Local authority commissioning of NHS Health Checks: a regression analysis of the first three years

Anne Mason, Dan Liu, Linda Marks, Howard Davis, David Hunter, Llinos Mary Jehu, Shelina Visram, Joanne Smithson

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Abstract

In April 2013, the public health function was transferred from the NHS to local government, making local authorities (LAs) responsible for commissioning the NHS Health Check programme. The programme aims to reduce preventable mortality and morbidity in people aged 40–74.

The national five-year ambition is to invite all eligible individuals and to achieve an uptake of 75%. This study evaluates the effects of LA expenditure on the programme’s invitation rates (the proportion of the eligible population invited to a health check), coverage rates (the proportion of the eligible population who received a health check) and uptake rates (attendance by those who received a formal invitation letter) in the first three years of the reforms. We ran negative binomial panel models and controlled for a range of confounders.

Over 2013/14–2015/16, the invitation rate, coverage rate and uptake rate averaged 57% 28% and 49% respectively. Higher per capita spend on the programme was associated with increases in both the invitation rate and coverage rate, but had no effect on the uptake rate. When we controlled for the LA invitation rate, the association between spend and coverage rate was smaller but remained statistically significant. This suggests that alternatives to formal invitation, such as opportunistic approaches in work places or sports centres, may be effective in influencing attendance.
Original languageEnglish
Pages (from-to)1035-1042
JournalHealth Policy
Early online date19 Jul 2018
DOIs
Publication statusPublished - 1 Sep 2018

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Regression Analysis
Health
Local Government
Statistical Models
Health Expenditures
Workplace
Population
Sports
Public Health
Morbidity
Mortality

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Mason, Anne ; Liu, Dan ; Marks, Linda ; Davis, Howard ; Hunter, David ; Jehu, Llinos Mary ; Visram, Shelina ; Smithson, Joanne. / Local authority commissioning of NHS Health Checks: a regression analysis of the first three years. In: Health Policy. 2018 ; pp. 1035-1042.
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abstract = "In April 2013, the public health function was transferred from the NHS to local government, making local authorities (LAs) responsible for commissioning the NHS Health Check programme. The programme aims to reduce preventable mortality and morbidity in people aged 40–74.The national five-year ambition is to invite all eligible individuals and to achieve an uptake of 75{\%}. This study evaluates the effects of LA expenditure on the programme’s invitation rates (the proportion of the eligible population invited to a health check), coverage rates (the proportion of the eligible population who received a health check) and uptake rates (attendance by those who received a formal invitation letter) in the first three years of the reforms. We ran negative binomial panel models and controlled for a range of confounders.Over 2013/14–2015/16, the invitation rate, coverage rate and uptake rate averaged 57{\%} 28{\%} and 49{\%} respectively. Higher per capita spend on the programme was associated with increases in both the invitation rate and coverage rate, but had no effect on the uptake rate. When we controlled for the LA invitation rate, the association between spend and coverage rate was smaller but remained statistically significant. This suggests that alternatives to formal invitation, such as opportunistic approaches in work places or sports centres, may be effective in influencing attendance.",
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Local authority commissioning of NHS Health Checks: a regression analysis of the first three years. / Mason, Anne; Liu, Dan; Marks, Linda; Davis, Howard; Hunter, David; Jehu, Llinos Mary; Visram, Shelina; Smithson, Joanne.

In: Health Policy, 01.09.2018, p. 1035-1042.

Research output: Contribution to journalArticleResearchpeer-review

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