Invited debate: NHS Health Checks--a naked emperor?

We briefly review here the evidence that the NHS Health Checks (NHSHC) programme represents an ineffective strategy and is currently wasting scarce resources. The NHSHC programme invites everyone in England aged 40–74 without cardiovascular disease (CVD) for a check every 5 years. The NHSHC website advertises that health checks can • prevent heart disease, diabetes, kidney disease stroke and dementia, • provide support and advice to help individuals manage and reduce their risk of future disease.1 However, the NHSHC programme fails to achieve both of these primary objectives. Furthermore, it relies on weak concepts, denies strong scientific counter-evidence and ignores persistent implementation issues. The 10 World Health Organization (WHO) Screening Criteria have been evaluated and refined over four decades.2 They remain a valuable test of any screening proposal (Table 1). This is crucial, because all screening has the potential for harm, and screening science can be counterintuitive.3 The NHSHC programme can be assessed against each of the 10 WHO Criteria. These cover the disease targeted, the test used and the treatment programme. We assess each of these areas in turn and whether NHSHC pass or fail on each criterion.