so looking at lifestyle factors, modifiable risk factors, biochemical tests, as well as sort of just other general checks. And importantly, this is embedded into primary care pathways.So essentially it's ensuring that these patients are followed up if they are determined to be high risk and potentially put on prescriptions or followed up with lifestyle modifications. So that's generally what the health check is at the moment.Speaker A00:02:16.690 - 00:02:31.070Brilliant. Yeah. And I guess the big question behind this paper is, do they actually make a difference?And I wonder what did we actually know about the impact of NHS health checks before you started this work? So what was out there in the literature already?Speaker B00:02:31.550 - 00:04:07.320Yeah, so there is a, a huge amount of evidence in different parts of the health check. So you might be aware already that it's a multifaceted intervention. So there's, there's the process bits like uptake and invitation.So there's a big amount of evidence that's been telling us that it's really important that we even just the method of invitation can be really influential on who takes up the health check. But then there's also the specific parts of the check itself.So how we communicate risk to patients, for example, can have an impact on how people go home and take on lifestyle advice. And then there's the body of evidence that's closer to where this paper sits, which is looking at clinical outcomes.And there is a whole body of evidence looking at surrogate markers, so things like does it shift the marker on blood pressure or bmi. And then there's the evidence on mortality, for example, or clinical endpoints such as stroke.And so far the evidence is predominantly positive to say we do see a change in clinical outcomes.And more re