A free health check at forty could save thousands of lives, doctors say.

Doctors across the region are calling for every adult to be offered a free health check at the age of forty, arguing that a single appointment of around half an hour could detect early signs of heart disease, diabetes and kidney problems in tens of thousands of people who currently have no idea they are at risk.

The proposal, set out in a report published on Monday by the Calder and Harrow Medical Society, estimates that a universal mid-life check could prevent around 2,300 heart attacks and strokes in the region over the next fifteen years and save as many as 4,000 lives over the longer term. It would cost an estimated £11m a year to deliver, a sum the report’s authors argue would be repaid several times over by avoided hospital admissions.

Health checks for adults in mid-life are currently offered only at the discretion of individual GP practices, and uptake varies enormously. In some parts of Calder, fewer than one in five eligible adults have had their blood pressure or cholesterol measured in the past five years.

What the check would involve

The report proposes a standard appointment, carried out by a practice nurse or trained health care assistant, at a GP surgery, pharmacy or community clinic. Patients would be invited by letter in the year of their fortieth birthday and again at forty-five and fifty. The check would include:

  • a blood pressure measurement, taken twice
  • a finger-prick or blood test for cholesterol and blood sugar
  • a urine test for early signs of kidney disease
  • height, weight and waist measurement
  • questions about smoking, alcohol, physical activity and family history
  • a calculated ten-year risk of heart attack or stroke, explained to the patient

Anyone found to be at high risk would be referred to their GP for further tests or treatment, while others would be offered advice, support to stop smoking or a place on a local exercise programme.

“Forty is the age at which the problems that kill people in their sixties are quietly getting started,” said Dr Helena Strachan, a cardiologist at Calder Royal Infirmary and one of the report’s authors. “High blood pressure and raised blood sugar have no symptoms. The only way to find them is to look.”

The evidence, and the doubts

Not everyone is convinced. Previous studies of general health checks have produced mixed results, with some large trials abroad finding little effect on overall death rates. Critics argue that checks tend to be taken up by the people least likely to need them – the health-conscious and the well-off – while those most at risk do not attend.

Dr Owen Lyall, a GP in the Selwyn district and a member of the regional primary care board, said he supported the principle but worried about capacity. “My practice already struggles to see people who are unwell,” he said. “If we are going to invite every forty-year-old in for a check, we need the staff and the appointments to do it properly, and to follow up on what we find. Otherwise we risk telling people they are at risk and then leaving them on a waiting list.”

The report’s authors acknowledge these concerns. They point to a pilot run in two Harrow practices last year, in which checks were offered in the evening and on Saturdays and invitations were followed up by a phone call. Uptake reached 62 per cent, compared with 23 per cent under the usual letter-only approach, and nearly one in eight people checked were found to have previously undiagnosed high blood pressure.

What happens next

The health committee of the Assembly is due to consider the proposal at its December meeting. The health minister has said she is “sympathetic” but wants to see detailed costings before committing funds in next year’s budget. In the meantime, doctors are urging anyone over forty who has not had their blood pressure checked in the last few years to ask for it. Many pharmacies in Calder already offer a free blood pressure test without an appointment. It takes five minutes, Dr Strachan said, and it might be the most useful five minutes of the year.