NHS Health Checks 25/26

Healthwatch Norfolk conducted an independent evaluation of the NHS Health Check programme on behalf of Norfolk County Council Public Health to understand local residents’ awareness, experiences and perceptions of the service. The evaluation included a survey of 507 eligible respondents and two focus groups involving 12 participants. 

The report found that awareness and understanding of NHS Health Checks remain inconsistent. Although most respondents correctly understood that the checks assess risks relating to heart disease and diabetes, many people mistakenly believed that they also included screening for conditions such as cancer or mental health problems. Many participants described the programme as a general health “MOT”, demonstrating confusion about its actual purpose and scope. There was also uncertainty about eligibility criteria, with some people unsure who qualified for a check. 

Knowledge about where NHS Health Checks can be accessed was heavily focused on GP surgeries. While awareness of pharmacy-based checks had improved since 2023, relatively few people knew they could also access checks in community venues such as leisure centres, libraries and community centres. Some participants welcomed these alternative locations because they were more convenient, while others questioned whether care delivered outside traditional healthcare settings was of the same quality. 

Almost half of eligible respondents reported having received an NHS Health Check within the previous five years, representing an improvement compared with the 2023 survey. However, the most common reason for non-attendance was still not receiving an invitation. Many participants felt overlooked because they had never been invited, despite being eligible. The findings suggest that uptake is influenced not only by personal choice but also by the effectiveness of the invitation process. 

Respondents generally viewed NHS Health Checks positively. Most people said healthcare professionals explained the tests and results clearly, and nearly nine in ten participants who had attended a check said they would attend again in the future. Satisfaction levels were higher than those reported in the 2023 evaluation. 

Many participants reported benefits from attending a health check, including reassurance about their health, a better understanding of their wellbeing, healthier eating habits, weight loss and increased physical activity. Some attendees were referred for further tests, prescribed medication or signposted to lifestyle support services. However, more than one in five respondents said the health check had made no difference to them. 

The quality and usefulness of lifestyle advice varied considerably. While some people found the advice clear, helpful and motivating, others felt it was generic, lacked personal relevance or was not provided at all. Focus group participants frequently reported receiving little follow-up support after their appointment, and some expressed uncertainty about what action to take after receiving concerning results. 

The report concludes that NHS Health Checks are valued by those who attend and that awareness, uptake and satisfaction have improved since 2023. However, significant challenges remain around public understanding of the programme, invitation processes, awareness of eligibility and consistency in the delivery of information, advice and follow-up. 

Key Recommendations

The report recommends that Norfolk County Council Public Health:

1. Continue to strengthen communication and advertising campaigns using both digital and physical channels.
2. Improve and diversify invitation methods to ensure all eligible residents are invited.
3. Review how eligibility criteria are explained to the public.
4. Increase awareness of where NHS Health Checks can be accessed.
5. Ensure people understand where they can seek health advice between five-year health checks.
6. Encourage national review of the programme’s name and messaging, as the term “NHS Health Check” may contribute to misunderstanding about what the service provides. 

Overall Conclusion

The evaluation found that NHS Health Checks in Norfolk are largely well regarded and can provide reassurance, health education and early identification of cardiovascular risk. However, improved communication, clearer invitations, better public understanding and more consistent follow-up are needed if the programme is to achieve higher uptake and a greater impact on health outcomes.