4. Community Insights on Health Checks
Cardiovascular ‘health checks’ refer to a broad range of preventative assessments delivered across a variety of settings, including general practice (such as the NHS Health Check), pharmacies, health buses, and community venues. Further details are provided in section 5. While these assessments vary in scope, they often include measuring of blood pressure, weight, and other cardiovascular risk factors, in order to understand risk, detect problems early, and provide advice and support to reduce that risk. As such, they can be thought of as a health ‘MOT’. The NHS Health Check programme specifically is a national cardiovascular disease prevention programme that offers adults aged 40 to 74 years a risk assessment every five years, commissioned by public health and delivered primarily in general practice.
4.1 Survey
As part of a local service equity audit in 2025, we surveyed 41 Camden residents about their awareness of the NHS Health Check programme, as well as their perceptions of its benefits and satisfaction with the service. Most respondents were female (61%), and participants were evenly distributed across the eligible age groups. By ethnic group, the largest proportion of respondents identified as Asian (39%), followed by White (29%) and Black (20%).
Main findings
When asked about their knowledge of the service, 61% of survey respondents were aware of the NHS Health Check programme. GP practices, including invitation letters, and family and friends were the most frequently cited sources of information. Other commonly reported sources included the NHS website, the NHS app and advertisements.
Respondents expected the service to provide advice on staying healthy, as well as support for the prevention and early detection of cardiovascular disease, stroke, diabetes, kidney disease and dementia. Less than half of respondents (46%) were aware of where they could access the service.
Overall, 29% of respondents had received an NHS Health Check, most commonly through their GP practice (20%), with smaller proportions accessing the service at community events (5%) or via the mobile health bus (5%). Meanwhile, 15% reported that they had not received an invitation. Among those who had received an NHS Health Check, 15% reported being satisfied or very satisfied with the service. Respondents particularly valued receiving information about their body mass index (BMI), blood pressure, cholesterol levels, physical activity and diabetes risk.
Awareness of referral pathways to community lifestyle services appeared limited. Apart from respondents who were not eligible for these services, most were unaware of this potential next step following a health check. This was reflected in the low level of reported lifestyle changes following the check.
4.2 Focus groups
We conducted a focus group discussion in November 2025 with 20 Camden residents to understand their awareness, access, experience and perceived impact of the NHS Health Check service delivered in general practice. However, these discussions also generated insights regarding the wider health check programme for cardiovascular diseases delivered in other settings such as the Camden Health & Wellbeing bus and pharmacies. Participants aged 30 years and over were recruited via the Health and Wellbeing bus, community champions, voluntary and community sector organisations and our primary care e-bulletins. Most participants were female (85%), and there was good representation across age groups. In terms of ethnicity, 70% of participants identified as Asian, 10% as Black and 10% as White. Deductive thematic analysis was undertaken with other emerging themes featured in the findings. The main themes and findings are described below.
Main findings
Awareness
Across focus group participants, there was limited awareness of the GP-practice based NHS Health Check service, who it is for, the type of care provided as part of the service and what kind of support can be expected. The few participants who knew of the service were notified by text or via the NHS app. There was greater awareness of the mobile health bus regularly seen in their vicinities and advertised in newsletters, and greater awareness of the pharmacy-based checks. A more comprehensive approach to communication and promotion was suggested, such as GP practice websites, emails, social media platforms such as Facebook and YouTube, community centres, newsletters and local publications. Information and invitations provided in community languages were considered particularly important for improving awareness and uptake. Stronger collaboration between GP practices and community organisations was also suggested as a way to improve awareness.
“Is it the one where you have the mobile bus and stuff or is it the one where you get asked to do when your 50?”
“Is it something like the bowel cancer test, or smear test?”
Invitations and communications
Participants highlighted several challenges relating to invitations and communications about the NHS Health Check service. Some recalled receiving text message invitations but reported ignoring them because the wording resembled generic health promotion messages, such as reminders about “staying on top of your health”, rather than clearly communicating the purpose and value of the service. In some cases, invitations were mistaken for promotional messages from private health providers or other commercial services.
Participants felt that invitations and reminders should provide more detailed information about what the assessment involves, who it is for, and why it is important. Several residents noted that they would have been more likely to attend had they known the appointment would include checks for blood pressure, cholesterol, and diabetes risk. Clearer explanations of what tests would be undertaken, who would conduct them, and how the results could support long-term health were seen as important.
“Do they actually have a breakdown on what actually happens in a health check, so that for someone who’s new to this they know what to expect? Because sometimes, I think, do I make time for this, would it be worthwhile, these things happen in your mind. So maybe a breakdown in the communications on what actually happens.”
Reasons for non-attendance
Several barriers to attendance were identified. Difficulties accessing appointments were frequently mentioned. There were also frustrations with telephone-based appointment booking systems, which some residents described as inconvenient and ineffective. Some participants felt there was little personal relevance to attending a health check, because they did not have a family history of cardiovascular disease and were not currently experiencing symptoms; a challenge given many cardiovascular risk factors are asymptomatic.
“If they have a slot, it’s not suitable for you because appointments aren’t available like they used to be. Now it’s three weeks, two weeks waiting, unlike before it was come tomorrow.”
“You feel fine, you look fit, so maybe people don’t feel the need for it. When you’re feeling fine, fit and healthy, how often will you go to a GP for a screening test? Same for parents, partners and friends, if they feel fine they won’t go often.”
Experience of health checks
Some participants praised their GP practices for consistently providing accessible, personalised and responsive services. Positive experiences of the NHS Health check service were linked to clear results, supportive staff, and holistic explanations. However, there was also significant dissatisfaction with the experience. Many cited how fragmented and long-winded the process was, with the range of assessments happening at different places and time points, sometimes unaided, and with little follow up information – for example, where technology was used, such as kiosk devices. Furthermore, there was often no explanation of what the results meant for them. Some described the service as a “test results recording exercise” with little practical value beyond having the blood tests done. More information about the results, their implications for their daily living, and next steps in terms of either how to access local community support or request a follow-up appointment, were suggested improvements. Some assumed that no follow-up communications meant normal results, but there was also a fear that this could mean they had “slipped through the system” leaving them unsure what further action was required. For those who were referred to onward services, this was accompanied with long waiting times and sometimes ended abruptly with a lack of follow-up. More broadly, for some participants, previous negative experiences with healthcare staff led to a reluctance to access and engage with preventative care.
“I also find that they just take a record when I had mine, they didn’t exactly say, right, what are we going to change or what are you going to change. They don’t care. You’ve lost a few inches in height and gained a few pounds in weight, and they just jotted it all down. It wasn’t helpful for me. It was more like a data collecting exercise. The only thing I took away from it is I’d got shorter and that was it. They didn’t say to me you could lose a bit of weight or how to get better.”
Inclusivity
Across the board, participants commended efforts by their GP practices to make services inclusive, including the availability of interpreters and accessible signage for people with visual or hearing impairments. However, some noted that interpreter services could be further improved through greater recognition of the different dialects spoken within language groups.
“When you actually make an appointment you should say ‘I need an interpreter or I need an advocate’. That would help things because I know now in GP surgeries, the signage is a lot more inclusive of different languages and also if you’re blind or deaf, so as long as you say you need more help.”
Perceived value of the service
Where participants understood the purpose of the NHS Health Check service, they recognised its potential value. Early detection of conditions such as high blood pressure, diabetes and raised cholesterol was viewed as a key benefit, particularly where diagnosis could support timely intervention and reduce the risk of future ill health. Participants valued the opportunity to identify health risks before symptoms develop and saw the service as a means of preventing, delaying or managing long-term conditions. Participants also expected health checks to provide practical support for improving health behaviours, including smoking cessation, increasing physical activity, weight management and wider lifestyle advice.
“I think there is benefit in it. So recently I had a routine blood test and I’ve got a bit of high triglycerides, so I thought, look, if I didn’t have those routine bloods, I would not know. So like now at least I know what not to eat and that I have to monitor my health.”
“Obviously it’s telling you what’s your body’s like inside. You can see that you might have put on weight or something else. When you get older, your metabolism changes and you are prone to more high blood pressure and diabetes, so it’s good to see how you’re doing. And I’m pretty sure they ask if you smoke and try and see if you can stop smoking. So it’s trying to get you to have a healthier lifestyle. And they ask you if you exercise, so it all helps.”
Community outreach services
Beyond NHS Health Check in GP practices, participants appreciated other forms of health checks in the community, such as the Camden Health and Wellbeing Bus. Those who had accessed the service described it as a quick, convenient and efficient way to receive health checks, which could be easily incorporated into busy daily schedules. Others who were more hesitant to engage with traditional NHS services or visit their GP saw this as a valuable opportunity. Participants particularly valued the personalised conversations they had with practitioners about reducing blood pressure, achieving a healthy weight and improving their overall health. They also appreciated its visibility in community settings, including near homes and schools. However, some felt that the scope of services available on the bus was limited, restricting the extent of support residents could receive. Others suggested increased outreach efforts to engage with unreached community groups.
“It would help if people are scared of going to their doctors, because you feel a bit more anonymous. I know obviously they would pass your information on but it might be the first step if you’re a bit worried about something.”
Follow up
Despite receiving lifestyle advice during health check conversations, many participants remained unaware of the local services and activities that could support healthier behaviours. Cost was frequently cited as a barrier to making changes, particularly where recommendations involved paid activities such as gym memberships. Participants felt that health check discussions should place greater emphasis on signposting residents to free or low-cost community resources. One recommendation was the provision of a follow-up text message summarising key results, recommended lifestyle changes and relevant community resources. Such messages were seen as a useful reference point that could reinforce advice provided during appointments and support residents to make practical changes in their everyday lives. Participants stressed that dietary advice should be culturally relevant and focus on realistic adaptations to traditional foods, rather than promoting complete dietary substitutions.
“…because sometimes a South Asian household, they might stick to their diet a specific way, and it needs to be a specific taste, color or the way it looks and it has to be a gradual process to make that change. In terms of practicalities, maybe give some alternatives; instead of this, have this, small changes each time. They can give some visuals too, and if surgeries do this instead, people will be one step to getting better.”
Health literacy
There was a notable contrast in experiences between residents with different levels of health literacy and confidence in navigating the healthcare system. Some participants described being able to understand their test results, conduct their own research, identify community support options, adopt healthier lifestyles and proactively seek follow-up appointments from their GP. In contrast, other residents reported leaving health checks with limited understanding of what their results meant or what actions they should take next. One older participant described relying on support from her daughter and friend to maintain healthy behaviours, such as regular walks together, highlighting the importance of social support in sustaining health behaviours.
Improving the NHS Health Check offer
Participants highlighted a number of opportunities to strengthen the NHS Health Check programme. A common view was that the service should provide a more comprehensive “one-stop shop” approach, where all relevant assessments and blood tests could be completed in a single visit, including other preventative services like cancer screening. This was viewed as a more convenient and time-efficient approach, particularly for older adults and people balancing employment, caring responsibilities and other commitments. Workplace-based health checks were also suggested as a way of improving access for residents with long or inflexible working hours. Flexible appointment times, particularly during evenings, were also considered important for residents in full-time employment. Participants also suggested providing estimated waiting times and increasing the involvement of community nurses, who were perceived as having more time for discussion and lifestyle advice.
“Although the bus is there, I would pass the bus 1,000 times. I wouldn’t go in there because it’s still detouring me from where I’m going, work or pick up. So, if it’s in that building, like where I work, like all school staff get their flu jab because they work in the schools.”