Local authority commissioning of NHS Health Checks: a regression analysis of the first three years

Anne Mason, Dan Liu, Linda Marks, Howard Davis, David Hunter, Llinos Jehu, Shelina Visram, Joanne Smithson

Research output: Contribution to journalArticlepeer-review


In April 2013, the public health function was transferred from the NHS to local government, making local authorities (LAs) responsible for commissioning the NHS Health Check programme. The programme aims to reduce preventable mortality and morbidity in people aged 40 to 74.

The national five-year ambition is to invite all eligible individuals and to achieve an uptake of 75%. This study evaluates the effects of LA expenditure on the programme’s invitation rates (the proportion of the eligible population invited to a health check), coverage rates (the proportion of the eligible population who received a health check) and uptake rates (attendance by those who received a formal invitation letter) in the first three years of the reforms. We ran negative binomial panel models and controlled for a range of confounders.

Over 2013/14 to 2015/16, the invitation rate, coverage rate and uptake rate averaged 57% 28% and 49% respectively. Higher per capita spend on the programme was associated with increases in both the invitation rate and coverage rate, but had no effect on the uptake rate. When we controlled for the LA invitation rate, the association between spend and coverage rate was smaller but remained statistically significant. This suggests that alternatives to formal invitation, such as opportunistic approaches in work places or sports centres, may be effective in influencing attendance.
Original languageEnglish
Pages (from-to)1035-1042
Number of pages8
JournalHealth Policy
Issue number9
Early online date19 Jul 2018
Publication statusPublished - 3 Sep 2018

Bibliographical note

© 2018 Elsevier B.V. All rights reserved. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy.


  • Cardiovascular diseases
  • Preventative care
  • Primary prevention
  • NHS Health Check

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