Three leading medics say the checks for over-40s have prevented as few as 1,000 deaths a year at a cost to the NHS of about £450,000 each

The NHS is wasting £450m a year on health checks for 40-74-year-olds because they often fail to spot that someone is at risk of having a heart attack or stroke, doctors have said.

The “mid-life MOTs” are a waste of time, widely ignored by patients and not based on sound evidence, and the money would be better spent encouraging people to eat more healthily to reduce their risk offalling seriously ill, they say.

The NHS introduced health checks in England in 2009 as a way of identifying if middle-aged and older people were at risk of heart disease, diabetes, kidney disease, stroke or dementia, and intervening to reduce the chances of that happening.

Since 2013 it has paid local authorities to carry them out, and they use doctors, nurses, pharmacists and healthcare assistants to carry them out. Qualifying patients are offered one every five years.

But a report by three leading medics says the examinations are “costly and ineffective” and prevent as few as 1,000 deaths a year from the conditions they are meant to spot.

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The criticism of health checks is contained in an article in the Journal of Public Health by Walter Holland, emeritus professor of public health medicine at the London School of Economics, Simon Capewell, a prominent public health expert at Liverpool University, and Dr Margaret McCartney, a Glasgow GP and campaigner against “over-treatment” of patients.

The checks have such a poor success rate that each of the 1,000 deaths avoided costs the NHS about £450,000 – far in excess of the £3,000 per quality-adjusted life-year of extra life that the National Institute for Health and Care Excellence (Nice) claims. Nice’s figure is “rather fanciful”, they say.

The assessments only comply with one of the World Health Organisation’s 10 criteria for screening, the authors say. They also argue:

• The global risk scores used failed to detect risk of heart attack or stroke in between a third and half of all patients.

• Barely half those invited to have a health check turn up, with smokers, young men, poorer people and some ethnic groups particularly reluctant to attend.

• The checks do not reduce avoidable deaths to anywhere near the extent originally envisaged in 2009.

The £450m budget should be spent instead on tackling the poor diet, smoking, drinking and physical inactivity that causes 80% of strokes and heart attacks.

“We believe that many of our colleagues in the Department of Health, Public Health England and NHS England privately agree that NHS health checks are costly and ineffective. However, as civil servants they are obliged in public to ‘toe the party line’.

“Lacking an independent voice, they must be seen to support ministers even when the scientific evidence points in the opposite direction. They are obliged to see the emperor’s clothes where none exist,” they write.

Public Health England, which administers the scheme, admitted that while just over 3 million patients were offered a health check in 2014-15, just 1.4 million – barely 49% of invitees – actually came.

“Two-thirds of deaths under 75 are preventable, such as strokes and heart attacks, and the NHS health check aims to help people take action to prevent these diseases in a systematic and cost-effective way. Each component of the health check is evidenced and aligned with Nice guidelines,” said Jamie Waterall, PHE’s national lead for the health-check programme.

Dr Chaand Nagpaul, chair of the British Medical Association’s GP committee, said: “This report reflects concerns that the BMA have been expressing for years about the cost effectiveness of the health-check system and whether they deliver any real benefit to patients.

“Given how scarce NHS resources are, we cannot afford to be wasting them on politically driven schemes that are not backed up by a clear evidence base.”

Dr Maureen Baker, chair of the Royal College of GPs, said: “At the very least, we would push for a move away from blanket health checks for an entire age group, to a more targeted scheme based on good evidence, directed at certain groups of people, for example those with learning disabilities, who stand to gain most from regular checkups.

“We would also question whether, while GPs across the country are making more consultations than ever before, without sufficient resources to meet the increasing demand, that large-scale health checks are the best use of GPs’ time that could be used more effectively elsewhere.”