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

Lookup NU author(s): Emeritus Prof David Hunter, Dr Shelina Visram



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


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 Checkprogramme. The programme aims to reduce preventable mortality and morbidity in peopleaged 40 to 74.The national five-year ambition is to invite all eligible individuals and to achieve an uptake of75%. 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 (theproportion 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 thereforms. 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 withincreases 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 coveragerate was smaller but remained statistically significant. This suggests that alternatives toformal invitation, such as opportunistic approaches in work places or sports centres, may beeffective in influencing attendance.

Publication metadata

Author(s): Mason AR, Liu D, Marks L, Davis H, Hunter D, Jehu LM, Visram S, Smithson J

Publication type: Article

Publication status: Published

Journal: Health Policy

Year: 2018

Volume: 122

Issue: 9

Pages: 1035-1042

Print publication date: 01/09/2018

Online publication date: 19/07/2018

Acceptance date: 12/07/2018

Date deposited: 27/07/2018

ISSN (print): 0168-8510

ISSN (electronic): 1872-6054

Publisher: Elsevier Ireland Ltd.


DOI: 10.1016/j.healthpol.2018.07.010


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