Screening Among Adults and the NHS Health Check

This topic area covers statistics and information relating to uptake of screening programmes including the NHS Health Check among adults in Hull including local strategic need and service provision. Further information relating to Screening and Vaccinations Among Children and Young People is available within Health Factors within Children and Young People. There is also a screening programme for chlamydia and further information on this is given within Sexually Transmitted Infections under Health Factors under Adults.

This page contains information from the Office for Health Improvement & Disparities’ Fingertips. Information is taken ‘live’ from the site so uses the latest available data from Fingertips and displays it on this page. As a result, some comments on this page may relate to an earlier period of time until this page is next updated (see review dates at the end of this page).

Headlines

• There are a number of screening programmes in place in the UK which aim to detect conditions before the person experiences symptoms and enables earlier treatment to prevent severe disease and increase survival.
• All the screening programmes were suspended for at least 2-3 month from March 2020 due to the COVID-19 pandemic. Furthermore, it is possible that fewer people were willing to attend due to shielding and self-isolation once the services resumed. It is also possible that staff absences related to COVID-19 and/or backlogs could have impacted on the uptake rates. In general, uptake rates have not yet recovered to previous levels. The exception is for bowel cancer screening which is undertaken within the home. Uptake rates for bowel cancer were relatively unchanged prior the pandemic, but increased during the COVID-19 pandemic and have continued to increase perhaps due to increased awareness of this specific cancer through the media.
• In the three years to 31 March 2023, 67.5% of women aged 53-70 years were screened for breast cancer in Hull (66.2% in England). The uptake had been around 71% in Hull prior to the COVID-19 pandemic (74% for England).
• In the last 3.5 years, the percentage of women aged 20-49 years screened for cervical cancer in 2023 was similar in Hull compared to England (65.7% versus 65.8%), although uptake was slightly lower in Hull compared to England among women aged 50-64 who had been screened in the last 5.5 years (72.2% versus 74.4%). The uptake had been around 72% among women aged 20-49 years and around 75% among women aged 50-64 years in Hull prior to the pandemic.
• In 2023, uptake for screening for bowel cancer among persons aged 60-74 years was lower in Hull (68.0%) compared to England (72.0%). The uptake rate in Hull has ben around 55% between 2015 and 2019, but increased slightly to around 60% in 2020 and 2021 and increased further in 2022 and 2023 to reach the highest level since the screening programme began.
• In 2022/23, uptake for screening for abdominal aortic aneurysm among men aged 65 years was lower in Hull (54.1%) compared to England (78.3%). The rate had been around 80% prior to the pandemic. The rate in 2020/21 for Hull dropped to around 50%, similar to the rate for England, however, the rate in England has recovered since, whereas the uptake rate in Hull has remained at just over 50%.
• Whilst more people in Hull who who were invited for an NHS Health Check have attended (increasing from 35% to 46% in the last five years from 2013/14-2017/18 to 2018/19 to 2022/23), the percentage of people who have been invited for an NHS Health Check has fallen sharply (from 88% to 27%), resulting in a relatively low percentage of the population receiving an NHS Health Check (decreasing from 31% to 12% in the last five years).
• For the latest cumulative five year period 2018/19 to 2022/23, whilst the percentage attending an NHS Health Check out of those invited is slightly higher in Hull compared to England (46% versus 42%), the percentage invited is much lower (27% versus 65%) with a much lower percentage of the eligible population in Hull receiving an NHS Health Check (12% versus 27%).

The Population Affected – Why Is It Important?

Throughout the life course, there are several screening programmes including screening for antenatal and newborns, abdominal aortic aneurysm (AAA), diabetic retinopathy, breast cancer, cervical cancer and bowel cancer.

Antenatal screening and screening for newborns aims to identify conditions which may require support whereas most of the screening programmes in adults can detect the condition before the person experiences symptoms, and thus can be treated earlier to prevent the disease developing or increase survival. There is also the NHS Health Check programme which “aims to help prevent heart disease, stroke, diabetes, kidney disease and certain types of dementia”. Everyone between the ages of 40 and 74, who has not already been diagnosed with one of these conditions or have certain risk factors, will be invited (once every five years) to have a check to assess their risk of these conditions, and will be given support and advice to help them reduce or manage that risk.

Cancer Research UK have produced an infographic detailing the benefits of Breast Cancer Screening. The Independent UK Panel on Breast Cancer Screening estimated that among 1,000 women aged 50-70 without any symptoms, five lives would be saved due to breast cancer screening.

The Office for Health Improvement & Disparities (formerly Public Health England) provide information on Bowel Cancer Screening programme. For every 100 people screened using the guaiac fecal occult blood test (gFOBt), two will have an abnormal result which may require follow-up by colonoscopy. One in every 300 people screened is estimated to have cancer.

The Office for Health Improvement & Disparities (formerly Public Health England) estimate that if all eligible women attended cervical screening regularly, then 83% of cervical cancer deaths could be prevented. For every 100 women being screened, it is estimated that four women would require colposcopy or referral for further investigation.

There are many barriers to screening as shown in following infographic below. These barriers have been identified for all cancer screening programmes.

Some barriers are associated with embarrassment for cancer screening, whereas other barriers are more practical, including time pressures to manage appointments with busy day-to-day life. The percentage of women who take part in cervical cancer screening has fallen over the last decade, particularly among younger women.

Participation in screening programmes can significantly improve quality of life and save lives by diagnosing and treating disease earlier. Cancer screening programmes are recognised to significantly improve prognosis, with early detection meaning treatment can be provided at the early stages of the disease.

The Hull Picture

The Office for Health Improvement & Disparities’ Fingertips provides uptake rates of most of the screening programmes for adults at local authority level. Further information is also available at sub-Integrated Care Board (sub-ICB) level for Hull and represents the patients registered with Hull GPs who have taken up screening, and this information is also available at individual General Practice level.

The uptake rates will differ slightly as those based on local authority level are given as the numbers screened within each calendar year (with data ending with the 31 March) and are given out of the estimated resident population in the relevant age group for screening. The uptake rates at sub-ICB level are given as the numbers screened within each financial year and are given out of the registered population (the number of patients registered with Hull GPs). The estimated resident population is around 267,000 people whereas the registered population is over 300,000 population with around 10% of patients registered with Hull GPs living in East Riding of Yorkshire. As screening uptake rates are lower among more deprived communities, it is possible that screening uptake rates are higher among East Riding of Yorkshire residents, and this could influence the uptake rates at practice level particularly among a small number of Hull practices where a relatively high percentage of East Riding of Yorkshire residents are registered as patients in that practice. For more information on the differences between the resident and registered population, see Population Estimates under Population.

Breast Cancer

During 2023, the uptake rate of breast screening among women aged 53-70 years was 67.5% which was higher than England (66.2%). The uptake rate is given as the percentage of eligible women who have had a test with a recorded result at least once in the last 36 months (3 years) over the calendar year (based on data ending with 31 March). Eligible women are women aged 53-70 years who are resident in the area who are eligible for breast screening excluding those whose recall has been ceased for clinical reasons (e.g. due to previous bilateral mastectomy).

However, there is a difference in the trends over time between Hull and England. The rate in Hull had been improving since 2013 when it was 68.6% until the COVID-19 pandemic. In contrast, there had been decreases for England over this period. Despite the gradual increase in Hull over time, the uptake rate had been consistently lower than England prior to the COVID-19 pandemic.

The percentages in 2021, 2022 and 2023 were affected by the COVID-19 pandemic. Breast screening services were paused for around three months (March to June 2020) and most Breast Screening Units continued with or had restarted screening very high risk women by mid-April with all recommencing activity between April and September 2020 (with the majority starting July 2020). However, there were backlogs compounded by workforce issues and fewer women presenting for breast screening perhaps due to shielding and self-isolation.

The indicator measures the number of women screened who were eligible over a three year period so the percentage screened was not affected as much as it might have if the indicator was measured over one year. However, it does mean that the percentage is also relatively low for the three year period ending 31 March 2023 as it was included two periods ending 31 March 2021 and 2022 which both would have been affected to some extent by the pandemic.

In Hull, the uptake rate for 2021 did not decrease as much as it did in England so the percentage in Hull was statistically significantly higher than England for the first time. In 2022 the uptake rates were similar for Hull (65.1%) and England (65.2%), but in 2023 the uptake rate in Hull was again significantly higher than for England (67.5% versus 66.2%).

The coverage rate at sub-Integrated Care Board (ICB) level is slightly higher at 69.9% for Hull (03F) for 2022/23 compared to the uptake rate reported based on residents of Hull. Around 8% of all patients registered with Hull GPs live in East Riding of Yorkshire, and this could influence the uptake rate when it is reported at sub-Integrated Care Board level (through combining uptake across GP practices).

Note the second indicator presented (“uptake rate”) relates to screening within six months out of those screened in the last year, but it does not specifically state this within Fingertips (and the label cannot be changed). More women in Hull attended their breast screening appointment within six months of invitation for 2022/23 compared to England.

There is no trend data for the new indicator which relates to women aged 53-70 years as it is a new indicator. However, women were previously eligible for breast cancer screening if they were aged 50 to 70 years so the previous indicator examined coverage for this age group. The screening coverage rate among patients aged 50-70 years who were registered with Hull GPs was quite static at around 67% between 2009/10 and 2013/14, but gradually increased to 70% for 2019/20. There was a decrease between 2019/20 and 2021/22 likely associated with the COVID-19 pandemic, although because the coverage examines uptake within the last three years there was a greater impact for 2021/22 as this covered a larger proportion of time in relation to the COVID-19 pandemic.

Among women aged 53-70 years who were registered with Hull GPs, 21,180 women out of an estimated 30,696 women eligible for breast cancer screening had attended screening in the last three years.

The percentage of female patients 50-70 years who take up breast cancer screening in the last year and the percentage who do so within six months of their invitation is available at practice level for all of Hull’s GPs is available on Fingertips. The percentage remained relatively constant between 2012/13 and 2018/19 at around 70% for Hull, but decreased between 2018/19 and 2021/22. The lower percentages in 2019/20 and 2020/21 could be influenced by the COVID-19 lockdown as screening services were temporarily suspended during the first lockdown which commenced at the end of March 2020. It would have made it more difficult to attend within six months for any breast screening appointments where letters were sent out in the early part of 2020 (within the financial year 2019/20). This would also be the case for 2020/21 and 2021/22. The percentage of Hull women attending their appointment within six months for both these years is similar to England. The percentage in Hull increased for 2022/23 with 68.1% attending their breast cancer screening appointment within six months of the invitation in Hull compared to 65.4% for England.

Note that this indicator presented relates to screening within six months out of those screened in the last year but it does not specifically state this within Fingertips (and the label cannot be changed).

Fingertips presents information on the percentage uptake of breast screening at practice level for women aged 53-70 years (opens an external website), although as at January 2024, the information is based on the 32 GP practices in Hull prior to April 2023. There are now 28 practices with B81002 and B81095 merging with B81074 in April 2023, Y02344 merging with B81112 in May 2023 and B81058 merging with B81008 in December 2023.

Practices serving more deprived populations (in terms of the average Index of Multiple Deprivation 2019 score of their practice patients) and with an older average age of their patients may be more likely to have lower uptake rates so the IMD score (and rank out of Hull’s 28 practices as at January 2024) and average age of patients (and rank) are given. The average IMD score of patients ranges from 19.7 (least deprived) to 53.0 (most deprived), and the average age of the patients ranges from 29.8 to 46.8 years for the 28 Hull practices (as at January 2024). The ranks are given as 1 for the practice serving the patients with the highest IMD score (most deprived) and 1 for practices with the lowest average age of patients (youngest patients).

Uptake for breast cancer screening ranges from 53.7% (Wilberforce Surgery) to 81.3% (City Health Practice – Field View Surgery).

For 2022/23, the percentages are lowest for the following practices with these practices having fewer than 60% of women undertaking breast cancer screening:

• B81032 – Wilberforce Surgery – 53.7% (IMD score 48.8, IMD rank 5, average age 34.9, age rank 5)
• B81017 – Kingston Medical Group (CHCP – City Centre) – 55.0% (IMD score 51.1, IMD rank 2, average age 35.8, age rank 4)
• B81119 – Goodheart Surgery – 56.3% (IMD score 46.1, IMD rank 7, average age 37.9 years, age rank 9)
• B81631 – Drs Raut & Thoufeeq (Raut Partnership) – 59.3% – (IMD score 42.3, IMD rank 12, average age 38.9, age rank 13)

Cervical Cancer

During 2023, the percentage of women aged 25-49 who had had screening for cervical screening within the last 3.5 years was similar in Hull and England, but statistically significantly lower in Hull compared to England among women aged 50-64 years who had attended within the last 5.5 years.

The percentage is given out of the number eligible for screening and resident in the area at a given point in time, and excludes those without a cervix (based on data ending with 31 March).

Among women aged 25-49 years, the percentage has been decreasing over time in Hull at a similar rate of decrease to England, although the rate of decrease in Hull has been slightly greater than England in 2021, 2022 and 2023. Despite this, the uptake rate in Hull had been consistently statistically significantly higher than England between 2012 and 2022.

Whilst the rate has been consistently decreasing, the falls in 2021, 2022 and 2023 were greater due the COVID-19 pandemic.

Based on analysis presented in the Journal of Medical Screening, routine invitations for cervical screening were reduced between April and June 2020 with the number of samples received by laboratories in England reduced by 91%, 85% and 43% during April, May and June 2020 respectively compared to 2018 (used as a baseline). On average, there were 12.6% more samples between August 2020 and April 2021 over the same months in 2018. Nevertheless, cumulatively by April 2021, the number of samples received by laboratories in England was 6.4% fewer than in 2018 (over the same months).

As screening uptake rates are reported as the percentage screened in the last 3.5 years, the rates are not as badly affected as they would have been if they had been produced on the basis of women who were eligible within a single year.

In contrast, for women aged 50-64 years, the percentage attending cervical screening has been consistently lower than England and the region, and has for the majority of the time between 2011 and 2023 has also been statistically significantly lower than England. Again, as in younger women, the rate has consistently decreased since 2012 although the changes between 2018 and 2020 were relatively small.

As with women aged 25-49, the COVID-19 pandemic did influence the uptake rates, both locally and nationally. For the period 2017 to 2023, uptake rate of cervical screening among women in Hull aged 50-64 years was statistically significantly lower than England.

The uptake rates should be less affected by COVID-19 for women aged 50-64 years compared to women aged 25-49 years as they are reported in relation to the number of women attending screening in the last 5.5 years rather than in the last 3.5 years as for women aged 25-49 years.

A similar pattern occurs when examining the percentage uptake of cervical screening among patients registered with Hull GPs when the data is presented at sub-Integrated Care Board level with the percentage in Hull (03F) being slightly higher than England for women aged 25-49 years and lower for women aged 50-64 years. Uptake rates are slightly higher when presented out of population registered with Hull GPs as around 8% of all patients registered with Hull GPs live in East Riding of Yorkshire where screening rates tend to be higher.

Whilst the percentage of women aged 25-49 years screened for cervical cancer has been decreasing in Hull in most years since 2011/12, the percentage stayed fairly constant at around 71% for 2016/17 to 2018/19 , before increasing in 2019/20. However, with the effect of the COVID-19 pandemic, the uptake rates are the lowest they have been, at 67.2% in 2022/23.

Among women aged 50-64 years registered with Hull GPs, the percentages attending cervical screening within the last 5.5 years was similar to England between 2011/12 and 2021/22, although the rate has fallen in Hull by slightly more than it has for England since then.

Fingertips presents information on the percentage uptake of cervical screening at practice level for women aged 25-49 years (opens an external website), although as at January 2024, the information is based on the 32 GP practices in Hull prior to April 2023. There are now 28 practices with B81002 and B81095 merging with B81074 in April 2023, Y02344 merging with B81112 in May 2023 and B81058 merging with B81008 in December 2023.

Uptake for cervical cancer screening among women aged 25-49 years ranges from 47.9% (Campus Health Centre / Newland Health Centre) to 83.8% (Laurbel Surgery).

Among women aged 25-49 years, the practices with the lowest rates for 2022/23 were as follows all having the percentage uptake is 60% or lower (with average Index of Multiple Deprivation 2019 score and age of their practice patients ranked out of 28):

• B81104 – Campus Health Centre (Newland Health Centre )- 47.9% (IMD score 25.7, IMD rank 26, average age 29.8 years, age rank 1)
• B81017 – Kingston Medical Group (CHCP – City Centre) – 53.6% (IMD score 51.1, IMD rank 2, average age 35.8, age rank 4)
• B81675 – Haxby – Calvert & Newington – 54.5% (IMD score 42.5, IMD rank 11, average age 35.3 years, age rank 3)
• B81058 – Sydenham House Group Practice – 55.1% (practice not longer exists, it was merged with B81008 (East Hull Family Practice) in December 2023 – the new combined uptake rate would be around 64.9%)
• B81052 – Princes Medical Centre – 57.8% (IMD score 38.7, IMD rank 15, average age 37.4 years, age rank 15)
• B81032 – Wilberforce Surgery – 58.0% (IMD score 48.8, IMD rank 5, average age 35.9 years, age rank 5)

Fingertips presents information on the percentage uptake of cervical screening at practice level for women aged 50-64 years (opens an external website), again presented for 32 practices (not for the 28 practices currently in Hull following mergers).

Uptake for cervical cancer screening among women aged 50-64 years ranges from 62.4% (Orchard 2000 Group) to 82.0% (Laurbel Surgery).

Among women aged 50-64 years, the practices with the lowest uptake rates for cervical screening for 2022/23 were as follows all having rates is 70% or lower (with average Index of Multiple Deprivation 2019 score and age of their practice patients ranked out of 289):

• B81018 – Orchard 2000 – 62.4% (IMD score 50.9, IMD rank 3, average age 37.2 years, age rank 7)
• B81058 – Sydenham House Group Practice – 62.9% (practice not longer exists, it was merged with B81008 (East Hull Family Practice) in December 2023 – the new combined uptake rate would be around 71.3%)
• B81017 – Kingston Medical Group (CHCP – City Centre) – 66.0% (IMD score 51.1, IMD rank 2, average age 35.8, age rank 4)
• B81052 – Princes Medical Centre – 67.5% (IMD score 38.7, IMD rank 15, average age 37.4 years, age rank 15)
• B81032 – Wilberforce Surgery – 68.6% (IMD score 48.8, IMD rank 5, average age 35.9 years, age rank 5)
• B81027 – St Andrew’s Group Practice – 68.6% (IMD score 50.4, IMD rank 4, average age 39.9 years, age rank 15)

Bowel Cancer

During 2023, the percentage of men and women aged 60-74 years in Hull screened for bowel cancer was the lowest across the Yorkshire and Humber local authorities and statistically significantly lower than the percentage for England.

Just over two-thirds of eligible men and women were screened for bowel cancer in Hull (68.0%), compared with 73.9% in Yorkshire and Humber and 72.0% in England .

The percentage relates to the percentage of the eligible population with an adequate faecal occult blood test (FOBt) screening result in the previous 30 months (based on data ending with 31 March). Those eligible for the bowel cancer screening are those who live in the area at a given point in time excluding those whose recall has been ceased for clinical reasons (e.g. no functioning colon) or if they opt out of the programme.

The percentage uptake of bowel cancer screening in Hull had been consistently around 55% between 2015 and 2019. Since then, the percentage has increased each year to reach 68.0% in 2023, it’s highest ever level, but still statistically significantly lower than England (72.0%).

Despite the recent increases, the percentage has remained statistically significantly lower than England, as it has been since 2015, although the pattern for Hull has been similar to England and the region. Generally, access to health services reduced at the end of March 2020 due to the COVID-19 pandemic and lockdowns, but it is possible that the uptake for bowel cancer screening increased as slightly more people were at home particularly those in their early 60s of working age, had more free time, or it is possible that people focused more on their health or were more aware of health-related issues during the pandemic.

There has been increased media and social media interest in bowel cancer in the last couple of years which could have increased uptake.

The percentages of patients aged 60-74 registered with Hull GPs who have taken up bowel cancer screening within the last 2.5 years is also available, and show a similar discrepancy with the rate in Hull (03F) being lower than England and lower than across the Humber and North Yorkshire Integrated Care Board. The percentage at sub-ICB level tends to be higher than the rate at local authority level as the local authority figures are based on residents and the sub-ICB figures are based on patients registered with Hull GPs, although the difference is relatively small.

Note the second indicator presented relates to screening within six months out of those screened in the last year, but it does not specifically state this within Fingertips (and the label cannot be changed). Two-thirds of patients registered with Hull GPs were screened within six months of their invitation out of those invited for bowel cancer screening in the last year which is lower than England (70%).

When the bowel cancer screening programme started in 2009/10 the percentage uptake in Hull was 49.8%, and whilst this increased over the next couple of years the rate remained relatively static at around 56% for the period 2011/12 to 2018/19. The rate then increased in Hull each year after 2018/19 to reach 69.2% in 2022/23. The trends over time in Hull have been similar to those for England and across the Humber and North Yorkshire Integrated Care Board, so it is possible that the way the programme has been administered or advertised has changed to prompt the increase in take-up, or it could be more people were at home and/or focused on their health (due to the pandemic) or were more aware of bowel cancer which increased take-up.

Between 2009/10 and 2017/18, around 54% of people were screened for bowel cancer within six months of their invite, but this increased to 56% in 2018/19 and to 69% in 2020/21, although there was a decrease to 66% in 2021/22 before another increase to reach 67.6% in 2022/23. A similar pattern of change in the last few years occurred for England and across the Humber and North Yorkshire Integrated Care Board.

Note that this indicator relates to screening within six months out of those screened in the last year but it does not specifically state this within Fingertips (and the label cannot be changed).

The percentage of patients aged 60-74 years screened for bowel cancer in the last 2.5 years is also available at practice level on Fingertips (opens an external website), although as at January 2024, the information is based on the 32 GP practices in Hull prior to April 2023. There are now 28 practices with B81002 and B81095 merging with B81074 in April 2023, Y02344 merging with B81112 in May 2023 and B81058 merging with B81008 in December 2023.

Uptake for bowel cancer screening ranges from 55.4% (Wilberforce Surgery) to 82.9% (Laurbel Surgery).

The practices with the lowest percentage of take-up of bowel cancer screening occurred in the following practices for 2022/23 being 60% or lower (with average Index of Multiple Deprivation 2019 score and age of their practice patients ranked out of 28):

• B81032 – Wilberforce Surgery – 55.4% (IMD score 48.8, IMD rank 5, average age 35.9 years, age rank 5)
• B81017 – Kingston Medical Group (CHCP – City Centre) – 56.4% (IMD score 51.1, IMD rank 2, average age 35.8, age rank 4)

Abdominal Aortic Aneurysm

The percentage of men in their 65th year who were screened for an abdominal aortic aneurysm (AAA) are available on Fingertips. The number eligible for screening is the total number of men aged 65 years who live in the area but it excludes men who die or move out of the area responsible for the local screening service before the screening can be offered.

For 2022/23, just over a half of men attended screening for AAA in Hull (54.1%) which was statistically significantly lower than the rate in England where almost eight in ten men attended screening (78.3%).

Until the COVID-19 pandemic, the uptake rate for screening of AAA among Hull men was similar to England, and was consistently around 80% between 2013/14 and 2018/19. There was a slight fall in 2019/20 due the COVID-19 pandemic as there is a three month period after the end of the financial year where men are counted as having been screened to account for cancellations and changes in appointments for men invited during the last few months of the financial year. This ‘grace’ period would have been from April to June 2020 at the same time as the COVID-19 lockdowns, so it appears that this had an impact on the reported uptake rates as initial screening appointments for mid-March to June 2020 were cancelled, and fewer men also attended.

A very similar reduction in the uptake rates occurred in England and the region as it did in Hull for 2020/21, but the rate remained relatively unchanged for Hull men in 2021/22 and then increased slightly in 2022/23, whereas large increases were seen for both England and the region.

Screening rates for cancer screening are reported out of those eligible for screening over a 2-5 year period, so it would be anticipated that the screening for AAA would be more affected during the COVID-19 pandemic but less affected subsequently as the eligible cohort is based on a single year. However, it is possible that uptake rates have been affected by a backlog, but it is also possible that men in Hull are less willing to attend the screening.

The uptake rates for England and the region are now approaching the level they were at pre-pandemic, but rates in Hull have a considerable way to go to return to levels observed prior to the pandemic.

NHS Health Check

There are three measures relating to take-up of the NHS Health Checks and they are given as cumulative figures over a period of time.

Everyone between the ages of 40 and 74 years, who has not already been diagnosed with heart disease, stroke, diabetes and/or kidney disease is eligible for an NHS Health Check and invited for a check every five years.

Local authorities have a legal duty to make arrangements to provide the NHS Health Check programme to 100% of the eligible population over a five year period and to achieve continuous improvement in uptake. The data demonstrates the cumulative progress made by local authorities over time.

In Hull for the five year period 2018/19 to 2022/23, 27.1% of the population eligible for an NHS Health Check were offered an NHS Health Check, of whom 45.8% took up the offer of an NHS Heath Check. Thus overall, 12.4% of the eligible population had an NHS Health Check (45.8% of 27.1%).

More than twice as many eligible people were offered an an NHS Health Check in England compared to Hull (64.7% versus 27.1%) and whilst the uptake rate among those invited was slightly higher in Hull compared to England (45.8% versus 42.3%), this resulted in a much lower overall percentage of Hull’s eligible population receiving an NHS Health Check with the figure just over half of that of England (12.4% versus 27.4%).

The percentage of people aged 40-74 years who were offered an NHS Health Check has steadily decreased in Hull from 88% for 2013/14-2017/18 to 27% for 2018/19-2022/23. There have also been decreases over time for England and across the region, but the decrease in Hull has been greater.

Whilst it is possible to influence the number of people who are invited for an NHS Health Check, it is more difficult to influence the uptake rates among those who have received an invite. Uptake rates tend to be lower in more deprived areas so it is not particularly surprising that the uptake rate has been significantly lower in Hull compared to England. However, the percentage of people who attended an NHS Health Check out of those who were invited for one has increased at a faster rate in Hull compared to England, and the percentage in Hull is now statistically significantly higher than England.

Despite similar uptake among those invited, because of the low number of invitations sent out in Hull, the overall percentage of people who received an NHS Health Check in the last five years is low and much lower than England.

The percentage of people who were sent an invitation for an NHS Health Check has fallen sharply in Hull, and despite an increasing percentage attending among those invited, this has resulted in a sharp decline in the overall percentage of eligible people attending an NHS Health Chcck.

During 2013/14 to 2017/18, almost one-third of Hull residents who were eligible for an NHS Health Check had a check, but for the most recent period 2018/19 to 2022/23, the percentage had fallen to 12.4% (with only one in eight eligible people attending).

Strategic Need and Service Provision

In general, the uptake of screening in Hull is low compared to other areas. Furthermore, there are relatively large variations in screening uptake rates within primary care practices, perhaps associated with the patients within those practices (for example, people living in less deprived areas including patients living in East Riding of Yorkshire).

In Hull, 13 of the GP practices are contracted to undertake NHS Health Checks so this could potentially explain some of the relatively low uptake in Hull, but the same reasons will apply to screening with uptake generally lower in more deprived areas like Hull compared to more affluent areas in other parts of the country. There is a Community Outreach Service that offers NHS Health Checks to patients registered with GP practices who do not want to deliver the NHS Health Checks, but not on a ‘call and recall’ basis coordinated through the practice.

Due to COVID-19, a large number of screening appointments were postponed which could potentially have an impact on the rates of late diagnosis among cancers and AAA that are picked up at screening appointments as well as postponing diagnosis and treatment of medical conditions through the NHS Health Check. However, for the case of bowel cancer screening which does not need an appointment or medical examination, uptake rates have increased slightly for 2020 and 2021. It is possible that changes in people’s working arrangements could have also made it easier to attend screening appointments. Furthermore, the impact on cancer screening uptake where eligible patients attend screening once in every three or five years will be lower compared to other services where patients attend more frequently. For instance, for breast screening where patients attend once in every three years, a disruption to the service of a few months will only impact on a relatively small percentage of patients over the entire three year period. For 2020/21, two-thirds of eligible women will have already been screened during 2018/19 and 2019/20, and probably some of those eligible for screening during 2020/21 might have had the opportunity to be screened during 2020/21 depending on when services resumed.

Resources

The Office for Health Improvement & Disparities (formerly Public Health England). Health Matters infographics

Cancer Research UK: Breast Cancer infographic

The Office for Health Improvement & Disparities’ Fingertips: https://fingertips.phe.org.uk/

NHS Breast Screening Programme, England 2020/21. COVID-19 impact during 2020-21. https://digital.nhs.uk/data-and-information/publications/statistical/breast-screening-programme/england—2020-21/covid-impact—programme-summary-2020-21

Castanon A, Reboli M, Pesola F, Pearmain P, and Stubbs R. COVID-19 disruption to cervical screening in England. Journal of Medical Screening, 2022; 29(3): 203-208. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9381684/

Public Health England (now Office for Health Improvement & Disparities). AAA standards report 2019 to 2020. https://www.gov.uk/government/statistics/abdominal-aortic-aneurysm-screening-standards-report-2019-to-2020/aaa-standards-report-2019-to-2020

Updates

This page was last updated / checked on 19 June 2024.

This page is due to be updated / checked in November 2024.