Unregulated high street health checks spark concern

Unregulated high street health checks spark concern
© iStock/moomusician

An investigation by The BMJ reveals that many UK companies are offering health checks with misleading claims that are not backed by evidence.

New findings highlight how some UK companies are making misleading claims and not explaining the potential harms of high street health checks. As a result, NHS healthcare professionals are often left to explain “abnormal results” to the patients.

Consumers are promised that the private health checks, which include blood tests, will put their health into their hands and spot problems early. One of the investigators found that the tests often contradict official medical guidance and do not fully explain the implications of the results for the patients.

In a linked opinion article, experts noted that clear regulation is needed for private blood tests and health checks to prevent poor quality, unnecessary testing that is costing the NHS.

Private testing and health checks readily available on high streets

Based on the findings from the investigation, The BMJ has reported two companies to the UK Advertising Standards Authority for misleading claims about the accuracy or detection rates associated with at-home tests. Another company removed their tests from its website after The BMJ got involved.

Examples of private testing include regular blood tests which promise to predict how many healthy years of life a person has left, a tiredness and fatigue finger prick test that measures iron, thyroid hormones, vitamin levels, and inflammation and screening with the option of a full refund if results fall within the normal range.

However, these tests are problematic. Bernie Croal, President of the Association for Clinical Biochemistry and Laboratory Medicine, outlined that 5% of test results will lie outside the normal reference range, so very few people will receive no “abnormal” results, even in situations where there’s nothing wrong with them.

Furthermore, many of the health checks offered are not recommended by the National Screening Committee “because it is not clear that the benefits outweigh the harms” and NHS GPs are often asked by patients to explain the results of private tests, creating more work for the healthcare system.

The companies selling private tests believe they are necessary

In 2019, the Royal College of General Practitioners reported a statement on private health checks, warning that “the organisation initiating the screening should not assume that GPs will deal with the result”.

On the other hand, the companies selling the private tests believe there is a clear role for them.

Sam Rodgers, a practising GP in southeast London and chief medical officer at Medichecks, illuminated that people are directed to their GP in around 7% of cases, whilst Nightingale Health claim that the tests are for “prediction and prevention rather than diagnosis or treatment” and it did not provide test results as such but overall risk information and lifestyle guidance. But, there is wide variation in the amount and accuracy of information provided to consumers when purchasing tests online.

For instance, prostate cancer risk (PSA) testing is available on the NHS for men without symptoms over the age of 50, after a discussion with a GP about the risks and benefits. Yet, private tests are easily available with no age recommendation at all and some contradict official advice about their accuracy.

Shaun O’Hanlon at EMIS, the healthcare IT company behind the app, said that all private provider testing services listed on Patient Access have been selected after a thorough review by the clinical team, which includes UK GPs, while NHS Digital say that services offered through third-party apps or websites connected to the NHS login service are the responsibility of the companies providing them.

But experts are calling for better regulation. Dr Margaret McCartney and colleagues commented the NHS “needs to robustly explain the criteria for high-quality screening and testing and explain when consumers should be sceptical and what they should question.”

They argued that the Care Quality Commission (CQC) should be empowered to appraise the apps that promote private screening as well as the screening companies themselves, and say placing a responsibility on companies to undertake the further investigation of abnormal test rest results “could help reduce the negative impact on the NHS.”


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