Attending an NHS Health Check was associated with lower mortality

For over ten years, the NHS Health Check has focused on numbers: how many people attend, how many leave with high cholesterol or blood pressure, and how many start a statin. Those measures matter, but they do not answer one key question: does the check actually translate to clinical benefit?

A team from Lambeth and the London School of Hygiene and Tropical Medicine has tried to answer that question using GP records. They tracked almost 159,000 people aged 40 to 74 without a history of heart disease, stroke, or hypertension from 2009 to 2023. Of these, 42,589 attended at least one check-up. The rest did not.

Attendance was associated with lower mortality

After adjusting for age, deprivation, ethnicity, smoking, alcohol and other factors, attendance was associated with a lower risk of death. The adjusted hazard ratio was 0.68, equivalent to a 32% lower relative risk. The gap widened with age. For people aged 70 to 74, the estimated ten-year risk of death fell from 18.1% to 12.9%.

Two features of the study stand out. The first is who it covered. More than 40% of participants were from Black, Asian, mixed, or other ethnic groups. Nearly two-thirds lived in the two poorest quintiles in England. Much of the evidence on the programme has come from more affluent and less diverse populations, so this adds something.

What the study can and cannot show

The second is how carefully the authors frame their result. Attendees were more likely to be overweight and to have a family history of heart disease, so they were not simply healthier people. The authors think that an unmeasured confounder would need a risk ratio of about 2 to explain the entire effect. They find this unlikely but cannot dismiss it. Cause of death is not reliably recorded, so the study cannot say which mechanism is responsible.

What this means for primary care

For GPs, the practical point is less about a single prescription and more about follow-up. The authors state that the findings back more investment in the programme, especially when integrated care systems assist with follow-up care. They also note that the study does not show how many attendees went on to treatment, which is a gap worth closing.

Randomised trials of general health checks often show little benefit. However, these trials examined various populations and interventions, which the authors note.

Reference

1. Saund J, Dodhia H, Vanoli J, et al. Association of the NHS Health Check with all-cause mortality: a longitudinal cohort study in primary care. Br J Gen Pract. 2026;76(770):e724-e733. https://doi.org/10.3399/BJGP.2025.0451