England’s MOT health test for people aged 40-74 years is ineffective, say researchers

The NHS health check programme is ineffective and wasting £450 million a year. In the image, patient has a health check with a GP

The NHS health check programme is ineffective and wastes £450m a year that could be better spent promoting a healthy lifestyle, according to research published in the Journal of Public Health

Researchers say the programme — described as a mid-life MOT for people aged 40–74 years in England — fails to meet a number of health screening criteria laid down by the World Health Organization (WHO). 

It fails on test suitability because the risk calculator has the potential to miss more than a third of people who go on to have a heart attack or stroke, the researchers argue.

The average uptake of the check — around 50% — means it also fails to achieve WHO criteria for being an acceptable test. The programme does not have a continued recruitment process, missing the mark on another WHO goal. 

The health checks prevent around 1,000 deaths a year, according to the study, and it is uncertain whether that figure meets WHO criteria regarding treatment effectiveness. And the annual cost of the scheme — estimated to be around £450m a year — throws into doubt whether it is cost effective according to WHO gold standards. The researchers calculate that each life saved is costing £450,000 a year. 

The researchers say that using resources to promote healthy eating has the potential to halve the development of early cardiovascular disease. They argue that at a time of austerity, healthcare professionals and local authorities are having to run a programme that has “debatable” health and cost effective benefits. At the same time, civil servants feel compelled to “toe the party line” and support government policy even if the evidence “points in the opposite direction”. 


[1] Capewell S, McCartney M & Holland W. Invited debate NHS Health Checks — a naked emperor? Journal of Public Health 2015;37:187–192. doi:10.1093/pubmed/fdv063

Last updated
The Pharmaceutical Journal, PJ, October 2015, Vol 295, No 7882;295(7882):DOI:10.1211/PJ.2015.20069454

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