Background to the report

Cardiovascular disease (CVD) is a general term for conditions affecting the heart or blood vessels, including heart attacks, strokes, heart failure and other arterial and aortic diseases. The British Heart Foundation estimates that there are approximately 6.4 million people in England living with CVD (as at September 2024).

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In 2022, CVD contributed to a quarter of deaths in England. Local authorities have a statutory duty to commission NHS Health Checks – used to help prevent CVD – for their local eligible population. While DHSC provides funding to local authorities for Health Checks through the public health grant, and retains policy responsibility, local authorities

Scope of the report

This report examines the effectiveness of the government‘s approach to identifying, preventing and managing CVD in England. It sets out:

  • levels and trends in CVD in England
  • the role of primary care in detecting and preventing CVD
  • commissioning, delivery and performance on Health Checks
  • wider public health work on preventing CVD

Video summary

Report director, Ashley McDougall, provides an overview.

Conclusions

Cardiovascular disease is one of the largest avoidable causes of death in England and undermines the ability of many to live healthy lives, at a cost of billions to the economy.

Health Checks are the government’s key means for identifying and supporting people at risk of CVD who are not routinely identified by primary care. Given the costs of CVD to the healthcare system and the wider economy, Health Checks have potential to deliver value for money.

However, there is currently no effective system for commissioning Health Checks, despite it being a statutory responsibility on local authorities. DHSC and local government have weak levers to encourage primary care or other services to deliver Health Checks.

As a result, in England, just under half of the annual eligible population attended a Health Check in 2023-24, and only 3% of local authorities delivered a Health Check for all of their annual eligible population in 2023-24. This is not a satisfactory basis for delivering an important and potentially life-saving and money-saving contribution to population health.

There is no systematic targeting of those most in need and there is wide variation in the number of Health Checks attended. DHSC and local authorities cannot routinely access data on what happens to people who receive checks so cannot assess the impact on health outcomes.

DHSC will need to more effectively incentivise and target Health Checks if it is to achieve the difference it wants and to embed them in a policy environment that promotes prevention rather than treatment.

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Publication details

Press release

View press release (13 Nov 2024)

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