Condition category
Not Applicable
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting
Publication status

Plain English Summary

Background and study aims
The NHS Health Check programme has been set up to help prevent heart disease, stroke, diabetes, kidney disease and some types of dementia in the general population. Everyone aged 40 to 74 and not either already diagnosed with one of these conditions, or have certain risk factors, will be sent an invite once every 5 years to attend an appointment to check on their risk of developing these diseases. They will be then given support or advice on how to manage or reduce such risks. The programme is a policy priority for the Department of Health, NHS England, Public Health England and local authorities in their efforts to tackle premature death and promote healthy lifestyles. However, the number of people who join the programme are significantly lower than desired, at around 50 per cent. Local authority commissioners of the NHS Health Check currently use a range of different letters and marketing to encourage those eligible to attend. However, there has not to date been any robust research into what type of letters or marketing strategies will are most likely to lead to an increase in the number of people taking part in the programme. There is compelling evidence in the field of behavioural science to suggest that a low cost intervention within the content of the invitation letter or a reminder text message may be effective at changing people’s behaviour. The aim of this study is to determine what type of patient invitation letter would be most likely to successfully encourage people to enrol on the NHS Health Check programme. The results will be used to help promote the uptake of Health Checks.

Who can participate?
People eligible for an NHS Health Check in the Borough of Northamptonshire during the duration of the study

What does the study involve?
This study tests whether a number of small, low-cost changes to the invitation process for Health Checks can increase uptake. Patients are randomly allocated to receive the usual letter of invitation (control), a new, shorter, action focused letter containing some questions and answers relating to the Health Check (intervention 1), or a shorter letter with a reference to the cost of the Health Check appointment (intervention 2).

What are the possible benefits and risks of participating?
There are no risks to participants. The standard NHS leaflet explaining the risks of attending a Health Check, or not, is including in both the control and intervention letters.

Where is the study run from?
GP surgeries in Northamptonshire (UK)

When is the study starting and how long is it expected to run for?
March 2013 to April 2014

Who is funding the study?
The Department of Health (UK)

Who is the main contact?
Annabelle Bonus

Trial website

Contact information



Primary contact

Ms Annabelle Bonus


Contact details

Richmond House
79 Whitehall
United Kingdom

Additional identifiers

EudraCT number number

Protocol/serial number


Study information

Scientific title

Using behavioural insights to change uptake of the NHS Health Check


Study hypothesis

Does making small, low-cost changes, based on behavioural insight, to the NHS Health Check invitation process change levels of uptake?

Ethics approval

NHS Health Research Authority NRES committee, 23/09/2013, ref: 13/SW/0293

Study design

Multicentre randomised controlled trial

Primary study design


Secondary study design

Randomised controlled trial

Trial setting

GP practices

Trial type


Patient information sheet

No participant information sheet available


NHS Health Checks


Patients in participating practices who are due to be invited to a health check are randomly allocated into one of three groups. This is a simple randomization done locally by each practice once a month. The letter variations should include:
1. National template (control)
2. A shorter letter containing some questions and answers relating to the Health Check
3. A shorter letter with a reference to the cost of the Health Check appointment

Intervention type



Not Applicable

Drug names

Primary outcome measure

Uptake of the NHS Health Check. This is recorded by the local IT system EmisWeb. This is recorded once the appointment is attended, and the data provided for analysis six months after the invitation letters are sent.

Secondary outcome measures

Not provided at time of registration

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

Any patient registered at a consenting participating GP practice in Northamptonshire during the trial duration who is due to be invited for an NHS Health Check. Patients aged between 40-74 are invited to attend for a Health Check via an invitation letter sent to the address held in their medical records. The letters are sent monthly by the individual GP practices.

Participant type


Age group




Target number of participants


Total final enrolment


Participant exclusion criteria

Participants will only be excluded if they are no longer eligible for an NHS Health Check at their GP's surgery, for example, if they have had one at a local pharmacy already.

Recruitment start date


Recruitment end date



Countries of recruitment

United Kingdom

Trial participating centre

Department of Health
United Kingdom

Sponsor information


Department of Health (UK)

Sponsor details

c/o Tabitha Brufal
Richmond House
79 Whitehall
United Kingdom

Sponsor type




Funder type


Funder name

Department of Health (UK)

Alternative name(s)

Funding Body Type

Funding Body Subtype


Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Basic results (scientific)

Publication list

2019 results in (added 17/12/2019)

Publication citations

Additional files

Editorial Notes

17/12/2019: The following changes have been made: 1. Publication reference added. 2. The final enrolment number has been added from the reference. 31/05/2019: Internal review. 07/07/2017: No publications found, verifying study status with principal investigator.