GPs could have to limit NHS Health Checks due to ‘budget constraints’

Exclusive GP practices in one area have been told they may have to limit the number of NHS Health Checks that they provide, due to ‘budget constraints’ faced by the local authority.

Pulse understands that Warwickshire county council is considering placing limits on the number of checks due to ‘record-breaking’ NHS Health Check delivery levels in the past two years.

Last month, practices were told not to book any new patients in for the checks before 1 April, while the council works with the LMC to ‘determine appropriate limits for individual practices’.

It comes after practices in the area were told in January that they should prioritise specific cohorts for the checks, including ‘ethnically diverse’ communities, current smokers, and those living within the 20% most deprived areas in Warwickshire.

The national prevention programme is meant to be open to all adults aged 40 to 74 years old who do not have any pre-existing health conditions such as stroke, diabetes, kidney disease, heart conditions including diagnosed high blood pressure and high cholesterol, and patients have been encouraged to ‘book at their local GP’.

To reallocate funds to the programme, the council decided in January to pause the Fitter Futures Adult Weight Management service, which supported behaviour change around healthy eating, weight management and physical activity to manage weight loss. According to its website, the service is ‘currently not accepting any new referrals until further notice’.  

Following initial communication from the ICB in January, last month the council agreed with Warwickshire LMC that upper limits ‘will not come into effect before 1 April’.

The council’s healthy lifestyle commissioner Melanie Campbell said: ‘No new patients are to be booked in for NHS Health Checks before 1st April 2025. This is to minimise disruption for practices and patients who are already booked in before April.

‘We will continue to work with the LMC over the coming weeks to determine appropriate upper limits for individual practices, and will share this with you before the end of the current financial year, to assist with your planning for year 2025/26.’

GPs told Pulse that the possibility of limits being placed on the numbers of NHS Health Checks provided was ‘disheartening’.

One Warwickshire GP told Pulse: ‘We’ve booked our clinics until the end of March and are not booking into April until we have confirmation of funding.

‘It is a pity as we’ve found new diabetics and hypertensives doing the checks and used them as opportunities to talk about diet, exercise, smoking and alcohol.’

Professor Azeem Majeed, a GP and head of primary care and public health at Imperial College London, told Pulse that potentially restricting the number of NHS Health Checks due to budget constraints was ‘very concerning’, as it may lead to missed opportunities to detect and manage chronic conditions early.

He said: ‘The NHS Health Check programme is helps to identify people at risk of conditions such as heart disease, type 2 diabetes, hypertension, and stroke – all of which are major contributors to ill health and premature mortality.

‘Early detection through these checks allows for timely intervention, lifestyle advice, and appropriate medical management, which can prevent complications and reduce pressure on the NHS in the long run.

‘GPs and primary care teams use these checks not only to identify new cases of diabetes and hypertension but also as a platform for broader health promotion, including discussions on smoking cessation, alcohol reduction, diet, and physical activity.

‘The Government has stated a shift from treatment to prevention is a priority for the NHS. I would therefore urge local authorities and NHS commissioners to explore sustainable funding solutions to ensure that NHS Health Checks remain accessible to those who need them.’

Previously, the council said it would work with PCNs to determine the maximum number of checks per each PCN, considering smoking prevalence and patient population deprivation indices, and indicated that there is ‘a small buffer’ for walk-in requests from eligible patients.

In a letter sent to practices in January, seen by Pulse, Warwickshire county council’s director of public health Dr Shade Agboola, said: ‘We have now reached the point where upper limits to the number of NHS Health Checks at a PCN level need to be placed, with a small buffer for walk-in requests from eligible patients, to fulfil our statutory duty.

‘I acknowledge this change will significantly impact the way practices are currently working, however having exhausted several alternatives, we believe this approach is the most effective and fair way to fulfil our duties, prioritising those facing the highest health inequalities within our budgetary constraints.’

The council told Pulse that both the Health Checks programme and the weight management service are ‘being reviewed’ in light of the budget for the next financial year.

A Warwickshire County Council spokesperson said: ‘We are discussing what measures need to be taken to manage the budget for Fitter Futures after a record number of health checks were completed under the new contract, and demand for other lifestyle services increased.

‘Due to financial pressures, in January this year we contacted Warwickshire primary care colleagues to inform them we had paused parts of the Fitter Futures contract and were looking at introducing upper limits to the number of NHS health checks carried out.

‘Since then, in light of the 2025-2026 Council budget being set, health checks and the wider Fitter Futures service are still being reviewed.

‘Currently, no upper limits on health checks have been applied to PCNs and we are working with the Warwickshire LMC to explore ways to best manage the budget for GP practices.’

Pulse has contacted Warwickshire LMC for comment. Warwickshire ICB and NHS England declined to comment.

Last year, the public spending watchdog said that the Government should consider giving GPs incentives to do NHS Health Checks via QOF.

And an analysis of NHS data showed that three in five people invited for an NHS Health Check in the previous year did not take up the offer.