NHS Health Checks
What is an NHS Health Check?
The NHS Health Check is a health check-up for adults in England aged 40 to 74. It’s designed to spot early signs of stroke, kidney disease, heart disease, type 2 diabetes or dementia. As we get older, we have a higher risk of developing one of these conditions. An NHS Health Check helps find ways to lower this risk.
Am I eligible for an NHS Health Check?
The check is for people who are aged 40 to 74 who do not have any of the following pre-existing conditions:
- heart disease
- chronic kidney disease
- high blood pressure (hypertension)
- atrial fibrillation
- transient ischaemic attack
- inherited high cholesterol (familial hypercholesterolemia)
- heart failure
- peripheral arterial disease
- currently being prescribed statins to lower cholesterol
- previous checks have found that you have a 20% or higher risk of getting cardiovascular disease over the next 10 years
You should have regular check-ups if you have one of these conditions. Your care team will be able to give you more information about this.
If you’re in the 40 to 74 age group without a pre-existing condition, you should receive a letter from your GP surgery or local council inviting you for a free NHS Health Check every 5 years. You can also call your GP surgery to book a Health Check. You may want to try this online Heart Age test.
How can I improve my test results?
Once you’ve had your NHS Health Check, your healthcare professional will discuss your results with you. You’ll be given advice to help you lower your risk of a stroke, kidney disease, heart disease, diabetes or dementia, and maintain or improve your health. But you do not have to wait until then to make healthy changes. Take the How Are You quiz and start now.
What is an NHS Health Check?
The NHS Health Check is a free check-up of your overall health. It can tell you whether you're at higher risk of getting certain health problems, such as:
During the check-up you'll also discuss how to reduce your risk of these conditions and dementia.
If you're over 65, you will also be told the signs and symptoms of dementia to look out for.
How will the NHS Health Check help me?
You will have your individual cardiovascular risk (risk of getting conditions related to the heart or circulation) calculated and explained to you.
While the cardiovascular risk levels vary from person to person, everyone is at risk of developing heart disease, stroke, type 2 diabetes, kidney disease and some types of dementia.
At your NHS Health Check you will be given advice on how to prevent them.
Your NHS Health Check can detect potential health problems before they do real damage.
What happens at the NHS Health Check?
An NHS Health Check takes about 20 to 30 minutes.
The health professional – often a nurse or healthcare assistant – will ask you some questions about your lifestyle and family history, measure your height and weight, and take your blood pressure and do a blood test. The blood test will be done either before the check with a blood sample from your arm, or at the check.
Your blood test results can show your chances of getting heart disease, stroke, kidney disease and diabetes.
If you're over 65, you will also be told the signs and symptoms of dementia to look out for.
You will then receive personalised advice to improve your risk. This could include talking about:
Where do you have an NHS Health Check?
This depends where you live.
You'll usually have your NHS Health Check at a GP surgery or local pharmacy, but it could happen at your local library or leisure centre.
In some areas, NHS Health Checks are offered from mobile units to passers-by and in workplaces.
How can I arrange to have an NHS Health Check?
You'll be invited for a free NHS Health Check every 5 years if you're between 40 and 74 years of age and do not already have a pre-existing condition.
If you're registered with a GP surgery that offers the NHS Health Check, you should automatically get an invitation. Do not worry if you have not been invited yet – you will be over the next 5 years.
Alternatively, your local authority will send you an appointment letter explaining where you have to go for your NHS Health Check.
If you're not sure if you're eligible for an NHS Health Check and would like one, or if you are eligible but have not had an NHS Health Check in the last 5 years, ask at a GP surgery for an appointment.
Do NHS Health Checks work?
The health conditions picked up by the NHS Health Check are, when added together, the biggest cause of preventable deaths in the UK, with around 7 million people affected by them.
In its first 5 years, the NHS Health Check is estimated to have prevented 2,500 heart attacks or strokes. This is the result of people receiving treatment after their Health Check.
The latest research suggests that:
- for every 30 to 40 people having an NHS Health Check, 1 person is diagnosed with high blood pressure
- for every 80 to 200 people having a Health Check, 1 person is diagnosed with type 2 diabetes
- for every 6 to 10 people having an NHS Health Check, 1 person is identified as being at high risk of cardiovascular disease
How do I get an NHS Health Check?
You can have an NHS Health Check if you're aged 40 to 74 and you have not had a stroke, or do not already have a pre-existing health condition.
If this applies to you, you can expect to receive a letter from a GP surgery or local authority inviting you for an NHS Health Check every 5 years.
You may also receive reminders about your NHS Health Check appointment by phone or email.
Will I get an NHS Health Check from my GP surgery?
Because the NHS Health Check programme is run by local authorities, how you get your check varies, depending on where you live.
The majority of NHS Health Checks are done in GP surgeries and local pharmacies, but in some areas they may also be offered at other suitable and accessible places in your area. For example, to passers-by at mobile units or at leisure centres.
What should I do if I’m under the age of 40 or over the age of 74?
People under the age of 40 are not included in the NHS Health Check programme because younger people have a lower risk of the health conditions tested for during the check. But if you have any questions, speak to a GP or nurse.
If you're over the age of 74 and have any questions or concerns, you should also speak to a GP or nurse as soon as possible.
Is there anything I can do to get an NHS Health Check other than wait to be invited?
You could ask your GP surgery if they offer the NHS Health Check and if they can let you know when you will be invited.
Ask a pharmacist
Some pharmacies offer NHS Health Checks. It's worth asking a local pharmacist if they can help.
Many pharmacies can take your blood pressure even if they are not providing the NHS Health Check.
Private health checks
If you're eligible, the NHS Health Check is free of charge, including any follow-up tests and appointments. Private health providers offer the tests available on the NHS Health Check, but you have to pay.
Online tests and tools
There are many online interactive tools and self-assessments that can help you immediately get an idea of how healthy you are.
- If you're over 30, take the online Heart Age test to see what your risk of getting heart disease or stroke is.
- Find out if you're at risk of type 2 diabetes.
- Use the BMI calculator to see whether you're a healthy weight for your height. If you're overweight, it will also tell you what your daily calorie range should be to help you lose weight.
- Could you be drinking too much? Find ways to drink less.
- Take the How Are You quiz for an overview of your current health and wellbeing.
If you feel unwell now
Your NHS Health Check results and action plan
After your NHS Health Check, you'll be given your cardiovascular risk of developing a heart or circulation problem (such as heart disease, stroke, type 2 diabetes or kidney disease) over the next 10 years.
The healthcare professional may describe this risk as low, moderate or high:
- low – you have less than a 10% chance of a heart or circulation problem in the next 10 years
- moderate – you have a 10% to 20% chance of a heart or circulation problem in the next 10 years
- high – you have more than a 20% chance of a heart or circulation problem in the next 10 years
Everybody's cardiovascular risk rises with age, so the next time you have an NHS Health Check your risk score may be higher, even if your test results remain the same.
There are some things about your risk which you cannot change, such as your age, ethnicity and family history. But the most important factors in your risk score (such as smoking, your cholesterol level and blood pressure) can be changed.
Your NHS Health Check results should also be broken down into:
- your body mass index (BMI)
- your blood pressure
- your cholesterol levels
- your alcohol use score
- your physical activity assessment result
- your diabetes risk assessment
You'll then have the chance to discuss how to improve your scores.
The NHS Health Check is also designed to find early signs of dementia.
Your heart age
At your NHS Health Check, sometimes your heart age is calculated using the heart age tool. This tells you the age of your heart compared with your real age and can be really helpful in understanding risk. For example, while you might have been told your risk was low, you could have a heart age higher than your real age. This can often be lowered by making changes to your lifestyle.
You can take the Heart Age Test now.
Your BMI score
People who have a BMI in the overweight or obese category are at greater risk of a range of serious health conditions, including heart disease, stroke, type 2 diabetes and certain cancers.
Reducing your BMI
If your BMI is higher than the healthy range (anything above 25, or anything above 23 if you have a south Asian background), you may be referred to a weight-management service that could help you to achieve a healthy weight, as well as looking at your diet and activity levels.
You can use the BMI healthy weight calculator to keep track of your BMI as your weight changes and to get advice on the best ways to achieve a healthy weight.
A BMI below 18.5 indicates that you may be underweight. This could be a sign that you're not eating a healthy and balanced diet that contains enough energy for your needs. Or it may be a sign of a wide range of underlying health conditions.
Your blood pressure score
When your blood pressure is measured, the reading has a higher and a lower number:
- your systolic blood pressure – this is the higher number indicating the pressure when your heart pumps blood out
- your diastolic blood pressure – this is the lower number indicating the pressure when your heart rests
Normal blood pressure is between 90/60 and 140/90. If your result are outside this normal range, the healthcare professional explaining your results will discuss this with you and what action to take.
High blood pressure (hypertension) is a problem because it increases the risk of serious health conditions such as heart attack, stroke, type 2 diabetes and kidney disease. High blood pressure usually causes no symptoms, so it's possible to have high blood pressure without knowing it.
Having a single raised blood pressure reading does not necessarily mean you have high blood pressure. Blood pressure can go up and down throughout the day and in response to stress.
If you have a raised blood pressure reading at your NHS Health Check, you may be given a blood pressure monitor to take home. Use this to see whether your blood pressure level is high at different times of the day over several days, which could indicate a health problem.
Reducing your blood pressure
Blood pressure can be brought down by making changes such as:
If necessary, you may be prescribed blood pressure-lowering medicines. Depending on how high your blood pressure is, the health professional might want you to try making changes to your lifestyle first, before prescribing medicines.
Low blood pressure
Low blood pressure (hypotension) does not necessarily indicate a health problem and is typically only a problem when it's accompanied by symptoms, such as dizziness or fainting, which may be signs of a health condition.
Your cholesterol result
Your cholesterol result will be broken down into:
- total cholesterol (TC) – healthy adults should have a total cholesterol of 5mmol/L or less
- HDL (called "good cholesterol") – this should be above 1mmol/L in men, and above 1.2mmol/L in women
- TC:HDL ratio – this is the ratio of HDL compared to TC and should be as low as possible. Above 6mmol/L is considered high
Lowering your cholesterol
If your cholesterol test results are outside the healthy range, your health professional will provide advice on how to lower your cholesterol through changes to your diet. They may also advise treatment with medicines, called statins.
Your alcohol use score
You will be given a score for your alcohol use based on questions your healthcare professional asked you during your NHS Health Check. Your answer to each question will get a score from 0 to 4.
An alcohol use score of 7 or more would indicate that you are drinking an amount of alcohol that's likely to be harming your health. Your healthcare professional will be able to advise you on ways to track your drinking and to cut down on alcohol.
If your score is 20 or more, you may have an alcohol dependence disorder (alcoholism). Your healthcare professional should be able to refer you for specialist support for cutting down on alcohol.
Your physical activity score
There is good evidence that taking part in moderate or vigorous physical activity every day can reduce your risk of more than 20 health conditions, from diabetes to dementia. It can also improve the management and reduce the risk of complications of many common conditions such as high blood pressure.
The Chief Medical Officer recommends that all adults should do some type of physical activity every day.
Adults aged 19 to 64 should:
- do at least 150 minutes of moderate intensity activity, or 75 minutes of vigorous physical activity, every week
- do regular muscle-strengthening exercise
- reduce the amount of time spent sitting or lying down
Adults aged 65 and older should:
- do at least 150 minutes of moderate intensity activity or 75 minutes of vigorous intensity activity every week if already active, or a combination of both
- do activities that improve strength, balance and flexibility on at least 2 days a week
- reduce time sitting or lying down
If you are interested in increasing the amount of physical activity you do, you will be offered help and support to gradually increase your activity.
Your diabetes risk assessment
Your health professional will take your blood pressure and BMI test results into account to assess whether you're at an increased risk of developing diabetes.
You may be invited for another test to check that you do not have diabetes if:
- your diabetes risk assessment score is more than 5.6%
- your BMI is more than 30 (27.5 or more for Asian people), or
- your blood pressure is high (at or above 140/90mmHg), or where the systolic blood pressure or diastolic blood pressure exceeds 140mmHG or 90mmHg respectively
Help to improve your results
If you smoke, you should be offered support and advice as part of your NHS Health Check.
All areas have a free local NHS Stop Smoking Services, which can help you find your best way of stopping and provide the medicine and support you might need. You are up to 4 times more likely to quit if you use NHS support than if you try to do it alone.
Improving your fitness
Doing the recommended 150 minutes of your choice of exercise each week – such as walking, dancing or swimming – will help to bring your weight and blood pressure down, as well as having many other benefits for your wellbeing.
People with a high BMI are at greater risk of a range of serious health conditions, including heart disease, stroke and certain cancers.
If you would like help with losing weight, download the free NHS weight loss plan and start today.
Eating a balanced diet, including vegetables, fruit and grains, plus some protein and dairy, will help you reduce your risk of cardiovascular disease.
The Eatwell Guide shows how much of what we eat overall should come from each food group to achieve a healthy, balanced diet.
Restricting your salt intake to no more than 6g each day can help your blood pressure readings come down. Find out more facts about salt.
When shopping for food, think about the food that you are buying and plan to stay within the recommended levels of calories, fats and salt. Learn more about how to make healthier food choices on our page about food labels.
Cutting back on alcohol
To reduce your risk of harming your health, including keeping your blood pressure in check, men and women are advised not to drink more than 14 units of alcohol each week on a regular basis.
Reducing your intake of alcohol and having several alcohol-free days a week will improve your overall health.
Taking prescription medicines
If your blood pressure was high, your healthcare professional may have offered you blood pressure-lowering medicines. Likewise, you may be prescribed cholesterol-lowering medicines. These medicines are usually taken as tablets.
These can have a very beneficial effect on your health, but you are likely to need to take them for a long time. Depending on your results, doctors will usually advise lifestyle changes first, to reduce your need for medicine and lower your risk of side effects from them, before prescribing these medicines.
Blood pressure medicines
Most people need more than 1 blood pressure medicine to help them manage their blood pressure.
Treatment for high blood pressure can include medicines such as:
- ACE inhibitors, which relax your blood vessels
- calcium channel blockers, which widen your arteries
- thiazide diuretics, which flush excess water and salt from the body
- beta-blockers, which reduce both your heart rate and the force at which blood is pumped around your body
The most commonly prescribed cholesterol-lowering medicines are called statins.
Statins can be prescribed to help lower high cholesterol, whether it's caused by a lack of exercise or a diet high in fat.
They can also help people who have an inherited condition that causes to much cholesterol in their blood (this is called familial hypercholesterolaemia).
Ask a pharmacist
A local pharmacist is a trained expert in medicines and can provide information and advice about your medicines, including how to take them and what to do if you have any side effects.