A national programme has been launched by the Department of Health to identify vulnerability to vascular diseases. Everyone between the ages of 40 and 74 will be entitled to the checks, which are expected to prevent up to 9,500 heart attacks and strokes every year.
Initial results from modelling work carried out by the department shows that a vascular check programme would prevent 4,000 people a year from developing diabetes. It could also detect at least 25,000 cases of diabetes or kidney disease earlier, allowing cases to be better managed and improving outcomes.
The checks would be based on straightforward questions and measurements such as age, sex, family history, height, weight and blood pressure. They would also include a simple blood test to measure cholesterol.
Everyone would receive a personal assessment report, setting out not only the person’s level of risk, but exactly what they could do to reduce it. For those at low risk, this might be no more than general advice on how best to stay healthy. Others may be assisted to join a weight management programme or a stop smoking service. Those at the highest risk might also require preventative medication with statins or blood pressure treatment.
The chairman of the charity Heart UK, Professor Andrew Neil welcomed the announcement – commenting: “Illness caused by heart disease costs the UK economy £2.9 billion a year and if unchecked will be the leading cause of disablement by 2020. We are especially pleased that family history will be checked, as inherited high cholesterol is an important contributor to cardiovascular risk.
Cardiovascular disease kills more men and women in the UK than any other disease and we hope that early detection will help prevent some of these deaths.”
However, Dr Laurence Buckman, chairman of the BMA’s GP Committee, said he had serious concerns about the pressure this will put on “an already overstretched general practice.” “Over a third of the population fall into the age range which for an average practice means two thousand patients. It could work out at 40 extra appointments a week – and that’s if they only need one appointment,” he commented. “If the process means they need two or three appointments, to ultimately be told they are fit and healthy, then you’re looking at doubling or tripling that number.
“Whether it is nurses, GPs, healthcare assistants or pharmacists who do these checks, there is not currently the workforce, the time in the day, or even the space in our surgeries to carry out this number of consultations. At the moment all our appointments are booked up with patients who are in immediate need of medical care.
“General practices already undertake health assessments for new patients covering things such as height, weight, blood pressure and urine testing. Those patients who are at risk regularly have their vascular risk factors checked including their cholesterol.”
Dr Buckman questioned the lack of scientific evidence behind the Government screening plans. He added: “To justify healthcare spending on this scale there would need to be very clear evidence that this is both cost and clinically effective. There have been no pilot schemes and the models the Government is using are theoretical. Inevitably large sale screening will impact on access to services for sick patients.”
