Exploring ethnic minority and underserved groups’ experiences of the NHS Cardiovascular Disease Health Check uptake in North East England
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Exploring ethnic minority and underserved groups’ experiences of the NHS Cardiovascular Disease Health Check uptake in North East England
Quick-read summary
Cardiovascular disease (CVD) is the leading cause of death worldwide, and CVD prevention is a public health priority.
People in the North East of England have some of the lowest healthy life expectancy and highest levels of heart disease and health inequalities in the country.
One way the NHS tries to prevent CVD is through free CVD Health Checks, offered every five years to adults aged 40-74. However, many people, especially those from ethnic minority and underserved communities, do not attend these checks. This study aimed to understand why people are not taking up these health checks and what could help.
We held group discussions with people from different ethnic and underserved communities in Middlesbrough. We asked about people’s experiences, knowledge, and what they knew about the heart checks. We looked for common themes about what stops or helps people to take part.
Our study found that many people faced barriers such as difficulties getting and attending appointments, not understanding what the checks involve, and feeling unsure or mistrustful about the process.
Participants suggested that making health checks available in local community spaces, such as community centres or faith settings, would make them easier to attend. They also said that working with trusted community champions could help build confidence and raise awareness about why these checks matter.
Our research shows that a one-size-fits-all approach to health checks does not work for everyone. To reduce health inequalities, health services should work with local people and share information in ways that people trust. Making services more visible, accessible, and trusted within communities could help prevent CVD and improve health in areas most in need.
Who is this evidence useful for?
This research would interest policymakers, healthcare professionals, and community organisations who aim to improve uptake of NHS Health Checks and reduce health inequalities. It also matters to local residents and community champions, whose involvement is key to designing accessible and trusted health services.
The research
- We used a Behavioural Insights approach to explore why people in underserved communities do not take up NHS Cardiovascular Disease (CVD) Health Checks.
- Seven focus groups of 45 participants from ethnic minority and deprived communities were conducted in Middlesbrough.
- Discussions explored people’s knowledge, attitudes, and experiences of CVD Health Checks and what would help them engage.
- Data were analysed thematically to identify key barriers and enablers to participation.
Why this research is unique
- It applied behavioural science principles to understand real-life barriers to preventive healthcare.
- It actively involved underserved communities in identifying practical solutions, making the findings more relevant for designing inclusive and community-based health services.
Key findings:
- Access barriers: Many people found it difficult to attend NHS Health Checks due to inconvenient appointment times, transport issues, and services being held in unfamiliar or formal healthcare settings.
- Lack of understanding: Participants often did not know what a CVD Health Check involved or why it was important.
- Trust and attitudes: Some communities felt uncertain or mistrustful about engaging with health services, especially when communication was not culturally sensitive or relatable.
- Community-based solutions: People said they would be more likely to attend checks if they were offered in familiar, trusted community spaces such as community centres, faith venues, or local events.
- Role of community champions: Involving trusted local figures to share information and encourage participation was seen as a powerful way to build confidence and increase awareness.
- Co-designed approaches: Participants highlighted that health initiatives should be developed and delivered with communities, ensuring services reflect local needs, languages, and preferences.
Why is this important?
These findings are important because they highlight why existing NHS Health Check programmes are not reaching the people who need them most, contributing to ongoing health inequalities in the North East of England.
By showing that trust, accessibility, and cultural relevance are key to engagement, this research offers practical ways to make preventive healthcare more inclusive.
Applying these insights could help increase early detection of CVD, reduce avoidable illness, and support fairer health outcomes across communities.
Public involvement
People from ethnic minority and underserved communities in Middlesbrough were directly involved in this research. We held workshops with community leaders and members which led to the co-design and implementation of practical solutions to the focus group findings, such as mobile CVD Health Checks conducted on health buses at Middlesborough FC.
Recommendations for policy and practice
This research could influence policy and practice by encouraging health authorities to redesign NHS CVD Health Checks to be more community-centred and accessible.
Additionally, it highlights the importance of involving trusted community champions and using targeted communication strategies, which could be integrated into public health campaigns to boost awareness and trust, ultimately helping to reduce health inequalities.
What happens next?
Next steps include sharing the findings with local health authorities, community organisations, and NHS teams to support service improvements.
Health Innovation North East have also further collaborated with community champions to co-design and pilot more accessible CVD Health Check approaches.
Find out more
Contact the lead author, Dr Sophia Brady: [email protected]
Read the full research paper
Further information
This work was a collaboration between researchers from the NIHR ARC North East and North Cumbria, and Health Innovation North East and North Cumbria.
You can read more about the work, here.
The work was covered by the BBC in October 2025: Why people in the North East ignore heart check invites – BBC News
Acknowledgments
Funding for this project was provided by the Innovations for Health Inequalities Programme via the Accelerating Access Collaborative (AAC).
The research was supported by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) North East and North Cumbria.