This briefing summarises NICE's recommendations for local authorities and partner organisations that could be used to encourage people to have NHS Health Checks and support them to change their behaviour after the NHS Health Check and reduce their risk factors. It is particularly relevant to health and wellbeing boards.
Local authorities are now responsible for commissioning NHS Health Checks. The NHS Health Check is a national risk assessment and prevention programme. Everyone attending NHS Health Checks will have their risk of developing heart disease, stroke, diabetes and kidney disease assessed through a combination of their personal details, family history of illness, smoking, alcohol consumption, physical activity, body mass index (BMI), blood pressure and cholesterol. They should then be provided with individually tailored advice that will motivate them and support any necessary lifestyle changes to help them manage their risk. Where additional testing and follow up is needed, people should be referred to primary care services. People aged 65–74 will be told about the signs and symptoms of dementia and informed about memory clinics if needed.
This briefing should be read alongside the Department of Health and Public Health England's NHS Health Check Best Practice Guidance that contains detailed information on conducting the risk assessment and risk management pathways that constitute the programme, as well as local authority responsibilities.
NICE recognises the debate on the effectiveness of health checks that is ongoing at the time of publication of this briefing. Because the NHS Health Check programme is currently part of the health delivery infrastructure in England, NICE seeks to support its effective delivery. NICE notes that where delivery and uptake are sub-optimal and the lifestyle advice offered does not meet the person's needs, then there is a risk of the programme being ineffective.
The purpose of this briefing is to highlight NICE public health guidance that:
can help local authorities to increase the uptake of the NHS Health Check (particularly through identifying and supporting those least likely to take up the offer of a health check. See for example NICE guidance on Identifying and supporting people most at risk of dying prematurely)
may support those responsible for delivering the risk assessment and management processes
provides the most appropriate evidence-based advice and support for those who are identified as being at risk through the health check process.
Successfully implementing NHS Health Checks may help reduce chronic illnesses and avoidable premature mortality, as well as the health and social care costs related to long-term ill health and disability.
The Local Authorities Regulations 2013 set out legal duties for local authorities to make arrangements:
for NHS Health Checks to be offered to each eligible person aged 40–74 years once every 5 years and for each person to be recalled every 5 years if they remain eligible
so that the risk assessment includes specific tests and measurements, as well as to ensure the person having their health check is told their cardiovascular risk score and their other results
for specific information and data to be recorded and, where the risk assessment is conducted outside the person's GP practice, for that information to be forwarded to the person's GP.
Local authorities are also required to seek continuous improvement in the percentage of eligible individuals taking up their offer of NHS Health Checks. Further information on these provisions is provided in the NHS Health Check Best Practice Guidance.
The National Institute for Health and Care Excellence (NICE) is an independent organisation providing guidance and advice to improve health and social care.
For further information on how to use this briefing and how it was developed, see 'About this briefing'.
 People diagnosed with the following are excluded from the programme: coronary heart disease, chronic kidney disease, diabetes, hypertension, atrial fibrillation, transient ischaemic attack, hypercholesterolaemia, heart failure, peripheral arterial disease and stroke. Also excluded are people who are being prescribed statins or who have previously had an NHS Health Check, or any other check undertaken through the health service in England, and found to have a 20% or higher risk of developing cardiovascular disease over the next 10 years.