Millions of people are missing out on health checks for potentially fatal conditions, an investigation has revealed, because cash-strapped hospitals deem them to be a low priority.As many as nine million patients may be missing out on checks designed to spot potentially fatal conditions such as heart disease and diabetes, unless current provision and uptake improve, according to the GP magazine investigation.
GP magazine sent Freedom of Information requests to all 151 primary care trusts (PCTs) in England, of which 118 responded.
The figures obtained show that, in 2011-12, 1.7 million checks were offered to patients: 14% of all those eligible for the programme. Around 920,000 checks were actually carried out. This is an increase on 2010-11 when 1.1 million checks were offered and 645,000 were carried out.
Around two thirds (64%) of PCTs did not provide enough NHS health checks to meet the Government’s 20% aspirational target in 2011-12, GP magazine said.
One fifth (21%) of PCTs admitted they will fail to meet the compulsory target in 2012-13, despite being given three years to prepare, the figures show.
Three PCTs did not provide a single check in 2011-12 and another provided just four checks.
A spokeswoman for NHS Cornwall and Isles of Scilly, which did not provide any checks in 2011-12, told GP magazine that the programme is not prioritised, “owing to other pressures”.
Nationally, patient uptake is falling, with only 54% attending a check in 2011-12, down from 60% in 2010-11. Just 11% of patients in NHS Portsmouth turned up for their check.
Despite government funding, six PCTs spent nothing on their programmes in 2011-12.
The figures also reveal a geographical disparity in funding for checks. In 2012-13, funding from PCTs varies from £1.3m in NHS West Sussex to just £28,452 in NHS Southampton City, GP magazine said.
Dr Richard Vautrey, deputy chairman of the British Medical Association’s GP committee, said: “The programme is done in such an ad hoc way, without central guidance. That’s why it is so patchy in uptake and, probably, effectiveness.
“It would have been far better to have greater national standards for the scheme, and national rates of payment for the scheme. This would have led to better cost and clinical effectiveness.”
Jules Payne, chief executive of the Heart UK charity, said: “It’s encouraging that the number of health checks conducted has increased on the previous year. However, these findings aren’t all good news. Some PCTs have indicated that they will deliver far fewer health checks than they should be, and there is enormous variance in PCT spending on health checks.
“This has all the classic ingredients of health inequalities and a postcode lottery for accessing services.”
Baroness Barbara Young, chief executive of the Diabetes UK charity, said public awareness needs to be raised.
“Something like this (the health checks) is pretty fundamental to tackling the rising tide of diabetes,” she said.
“I think the problem with the geographical disparity is that it has not actually been mandatory, it has been optional. Some PCTs have taken it very seriously, some haven’t. The other missing link in this is public awareness. It is hugely patchy.”
Natasha Stewart, senior cardiac nurse at the British Heart Foundation, said the lack of provision or uptake means many people are unaware that they have cardiovascular disease.
“The results of this survey reflect concerns that people aren’t being offered the check, or they are not taking the NHS up on their offer,” she said.
“This means there are a lot of people who are unaware they are living with cardiovascular diseases, or the risk factors which lead to them. Local authorities need to take health checks out into the community, rather than expecting the community to come to them.”