Delivering health checks in the workplace: an implementation evaluation of the Workplace Cardiovascular Disease Checks Pilot

Cardiovascular disease (CVD) is one of the main causes of death in England. It is largely preventable by reducing risk factors such as smoking, overweight and obesity, physical inactivity and an unhealthy diet.

In England, the NHS health check programme aims to identify people at risk of developing CVD and to support them in improving their health by providing advice and medication (if needed). It targets people aged 40 to 74 years who do not have an existing diagnosis of CVD, diabetes or chronic kidney disease. People can receive a health check every five years.

To date, uptake of the NHS health check has been low, and existing data show that some people are less likely to attend than others, such as men and younger people. This is of concern given that men have a higher risk of developing CVD than women and on average develop CVD about 10 years earlier.

To improve access and increase uptake among those who are less likely to have had an NHS health check, the government piloted a programme to run CVD health checks in the workplace. The pilot included 48 local authorities delivering 46 workplace health check programs between August 2024 and May 2025.

The project aimed to find what can be learnt from the pilot of this scheme and share this with policymakers. In particular, we looked at:

• How feasible it was to implement cardiovascular health checks in workplaces, and

• whether offering CVD health checks in workplaces increased uptake among groups of people who are less likely to have had an NHS health check.

The research involved three stages. First, we conducted a semi-structured survey with local authority leads from all 46 programmes taking part in the pilot to understand how local authorities implementedworkplace CVD health checks - who was involved, how they engaged workplaces, and how approaches differed between local authorities and different types of workplaces. In the second stage, we selected five programmes that were using different approaches and interviewed a wider range of stakeholders (16 interviews involving 21 participants) to gain a deeper understanding of what had worked well or not so well, for whom and under what circumstances. These interviews included representatives from workplaces who had participated in the programme.

Finally, we analysed data on who received a CVD health check in the workplace to examine inequalities in uptake of checks and in the detection of CVD risk factors. We involved members of the public to advise on the conduct of the research.

We found that the workplace CVD health checks pilot was feasible and was viewed positively by local authorities. Local authorities were able to tailor eligibility criteria and health check formats to suit workplace needs, including offering checks to people under 40 who would not normally qualify for an NHS Health Check. Most programmes offered checks face-to-face in workplaces. Seven programmes offered checks using digital self-service stations or self-testing via an app that people could use in their own homes. Local authorities often used existing relationships with workplaces to promote the pilot programme, and they described challenges in engaging workplaces and sectors employing large numbers of key population groups, particularly within the timeframe of the pilot. Most checks were delivered in large workplaces, particularly in the public sector.

More than 96,000 CVD health checks were delivered through the pilot. Our analysis found that the pilot successfully reached many younger adults, with over one-third of participants aged under 40. Women made up around half of participants, largely because many participating workplaces were in sectors such as healthcare and social care, where women form a large part of the workforce. The checks identified notable levels of CVD risk factors, including among younger people.

Overall, the pilot showed potential for workplace CVD health checks to complement the NHS health check programme, but effective implementation requires flexibility, time and continued support to build and maintain relationships with workplaces and to reach key groups with higher CVD risk.