Less than half of eligible people have received a ‘midlife MOT’ from the NHS since 2019, watchdog says

Less than half of people over 40 in England are getting the heart health checks they are entitled to, according to the government’s spending watchdog.

The National Audit Office called for an investigation into how NHS health checks are being offered in England after it emerged that only 44% of eligible adults had attended one in the last five years.

The checks, known as midlife MOT, were introduced in 2009 to help identify people who are at higher risk of developing heart disease, stroke, kidney disease and diabetes and to provide tailored advice and treatment to help them manage their risk more effectively. control.

Heart disease affects an estimated 6.4 million people in England, costing the healthcare system £7.4 billion per year and the wider economy an estimated £15.8 billion per year. It contributed to a quarter of all deaths in England by 2022. In 2019, NHS England’s long-term plan set a target to prevent 150,000 cases of heart attacks, strokes and dementia by 2028-29.

People aged 40 to 74 without pre-existing cardiovascular disease or certain other health problems are eligible for a health check every five years.

Approximately 20% are invited for a check-up each year, reaching the entire eligible population over a five-year cycle. But in 2023/2024, only 8.8% were present – ​​which equates to 44% coverage over five years, according to the NAO.

Local authorities have been responsible for carrying out health checks since 2013, when elements of public health were transferred to municipalities. But the NAO found that in 2023/2024 only five local authorities provided health checks to everyone entitled to them.

The report, “progress in preventing cardiovascular disease”, calls on the government to assess whether local authorities are best placed to carry out health checks.

The Department of Health and Social Care should also “set clear targets for the numbers or percentages of the eligible population who should attend health checks, so that these are attended and not just offered,” the NAO said. And there should be incentives to ensure that those at highest risk for cardiovascular disease receive their checks.

Gareth Davies, head of the NAO, said: “Thousands of lives are lost every year to cardiovascular disease, while billions are spent fighting it.

“Health checks can play a crucial role in reducing these numbers, but the system is not working effectively, meaning not enough people are getting checks. This is an unsatisfactory basis for implementing an important public health intervention.

“The Department of Health and Social Care must address weaknesses in the current system for targeting and delivering health checks if it is to achieve the desired preventive effect.”

Commenting on the findings, David Fothergill, chairman of the Local Government Association’s community wellbeing board, said an £858 million cut to public health funding since 2015 had inevitably limited local authorities’ ability to fund these services. “This has led to a shift towards reactive care, despite evidence of the benefits of early intervention,” he added.

Professor Sir Stephen Powis, the national medical director of NHS England, urged people aged between 40 and 74 to have the NHS health check, saying: “These free mid-life MOTs are an essential way to to notice the early warning signs of possible life. threatening conditions such as high blood pressure, heart disease or type 2 diabetes.”

John Maingay, director of policy and advocacy at the British Heart Foundation, said: “So many cases of cardiovascular disease are preventable, yet it is alarming that premature death rates in England have risen since 2019.

“The government has an opportunity to think more radically about how we can better detect and prevent cardiovascular disease as it develops a 10-year health plan and continues its health mission.”

William Roberts, chief executive of the Royal Society for Public Health, said policymakers should consider offering health checks in the workplace, alongside pharmacies and dentists. “The most effective public health interventions meet people where they are,” he added.

A spokesperson for the Department of Health and Social Care said: “Since this research was conducted, we have begun trialling comprehensive heart health checks in workplaces, and we are developing a digital version of the check to provide people with an even more accessible and convenient service . .

“Our reforms will help us prevent and catch diseases earlier so they can be treated more quickly.”