Weighing up workplace, and NHS, health ‘MOTs’

Research now firmly questions the benefits of the NHS Health Check “health MOTs”, but that doesn’t mean employers should discount the value of offering their own workplace-based health screening.    

The NHS Health Check is commonly called the NHS’ “mid-life MOT” check, and is offered to people between the ages of 40-74.

The free health checks, which people arrange through their GPs, are available to people without any pre-existing conditions and primarily check circulatory and vascular health.

The mass screening initiative was launched back in 2009 and is estimated to be the largest cardiovascular disease risk assessment programme in the world, and is calculated to cost the NHS some £165m a year.

But clinicians and GPs have long been sceptical of the programme, with the Royal College of General Practitioners last year questioning whether there was robust enough evidence to warrant the checks continuing.

More recent doubts about them have been raised in a study by researchers from Imperial College London, which has argued the checks offer only “marginal” health benefits.

The study concluded the checks only reduced the 10-year risk of cardiovascular disease by 0.21%, and resulted in very small improvements in blood pressure, cholesterol levels and body mass index. There was no increase in the number of people who stopped smoking.

This 0.21% figure was the equivalent to just a single cardiovascular event, such as a stroke or heart attack, being avoided each year for 1 in every 4,762 people who attended a health check, the research in the Canadian Medical Association Journal said.

Kiara Chang, lead author of the research from the School of Public Health at Imperial, said: “Cardiovascular disease is the leading cause of death across the world – and so we urgently need effective initiatives to tackle the condition. However, these findings suggest the NHS Health Check scheme offers very modest benefits.”

 

What, then, should employers make of all this?

So should, by inference, employers that offer similar workplace health checks to their employees also now be taking a second look at this sort of health screening?

The BHWA’s position on this is clear: even if there are question-marks over the NHS Health Check programme, there is still great confidence in the wider benefits to employers of enabling employees to have a more bespoke health assessment through work-based schemes. And there is a positive track record to back this up.

Even on a practical level, the presumed similarities between what workplaces can offer, compared to the NHS offering are, in fact, slim. The actual take-up rate for the NHS Health Check is low, with only around a fifth (21%) of people eligible for a check attending their appointment, so employers are unwise to rely on this avenue.

Conversely, employers tend to think more broadly than the mid-life range and blanket approach applied by the NHS, and they usually opt to include all staff indiscriminate of age – with often as a result report much higher attendance and engagement rates.

Employers can tailor their programme to the job roles in question, and use the opportunity sensitively to address any health taboos troubling managers, or indeed employees themselves, in a more confidential and safe environment.

And the ensuing clinical data, though of course valuable in itself, is just the starting point.  By encouraging employees to engage with a workplace screening programme – whether that’s through following it up with health promotion activity or giving participants enablers, such as flexible hours, or adjustments that act upon recommendations – employers are sending out a strong and important health-related message.

This is, very simply, that you, as the employer, take the health and wellbeing of your employees seriously, and you are proactively encouraging people to take opportunities to change their lifestyles and health behaviours.

Promoting or allowing time off for the NHS Health “MOT” may imply this to an extent, but proactive employer-led screening sends out this message in spades.

For a front-line opinion, we turned to BHWA founder member Mark Braithwaite, managing director of Gipping Occupational Health.

He is adamant workplace health checks not only still have a place, but they are in fact an undeniably valuable specialist element of an employer’s health and wellbeing culture.

Employer-based workplace health checks are more meaningful in relation to a person’s job role than NHS Health Checks,” he points out. “Therefore people take on board health messages when they make the connection with job security and their health.”

There can also be advantages from the peer support often generated as a result, and the encouragement individuals tend to get from colleagues. Such checks can have a positive and long-term impact on an organisation’s workplace culture as well as on the individuals themselves, he suggests.

Braithwaite, in fact, even cites an example of how an individual in an organisation they worked with was helped as a result of workplace health screening.

The outcome of the health assessment highlighted an urgent need for the employee to address their weight. The OH advisor was able to spend time talking with the employee to better understand what barriers existed and how the employee could overcome these and start working towards improving their health.

“The employee made changes to lifestyle, which included an improved diet and taking more exercise, which all contributed to a steady and sustained improvement in his health. Initially, having a programme of workplace assessments –where employees were required to take part – meant he was unable to ‘avoid’ the issue.

Following this up as part of regular on-site services for the company, the OH advisor was then able to monitor the employee’s progress and stimulate engagement. Ultimately, the company and colleagues also offered encouragement and support and this then extended to the employee’s family, who also joined in with improving their diet and exercise.

“It was a successful ‘reality check’ that emphasised the impact of continuing with his current lifestyle habits, which included the risk of not being able to continue in his role because of his health issues, all of which were able to be done in a sensitive and supportive way outside of a clinical environment” Braithwaite points out.

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