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Increasing uptake of NHS Health Checks: a randomised controlled trial using GP computer prompts

Gold, Natalie and Tan, Karen and Sherlock, Joseph and Watson, Robin and Chadborn, Tim (2021) 'Increasing uptake of NHS Health Checks: a randomised controlled trial using GP computer prompts.', British Journal of General Practice, 71 (710). e693.


Background Public Health England wants to increase the uptake of the NHS Health Check (NHSHC), a cardiovascular disease prevention programme. Most invitations are sent by letter, but opportunistic invitations may be issued and verbal invitations have a higher rate of uptake. Prompting staff to issue opportunistic invitations might increase uptake. Aim To assess the effect on uptake of automated prompts to clinical staff to invite patients to NHSHC, delivered via primary care computer systems. Design and setting Pseudo-randomised controlled trial of patients eligible for the NHSHC attending GP practices in Southwark, London. Method Eligible patients were allocated into one of two conditions, (a) Prompt and (b) No Prompt, to clinical staff. The primary outcome was attendance at an NHSHC. Results Fifteen of 43 (34.88%) practices in Southwark were recruited; 7564 patients were eligible for an NHSHC, 3778 (49.95%) in the control and 3786 (50.05%) in the intervention. Attendance in the intervention arm was 454 (12.09%) compared with 280 (7.41%) in the control group, a total increase of 4.58% (OR = 2.28; 95% CI = 1.46 to 3.55; P<0.001). Regressions found an interaction between intervention and sex (OR = 0.65; 95% CI = 0.44 to 0.86, P = 0.004), with the intervention primarily effective on males. Comparing the probabilities of attendance for each age category across intervention and control suggests that the intervention was primarily effective for younger patients. Conclusion Prompts on computer systems in general practice were effective at improving the uptake of the NHSHC, especially for males and younger patients.

Item Type:Article
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Publisher statement:This article is Open Access: CC BY 4.0 licence (
Date accepted:13 April 2021
Date deposited:14 October 2021
Date of first online publication:26 August 2021
Date first made open access:14 October 2021

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