The Department for Health and Social Care (DHSC) has announced the novel appointment of a Government 'champion for personalised prevention', in the person of John Deanfield, CBE, professor of cardiology at University College London.
As first-ever champion, he has been tasked with exploring "how people can live longer, healthier lives by using technology, intelligence, and data to predict, prevent, and diagnose risk factors for cardiovascular disease (CVD)". He will lead a taskforce with expertise on health policy, health technology, behavioural science, big data, and health economics, in what the Government described as a "radical new approach to prevent life-threatening CVD".
Prof Deanfield, who led a review into the NHS Health Check in 2021, said: "I am thrilled to continue my work with the Government on CVD prevention. This appointment provides a real opportunity to radically rethink our approach to cardiovascular health and disease prevention and I'm confident we have the right people around the table to do this."
The Health Check was introduced in 2009 "to encourage healthcare professionals to measure and manage the cardiovascular risk burden in the apparently healthy population". The review concluded that it had "achieved many of its aims" and "revealed a surprisingly high level of modifiable risk factors (more than three-quarters of attendees had at least one elevated risk factor) even among people aged under 50".
'Surprisingly High Level of Modifiable Risk Factors'
The DHSC said: "CVD and its risk factors are major drivers of ill-health, economic inactivity, and premature death. It accounts for up to 250,000 hospital admissions and around 140,000 deaths in England each year and costs the NHS approximately £7.4 billion annually."
Prof Deanfield has been asked "to explore and expand the role of technology, so people can better look after their health and reduce the risk of CVD", using the latest health technology, intelligence, and data. The new taskforce will explore a range of ideas, including the use of personalised data better to predict and prevent ill health, and how the latest health technology could be used to predict, prevent, diagnose, and treat key risk factors for CVD and other health conditions.
It also aims to advise the Government "on how individuals, businesses, and public services could be incentivised to support prevention outside the NHS". A set of evidence-based recommendations will be produced "to deliver a vision for a modern, personalised cardiovascular disease prevention service", which the DHSC said "could help reduce pressure on the NHS by tackling the quarter of a million hospital admissions for cardiovascular disease each year".
Prevention Could Help Other Conditions
In the foreword to his 2021 Health Check review, Prof Deanfield said: "It is now clear that the same behaviour and risk factors already measured in the NHS Health Check increase the risk not just for cardiovascular disease but also for conditions such as obesity, diabetes, cancer, and dementia."
The review recognised a potential benefit from including other increasingly common conditions, such as musculoskeletal and mental health, "especially those that have causal links to risk factors or affect an individual's ability make behavioural changes". Hearing charity RNID this week called for the check also to incorporate a hearing test, noting that hearing loss was a major risk factor for dementia that could be mitigated by hearing aids.
The new CVD prevention taskforce will also aim toidentify how the vision for CVD prevention might impact on conditions with shared risk factors, including diabetes and dementia.
In warmly welcoming the announcement of Prof Deanfield’s appointment, Professor Sir Nilesh Samani, medical director at the British Heart Foundation said: "About 8 in every 10 cases of CVD can be attributed to modifiable risk factors such high blood pressure, high cholesterol, obesity, poor diet, and smoking. These key risk factors are also associated with a range of other major health conditions, such as type 2 diabetes, cancer, and types of dementia."
Ongoing Programme to Reduce Lifetime Risk
Prof Deanfield said: "We intend to build on my recent review of the NHS Health Check and evolve this vision into an ongoing, life-long programme that empowers people to take control of predicting, managing and reducing their lifetime cardiovascular risk."
The announcement of his appointment, which is expected to last at least 6 months, coincided with the publication of the Office of Health Improvement and Disparities (OHID) latest quarterly NHS Health Check data, covering October to December 2022. It showed that 677,118 offers were made 271,899 checks carried out – a 40% uptake rate – in the third quarter of 2022/23, up from 300,877 and 136,100, respectively (45% acceptance) in the same quarter in 2021/22.
NHS National Medical Director, Professor Sir Stephen Powis, said: "To improve further the numbers of eligible people completing the NHS Health Check, a new digital check is being tested and evaluated in Cornwall. This came off the back of the review led by Professor Deanfield in 2021 and a report is expected in 2023.
"The Government is now exploring how to make a digital NHS Health Check available nationally, alongside the in-person check. The check will help users to take actions to improve their health independently, link to national and local services, and enable general practice to start clinical care where appropriate. This work will tie in closely with the overall vision of the Government champion for personalised prevention."
He noted that while there had been significant reductions in CVD over the last 30 years, it remained a major cause of premature death and disability, particularly hitting healthy life expectancy for people in less well-off areas.
"Finding new ways of combining data and technology with on-the-ground services has real potential to prevent illness, save more lives and reduce the cost of CVD to the NHS in the long term, so we look forward to working with Professor Deanfield and partners to identify the most promising opportunities."