Abstract
BackgroundPostcode lotteries in health refer to differences in health care between different geographic areas. These have been previously associated with clinical services. However there has been little documentation of postcode lotteries relating to preventative health care services. This paper describes a postcode lottery effect in relation to the NHS Health Checks Programme (a national cardiovascular screening programme in England) in eight PCTs in the North West sector of London.MethodsA descriptive cross-sectional analysis of the Health Checks Programme was carried out in eight PCTs in North West London using a structured data-collecting instrument.ResultsThe analysis found variation in the implementation of the national Health Checks Programme in terms of: the screening approach taken; the allocated budget (which varied from £69,000 to £1.4 million per 100,000 eligible population); payment rates made to providers of Health Checks; tools used to identify and measure risk of cardiovascular disease and diabetes; monitoring and evaluation; and preventative services available following the health check.ConclusionsThis study identifies a postcode lottery effect related to a national public health programme. Although it is important to allow enough flexibility in the design of the Health Checks Programme so that it fits in with local factors, aspects of the programme may benefit from greater standardisation or stronger national guidance.
Highlights
Postcode lotteries in health refer to differences in health care between different geographic areas
This paper describes a ‘postcode lottery’ effect in relation to the NHS Health Checks Programme which was introduced in 2009 by the Department of Health (DH) to provide population-wide screening for cardiovascular disease (CVD)
Inconsistency in the way ‘pre-existing CVD’ was defined resulted in differences in eligibility: national guidance had not specified whether patients with hypertension and atrial fibrillation, or patients already on statin medication should be included or excluded from the Health Checks Programme
Summary
Postcode lotteries in health refer to differences in health care between different geographic areas. These have been previously associated with clinical services. There has been little documentation of postcode lotteries relating to preventative health care services. This paper describes a postcode lottery effect in relation to the NHS Health Checks Programme (a national cardiovascular screening programme in England) in eight PCTs in the North West sector of London. Postcode lotteries in health refer to variations in health care between different geographical areas that appear arbitrary and un-linked to health need. This paper describes a ‘postcode lottery’ effect in relation to the NHS Health Checks Programme which was introduced in 2009 by the Department of Health (DH) to provide population-wide screening for cardiovascular disease (CVD). The national programme aims to achieve full coverage of the target population over a five year period
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