A cross-sectional study examining the equitability of invitation, uptake and coverage for NHS Health Check

Background: The evidence for access to NHS Health Check (NHSHC) varies considerably across the country. This study examined the equity in invitation, uptake and coverage of NHSHC and impact of different invitation methods.

Methods: This patient-level cross-sectional study from 52 general practices in Walsall used adjusted logistic regressions to examine the association between patient characteristics (age, sex, ethnicity and deprivation) and NHSHC access.

Results: Over the 5-year study period, 61 464 people were eligible for NHSHC, 66% were invited, uptake was 74% and coverage was 55%. Males had lower odds of: invitation (AOR: 0.78, 95% CI: 0.75–0.81), uptake (0.73, 95% CI: 0.70–0.77) and coverage (0.69, 95% CI: 0.66–0.71). Compared with White, the ‘Other’ ethnicity group (mixed backgrounds, other Asians that are not South Asians and other ethnic groups) had lower odds of: invitation (0.74, 95% CI: 0.67–0.81), uptake (0.86, 95% CI: 0.75–0.98) and coverage (0.74, 95% CI: 0.68–0.81). The most deprived areas had lower odds of invitation, uptake and coverage. Opportunistic invitation had a 25-fold increase in odds of uptake.

Conclusions: The study has highlighted areas of inequities in access to NHSHC. The group most negatively affected were men, people from particular minority ethnic groups and people from deprived communities. Further actions are needed to reduce these inequities.