Bridging Health Divides: An Exploration of Barriers and Facilitators of NHS Health Checks in Socioeconomically Deprived Communities in the Tees Valley

EXECUTIVE SUMMARY
Background
The NHS Health Check programme is designed to reduce cardiovascular disease and other preventable conditions by identifying and addressing key risk factors. However, participation in the programme is often low, particularly in socioeconomically deprived areas. In the Tees Valley, health inequalities persist and access to preventive services can be challenging.
Rationale and Aim
There is a need to better understand the specific challenges faced by residents of deprived areas in accessing NHS Health Checks. By gaining insights both from community members and stakeholders involved in delivering the programme, the present study aimed to explore barriers and facilitators to NHS Health Check attendance in these underserved communities, in order to produce evidence-based recommendations that could enhance participation and, ultimately, reduce health inequalities in the region.
Method
A mixed-methods approach was used to explore public and stakeholder perspectives on NHS Health Checks. Qualitative interviews were conducted with 12 community members eligible for health checks from socioeconomically deprived areas of the Tees Valley (seven of whom had not had a check), and five stakeholders involved in the delivery of the programme. These interviews aimed to capture personal experiences, perceptions of the programme, and suggestions for improvement. Thematic analysis was used to identify recurring themes.
In addition to interviews, a survey was administered to Tees Valley community members living in socioeconomically deprived areas and eligible for NHS Health Checks. The survey covered key demographic information, awareness of the programme, and experiences of attending a Health Check. A total of 23 participants completed the survey, with most respondents from Stockton-on-Tees Borough Council and Hartlepool Borough Council. The average age of participants was 49 years, ranging from 40 to 74 years. Just over half of the participants were female and most were White British. The survey data were analysed alongside the qualitative data to provide a comprehensive understanding of barriers and facilitators to NHS Health Check attendance.
Findings
The study revealed several common barriers to attending NHS Health Checks. Limited awareness and unclear communication were significant obstacles, with many participants either unaware of the programme or unclear about its purpose and benefits. Fear of discovering health problems emerged as a psychological barrier, preventing some individuals from attending. Issues of mistrust and stigma within healthcare, particularly among marginalised groups, also discouraged participation.
Practical challenges such as difficulties in booking appointments, rigid GP schedules, and geographic obstacles were frequently cited as barriers. Many participants suggested that offering health checks in community settings and providing more flexible appointment options could increase attendance. Some individuals felt that self-monitoring their health reduced the need for formal checks, although this view was less prominent in the survey responses.
Despite these barriers, many participants expressed a willingness to attend health checks if communication and access were improved. Stakeholders echoed many of these concerns and highlighted the need for increased funding, better public awareness campaigns, and a more flexible, community-integrated delivery model.
Conclusion
The findings from this study highlight both barriers and opportunities for improving the NHS Health Check programme in socioeconomically deprived areas of the Tees Valley. Key challenges such as low awareness, fear, mistrust, and access difficulties must be addressed to increase participation. However, the willingness of many individuals to attend, if improvements are made, presents an opportunity for action. By implementing our recommendations, such as enhancing communication, offering more flexible appointment options, and fostering collaboration between local authorities and healthcare providers, the NHS Health Check programme could better serve socioeconomically deprived communities and contribute to reducing health inequalities in the Tees Valley.
Key Messages
• Most participants reported having a positive experience with the NHS Health Checks, with many expressing that they would willingly attend another. This reflects the programme’s success in delivering a valuable health service that resonates well with the community.
• Effective communication strategies are essential to raise awareness of the NHS Health Check programme, particularly in socioeconomically deprived areas.
• Efforts should focus on reducing the fear of negative health findings and building trust within marginalised communities.
• Offering flexible appointment times and community-based health checks could remove logistical barriers and increase participation.
• While some individuals feel confident in self-managing their health, there is an opportunity to integrate these practices into formal health checks.
• Promoting partnerships between local authorities, healthcare providers, and community organisations can enhance the reach and impact of the NHS Health Check programme.