- Dylan J SummersNHS GP
- York, UK
Salisbury cites the rise of commercial health checks as contributing to additional work for GPs.1 Some have suggested that this is similar to routine screening offered by the NHS, such as NHS Healthcheck. But there is a key difference. Although the evidence for NHS Healthcheck is debatable, it measures at least a few parameters (haemoglobin A1c, blood pressure, cholesterol) for a clearly defined purpose – to assess cardiovascular risk.
Blood tests offered as part of private screening usually do not have such a clear purpose. I have had patients referred to me from private providers who have had borderline abnormalities in liver function tests, complete blood counts, C reactive protein and B vitamins12. None of the patients had any clinical features that would have warranted testing.
Which of these findings presents a dilemma: am I willing to accept the clinical risk of assuring the patient that this abnormality is unlikely to be significant? Or am I going to use NHS resources to research them further? Or worse, in the case of B vitamins12initiate lifelong treatment that is probably unnecessary?
It’s hard to begrudge the private company getting paid to provide this ‘service’ while the NHS picks up the costs as a result.