To ask Her Majesty's Government whether they have undertaken a cost-benefit analysis of the effects of the qualifying age range of 40 to 74 for the NHS Vascular Risk Assessment programme on the level of risk of diabetes of (a) persons over 25, and (b) black, Asian and minority ethnic persons over 25.
The National Health Service Health Check programme (formerly vascular checks) is a universal and systematic programme for everyone between the ages of 40 and 74 that will assess an individual's risk of heart disease, stroke, kidney disease and diabetes and will support people to reduce or manage that risk through individually tailored advice. The programme was developed on the basis of advice from the National Screening Committee. It advised that, on current evidence, there was not a case for whole population screening for diabetes. However, there was a good case for targeted screening for diabetes in the wider context of cardiovascular risk assessment.
The department undertook modelling on a vascular risk assessment and management programme, which included diabetes to establish whether such an approach would be cost and clinically effective as well as identifying the optimal starting age. Both the technical consultation on the modelling and the impact assessment are available in the House of Lords Library. Three different starting ages for the programme (40, 45 and 50) were modelled. The age range of 40 to 74 for everyone was found to be both clinically and cost effective.
In taking the decision about the age range with which to launch the programme, the department took further advice from the National Screening Committee and leading United Kingdom diabetologists. Their view was that, given the current state of knowledge, age 40 represented a good starting point for combined diabetes, cardio-vascular and kidney disease risk assessment. The content and age parameters of the programme will be kept under review.
We understand that some primary care trusts maybe inviting people into the programme who are under 40 years of age, for example, in areas that have significant South Asian communities who are generally at higher risk of vascular disease including diabetes. However, this scenario was not tested through the modelling, and so we have no evidence of its clinical or cost effectiveness.