April 2013 was an important date for the NHS Health Check programme, as for the entire English NHS. The Health and Social Care Act brought the programme under the control of local government via new arrangements for public health. The programme offers everyone between the ages of 40 and 74 years screening for cardiovascular risk factors, diabetes, and renal disease with 5-yearly recall. Given difficult beginnings, including an uncertain evidence base and faltering roll-out, this article explores the programme’s current status, 1 year after its change in commissioner. We consider health checks against some of the key concepts outlined in standard criteria for screening, ‘Wilson’s criteria’: namely the condition’s importance; efficacy of the test and treatment; and arrangement of the programme. We ask whether it should remain, in its current form, the flagship of English cardiovascular disease (CVD) prevention. As CVD is the largest cause of morbidity and mortality internationally, the importance of prevention is self-evident. CVD reduction in high-income countries has arguably been the greatest population health improvement of the late 20th century. However, there is still room for improvement. Evidence suggests reductions in incidence are stalling while CVD remains a leading cause of premature mortality.1 An ageing population, leading to increased prevalence, and rising treatment costs, seem destined to force spiralling CVD spending. With aspects of the aetiology and natural history well known, CVD is a potentially important candidate for prevention and therefore screening. In screening, the test is used for the ‘presumptive identification of unrecognised disease or defects’. How, therefore, do health checks do this? CVD risk calculation is central to any intervention; however, there are questions about the calculators. …