The National Health Service (NHS) Health Check Programme aims to identify and manage patients in England aged 40-74 years with a 10-year cardiovascular disease (CVD) risk score over 20%. In an article published in the European Journal of Cardiovascular Prevention & Rehabilitation. Andrew Dalton and colleagues from the Department of Primary Care & Public Health at Imperial College London assessed the prevalence of high CVD risk in the English population, using the two CVD risk scores and the 20% cut off mandated in national policy, and the prevalence of risk factors within this population. They found that of those eligible for an NHS Health Check, 10.5% (2,012,000) had a risk score greater than 20% using the QRISK2 risk score; 22.0% (4,267,000) using Joint British Societies' (JBS2) score. To reduce risk in those at high CVD risk, we estimate the total costs of the Programme to be £176 million using QRISK2 or £378 million using JBS2. They concluded that a large number of high-risk patients will be identified by the NHS Health Check programme. The NHS must consider whether extra costs for the programme if JBS2 is used are justified.
NHS budgets are under considerable pressure. It is therefore unsurprising that many NHS Integrated Care Boards (ICBs) In England will aim to prioritise price in contract awards, But this approach is a significant threat to community-centred healthcare. While competitive tendering is a legally required, an excessive focus on costs in awarding NHS contracts risks overshadowing key factors such as established community trust, local expertise, and the long-term impact on continuity of care. This shift towards cheaper, often external, commercial providers threatens to cut the links between communities and their local health services. The argument that competitive tendering is solely about legal compliance, and not cost, is undermined by the very nature of such tendering, which by design encourages the lowest bid. This approach risks eroding the social fabric of local healthcare provision, where established relationships and understanding of specific community needs are essential. Establishe...

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