CVD prevention: NHS Health Checks (2024)

Making the case for action

By promoting healthy ageing and tackling the top 7 risk factors for early death and disability, the NHS Health Check provides a cornerstone for the prevention of cardiovascular disease (CVD) and other diseases that share common risk factors. These include dementia, respiratory disease and some types of cancer. As a result, the Health Check programme has benefits across the health and social care system.

Everyone attending NHS Health Checks has their risk assessed by looking at their personal details, family history of illness, smoking, alcohol consumption, physical activity, body mass index, blood pressure and cholesterol levels. They are then given individually tailored advice that will motivate them and support any necessary lifestyle changes to help them lower their risk. Public Health England (PHE) has also published tips on encouraging people to attend NHS Health Checks.

The NHS HealthCheck website includes advice on restarting services during the COVID-19 pandemic.

The NHS Long Term Plan

The NHS Long Term Plan includes an ambition to prevent 150,000 strokes, heart attacks and dementia cases over the next 10 years by improving the detection and treatment of atrial fibrillation, hypertension and high cholesterol. To support this, a coalition led by PHE has agreed specific ambitions for detecting and managing these high-risk conditions (see Health matters: preventing cardiovascular disease).

The coalition highlights that more could be made of the opportunity the NHS Health Check gives to ensure that people at high risk of CVD are offered clinical management.

We've published guidance, quality standards and practical tools and resources to help improve local approaches to NHS Health Checks and support systematic detection and treatment of CVD risk factors.

Our guidance and quality standards are aligned to the NHS RightCare and PHE cardiovascular disease prevention pathway and will support the ambitions for CVD prevention.

Use data about your area

Reviewing data on what’s happening in your area helps you compare how you're doing with other areas and make decisions on how to improve care. These resources provide data related to CVD prevention, as well as estimating the potential impact of improving the uptake of NHS Health Checks and CVD prevention in each area:

• NHS Health Checks fact sheets and CVD prevention ‘size of the prize’ impact estimates show the potential impact of improving the uptake of NHS Health Checks and CVD prevention in each area.
• PHE’s latest NHS Health Check stocktake and action plan published in January 2018 has more details on how PHE is working with partners to support improvement in the programme over the coming 5 years.
• PHE’s cardiovascular disease profiles for each clinical commissioning group (CCG) cover coronary heart disease, diabetes, kidney disease and stroke.
• CVD Prevention Packs aim to provide information for the CVD prevention project. The CVD prevention programme set 10 year ambitions focussing on the 3 CVD risk factors: hypertension, atrial fibrillation and dyslipidaemia.
• GP Profiles cover a wide range of primary care indicators including cardiovascular diseases.
• RightCare's ‘where to look’ packs include headline opportunities, improvement opportunity tables and pathways on a page showing how CCGs in your area differ from their peers.
• PHE’s return on investment tool helps commissioners decide the best approach to preventing CVD in their populations, by showing predicted impacts of different interventions. Optimising use of statins and antihypertensives could bring some of the biggest cost savings.

NICE Guidance to support the implementation of NHS Health Checks

NICE guidance sets the standards for high-quality healthcare and encourages healthy living. Our topic pages on physical activity, diet, nutrition and obesity, smoking and tobacco and alcohol list our guidance in these areas, along with quality standards, NICE Pathways and other advice.

We have also produced a resource on the Making Every Contact Count programme, which links to guidance on helping people change their behaviour to live a healthy lifestyle. These principles apply equally to NHS Health Checks.

These guidelines will also help with encouraging people to attend NHS Health Checks and support them to reduce their risks:

• cardiovascular disease: risk assessment and reduction, including lipid modification
• cardiovascular disease: identifying and supporting people most at risk of dying early
• cardiovascular disease prevention
• dementia, disability and frailty in later life: mid-life approaches to delay or prevent onset
• hypertension in adults: diagnosis and management
• behaviour change: individual approaches
• community engagement: improving health and wellbeing and reducing health inequalities.

Using our Pathway for encouraging people to be physically active, you can easily drill down to the information you need. By clicking on the boxes in the flowchart, a summary of the relevant recommendations appears on the right. This includes hyperlinks to the actual guidance should you want more information.

Support for improving quality

We publish a range of tools and resources to help with putting our guidance and quality standards into practice. You can find these on the ‘tools and resources’ tab for each piece of guidance or standard.

NICE has endorsed various tools produced by other organisations that are in line with our guidance. These include:

• The Lipid management national treatment algorithm and pathway is a 2-page algorithm and pathway to provide a consistent approach to lipid management and modification across NHS organisations in England. It covers primary and secondary prevention, diagnosis, risk assessment, prescribing and monitoring.
• The Statin intolerance national algorithm and pathway is a 2-side algorithm and pathway supporting a consistent approach to managing statin intolerance across NHS organisations in England. It is for people at high risk of cardiovascular disease, who report potential intolerance to high intensity statin treatment.
• Breaking free is an online cognitive behavioural therapy (CBT) programme for people attempting to overcome difficulties with drug and alcohol usage, as well as any mental health issues associated with substance misuse. It's intended to be used in conjunction with healthcare professionals in all UK healthcare settings and the third sector.
• Via the RCGP introductory certificate in obesity, malnutrition and health, health professionals explore challenging aspects of putting obesity guidance into practice through a workbook and interactive workshops.
• PHE’s weight management: guidance for commissioners and providers is intended to support the commissioning and delivery of tier 2 weight management services for children, families and adults.
• The National Centre for Smoking Cessation and Training routes to quit model was developed to try and encourage more smokers, even if they're not ready to stop in the near future, to access services and engage with an evidence-based form of support.