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Patient experience of NHS health checks: a systematic review and qualitative synthesis
  1. Juliet A Usher-Smith1,
  2. Emma Harte2,
  3. Calum MacLure2,
  4. Adam Martin3,
  5. Catherine L Saunders1,
  6. Catherine Meads4,
  7. Fiona M Walter1,
  8. Simon J Griffin1,5,
  9. Jonathan Mant1
  1. 1 The Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
  2. 2 RAND Europe, Westbrook Centre, Cambridge, UK
  3. 3 Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
  4. 4 Faculty of Health, Social Care and Education, Anglia Ruskin University, Cambridge, UK
  5. 5 MRC Epidemiology Unit, University of Cambridge, Institute of Metabolic Science, Cambridge, UK
  1. Correspondence to Dr Juliet A Usher-Smith; jau20{at}


Objective To review the experiences of patients attending NHS Health Checks in England.

Design A systematic review of quantitative and qualitative studies with a thematic synthesis of qualitative studies.

Data sources An electronic literature search of Medline, Embase, Health Management Information Consortium, Cumulative Index of Nursing and Allied Health Literature, Global Health, PsycInfo, Web of Science, OpenGrey, the Cochrane Library, National Health Service (NHS) Evidence, Google Scholar, Google, Clinical and the ISRCTN registry to 09/11/16 with no language restriction and manual screening of reference lists of all included papers.

Inclusion criteria Primary research reporting experiences of patients who have attended NHS Health Checks.

Results 20 studies met the inclusion criteria, 9 reporting quantitative data and 15 qualitative data. There were consistently high levels of reported satisfaction in surveys, with over 80% feeling that they had benefited from an NHS Health Check. Data from qualitative studies showed that the NHS Health Check had been perceived to act as a wake-up call for many who reported having gone on to make substantial lifestyle changes which they attributed to the NHS Health Check. However, some had been left with a feeling of unmet expectations, were confused about or unable to remember their risk scores, found the lifestyle advice too simplistic and non-personalised or were confused about follow-up.

Conclusions While participants were generally very supportive of the NHS Health Check programme and examples of behaviour change were reported, there are a number of areas where improvements could be made. These include greater clarity around the aims of the programme within the promotional material, more proactive support for lifestyle change and greater appreciation of the challenges of communicating risk and the limitations of relying on the risk score alone as a trigger for facilitating behaviour change.

  • NHS Health Check
  • patient experience
  • systematic review
  • qualitative synthesis

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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  • Contributors JUS developed the protocol, screened articles for inclusion, extracted and synthesised the quantitative and qualitative data, interpreted the findings and wrote the first draft of the manuscript. EH screened articles for inclusion, extracted and synthesised the qualitative data, interpreted the findings and critically revised the manuscript. CMa extracted and synthesised the qualitative data and critically revised the manuscript. AM screened articles for inclusion, interpreted the findings and critically revised the manuscript. CS, CM, FW, SG and JM developed the protocol, interpreted the findings and critically revised the manuscript.

  • Funding This work was funded by a grant from Public Health England. JUS was funded by an NIHR Clinical Lectureship and FW by an NIHR Clinician Scientist award. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. All researchers were independent of the funding body and the funder had no role in data collection, analysis and interpretation of data, in the writing of the report or decision to submit the article for publication.

  • Disclaimer The corresponding author has the right to grant on behalf of all authors and does grant on behalf of all authors, an exclusive licence on a worldwide basis to the BMJ Publishing Group Ltd and its Licensees to permit this article (if accepted) to be published in BMJ editions and any other BMJPGL products and sublicences to exploit all subsidiary rights, as set out in our licence (). All authors had full access to all of the data in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis The corresponding author affirms that the manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data are available from the reports or authors of the primary research. No additional data are available.