Projected health and economic impacts of improving attendance to the NHS Health Check in England: A sex-disaggregated analysis with implications for men’s health
This microsimulation study projects that increasing NHS Health Check uptake in England to 75% by 2040 would prevent nearly 300,000 chronic disease cases and generate significant health and economic benefits, particularly for men, with an incremental cost-effectiveness ratio of £3,306 per QALY when including system cost savings.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Imagine the NHS Health Check as a giant, friendly "health radar" scanning millions of people in England between the ages of 40 and 74. Its job is to spot troublemakers like high blood pressure, extra weight, and smoking before they turn into serious villains like heart disease, strokes, and cancer. But here's the glitch in the system: while women are happily stepping up to the radar, men are mostly hiding in the bushes. In 2017–2018, only about 38% of eligible men showed up, compared to 44% of women.
This study runs a massive, futuristic computer simulation—a "what-if" video game for the next 16 years (2024 to 2040)—to see what happens if we finally convince everyone, especially the men, to step up to the radar. The goal? To get 75% of eligible people to attend their check-up.
The Big Reveal: A Health Time Machine
The simulation suggests that if we hit that 75% target, we could stop a staggering 292,000 new cases of serious diseases from ever happening. Think of it as a shield that blocks nearly 300,000 future health disasters. Because men currently have a higher burden of disease and attend less often, they would be the biggest winners in this scenario. The simulation projects that 172,000 of those avoided cases would be in men, compared to 120,000 in women.
The Money Trail
Now, let's talk about the cash. Running this "health radar" for everyone would cost the NHS a lot upfront. The simulation calculates that delivering the extra 16.7 million checks needed would cost £4.69 billion. However, because so many people avoid getting sick, the NHS saves a massive amount of money on treating those illnesses later.
- Direct savings (hospital bills, meds, etc.): £1.81 billion.
- Indirect savings (money saved because people stay at work and don't miss days): £1.99 billion.
When you do the math, the total cost to the system drops to just £1.64 billion. The study suggests this is a brilliant deal: for every £1 spent, the system gets back a huge return in health and money. In fact, the "cost per quality-adjusted life year" (a fancy way of saying "cost per healthy year of life gained") is estimated at just £3,306 when you count the savings, or £9,445 even if you ignore the savings. Both numbers are well below the usual limit the UK uses to decide if a health program is worth the money.
The "Work-Life" Bonus
Here is a fun twist: the simulation shows that men would gain a massive 85,000 extra "years of working life," while women would gain 16,000. This isn't just about money; it's about keeping people active and productive in their later years. The study suggests that because men are more likely to be in the workforce during these ages, getting them healthy keeps the economy humming.
What the Simulation Does NOT Say
It's important to remember this is a computer model, not a crystal ball that has already happened. The authors are careful to say they didn't include every single disease (like type 2 diabetes or kidney disease) or every risk factor (like cholesterol or alcohol) because the data wasn't ready for the simulation. This means the real-world benefits might actually be even higher than the numbers above.
Also, the study explicitly rules out the idea that this is just a "one-size-fits-all" fix. It argues that because men and women face different barriers and have different health risks, we can't just use the same invitation letter for everyone. The simulation suggests that to hit that 75% target, we need "gender-responsive" strategies—like the "AHEAD" program in Lancashire, which used evening appointments and tailored communication to boost male attendance from 37% to 61%.
The Bottom Line
This paper doesn't claim to have solved the problem yet. Instead, it uses a powerful simulation to suggest that if we invest in getting more men (and women) to their health checks, we could prevent nearly 300,000 cases of disease, save billions of pounds, and gain nearly 500,000 healthy years of life by 2040. It's a strong signal that a little extra effort to make health checks more welcoming to men could pay off in a huge way for everyone.
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