Implementing workplace cardiovascular disease checks: evaluation of a pilot programme in England

Abstract Background Since 2009, the National Health Service (NHS) in England has been running a Health Check programme for the early detection of cardiovascular disease (CVD) among people aged 40-74 years. Local authorities deliver the NHS Health Check largely via primary care, but uptake has been low among younger men, those living in more deprived areas, and some minoritised groups. In 2024, the Government funded a programme to pilot CVD health checks in workplaces to reach those groups. Methods We conducted a process evaluation to assess the feasibility and reach of workplace CVD health checks, using (i) an interviewer-administered survey of all 45 participating local authorities; (ii) in-depth analysis in five local authorities; and (iii) secondary aggregated data on workplaces engaged and numbers of checks delivered. Qualitative data were analysed thematically; quantitative data were analysed descriptively to examine participation among workplaces, by size and sector, and among employees. Results Local authority approaches to implement workplace health checks varied widely, reflecting local geographic and industry characteristics and challenges engaging people least likely to take up health checks and recruiting smaller, remote workplaces. Most local authorities lowered the age of eligibility for checks to reach younger workers and meet workplaces’ interest in a universal offer. The short timeframe for delivery of the pilot created tensions between quantity (i.e., number of checks delivered to reach targets) and quality in reaching people less likely to take up the NHS Health Check in primary care. Conclusions The pilot is part of wider UK government activity to promote healthy workplaces. Our evaluation offers insights into the feasibility of implementing CVD health checks in workplace settings. Engaging workplaces in a free offer was not straightforward, and the timescale and one-off funding meant the pilot struggled to reach more disadvantaged people and workplaces. Key messages • Cardiovascular disease checks can be feasibly implemented in workplaces when tailored to local area and workplace needs, but establishing relationships with workplaces requires time and support. • The focus on meeting targets within short timeframes diverted many local authority offers away from reaching the hardest-to-reach workplaces and employees.