The short answer: the NHS Health Check is a free check for adults aged 40 to 74 who do not already have a diagnosis of the conditions it screens for, offered about once every five years. It estimates your risk of heart disease, stroke, type 2 diabetes and kidney disease from your blood pressure, a cholesterol blood test, a height and weight measure and lifestyle questions. It does not include eyes, teeth, hearing, prostate, mental health or skin. Those are separate conversations, and worth asking for by name.
That is the shape of it. What follows is what the check contains, what it leaves out, the questions worth adding after fifty, and a plain log so the numbers mean something from one appointment to the next.
What the NHS Health Check actually is
The NHS Health Check is free, and it is offered to adults aged 40 to 74 who do not already have a diagnosis of the conditions it screens for. If you are already being treated for high blood pressure, diabetes, kidney disease or heart disease, you are not the audience for it. Everyone else is invited roughly once every five years, usually by their GP surgery.
The appointment is short and unglamorous. Four things go in: your blood pressure, a cholesterol blood test, your height and weight, and lifestyle questions covering smoking, alcohol, activity and diet.
Those four are combined into a risk estimate: your chance of heart disease, stroke, type 2 diabetes and kidney disease over the years ahead, not a diagnosis of anything. A figure is only useful if it is written down, which is where most people leave it.
What it does not cover
This is the part that surprises people. The Health Check is not a general MOT. Six common areas sit outside it.
- Eyes. Sight is the optician's territory.
- Teeth and gums. That is the dentist, on its own cycle.
- Hearing. Not tested, unless you ask.
- Prostate. No national screening programme, and no prostate test in the check.
- Mental health. Low mood, anxiety and poor sleep are not part of it unless you bring them.
- Skin. Moles and changing patches are not examined.
None of that is a fault in the check; it is a boundary of it. Each is a separate conversation, and none will come up unless you ask for it by name. If you would rather talk about food than figures, our nutrition over 50 guide covers that ground.
The questions worth adding at 50 plus
The Health Check buys about ten minutes of a professional's attention, at no cost. Use it by arriving with questions. These are the seven worth having in your notes after fifty: questions, not instructions, because your GP decides what needs testing.
What is my blood pressure number, and where should it sit?
Ask for the figure, in both numbers, rather than a verdict of "fine". Blood pressure is written as systolic over diastolic, so ask where your reading sits against the range the NHS describes as normal, and whether it should be repeated: one reading taken in a surgery is often higher than your everyday level. Our guide to blood pressure after 50 explains both numbers.
What are my cholesterol figures and my overall cardiovascular risk estimate?
Cholesterol is a blood test, and the report has more than one line on it. Ask for your total cholesterol, your HDL and your non-HDL, sometimes given as LDL, and for the figure that matters most: your overall risk estimate, usually a percentage chance of a cardiovascular event over the next ten years. Then ask which factors are pushing it up. Age and family history cannot be changed; blood pressure and smoking can.
Waist-to-height as well as weight
Height and weight are measured and a BMI follows. Ask for your waist to be measured as well, because weight alone is a blunt instrument after fifty: two people of the same weight can carry it in very different places. The NHS line is a simple one — keep your waist to less than half your height. We go through it in waist-to-height ratio after 50.
Blood sugar and HbA1c
The Health Check estimates your risk of type 2 diabetes, and a blood test may be part of it. Ask which test was used — a fasting glucose, a random glucose or an HbA1c — and what your figure was. HbA1c reflects average blood glucose over the previous two to three months, which is why it is often the one quoted.
Kidney function
Kidney disease is the fourth risk, and the least discussed. Ask whether your kidney function was assessed, and how — typically an eGFR from a blood test, and often a urine test for protein. Kidneys are quiet, so ask for the figures: a baseline you can look back at beats a reassurance you cannot.
Vitamin D, if you are indoors most of the day
NHS guidance is straightforward: a daily vitamin D supplement is recommended through the autumn and winter, and all year for anyone mostly indoors or who covers up outside. Ask whether a blood test is appropriate in your case, particularly if you work inside or have a condition affecting absorption. Whether to test is a decision for your GP.
The men's health questions: prostate and testosterone
Two conversations that men over fifty often postpone. Prostate: there is no national screening programme and nothing in the check looks at the prostate. If your urinary habits have changed — getting up in the night, a weaker stream, urgency — say so. A GP decides whether testing such as a PSA blood test is appropriate. Testosterone: if energy, libido or mood have changed over months rather than weeks, describe the pattern. Whether to test is a clinical decision, and if a test is done it is usually an early-morning sample.
How to prepare for the appointment
Ten minutes goes further if the groundwork is done.
- A list of every medicine and supplement, with doses. Keep it in your phone, including the things you do not think of as medicine: the nightly painkiller, the vitamin D, the herbal sleep tablet.
- Ask about fasting when you book. Some cholesterol and glucose tests need you to have fasted and some do not.
- Book a morning slot if you can. If a fasting test is planned, that means less of the day spent waiting to eat.
- Take three home blood pressure readings and your waist measurement. Readings from different days tell a GP far more than one from a busy room.
- Take a written list of questions. Six lines on a note beat a memory of two.
Your results log
Numbers only become useful when you can see them move. One page, one row per appointment, nothing else. If you prefer something structured, the Health Journal prints these columns.
| Date | Blood pressure | Cholesterol (total, HDL, non-HDL) | HbA1c or blood sugar | Waist (cm) | Weight | Questions for next time |
|---|---|---|---|---|---|---|
| 19 Oct 2026 (example) | 138/84 | 5.4, 1.2, 3.7 | 41 | 98 | 86 kg | Ask whether to repeat BP at home; ask which kidney test was done |
| — | — | — | — | — | — | — |
| — | — | — | — | — | — | — |
The last column is the one people leave blank, and the one that pays best: a question written down at one appointment becomes the first thing you ask at the next. Units differ between surgeries, so copy each figure exactly as given.
When to ask for an appointment sooner
Most of what a Health Check turns up is routine, and a five-year cycle suits routine. A few things are not, and none should wait for an invitation letter.
- Chest pain or breathlessness.
- Unexplained weight loss.
- Blood in your urine or your stools.
- A new lump.
- Sudden changes to your vision.
- Ongoing fatigue.
- Anything that is new and getting worse.
Contact your GP with any of these, and use NHS 111 when the surgery is closed. For chest pain or severe breathlessness, call 999.
When to talk to a GP
Two practical points about access. First, you can raise any question with your GP outside the five-year cycle: ringing the surgery does not require an invitation letter. Second, the six areas the Health Check does not cover — eyes, teeth, hearing, prostate, mental health and skin — each go to a different service, so ask which and how. Nothing in this article is medical advice, and the points above describe what the NHS offers and what is worth asking about rather than what is right for you individually.
Start with the week before the appointment
The free 7-Day Guide is a week of small, specific actions — one a day, no gym and no gear. It includes the home blood pressure routine and the waist measurement that make the numbers here worth recording.
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Common questions
Is the NHS Health Check free, and who gets it?
Yes. It is free, and it is offered to adults in England aged 40 to 74 who do not already have a diagnosis of the conditions it screens for: heart disease, stroke, type 2 diabetes and kidney disease. Invitations come from your GP surgery, about once every five years.
What does the NHS Health Check actually test?
It measures your blood pressure, takes a cholesterol blood test, records your height and weight, and asks lifestyle questions covering smoking, alcohol, activity and diet. Those estimate your risk of heart disease, stroke, type 2 diabetes and kidney disease. It is a risk estimate, not a set of diagnoses.
Does the NHS Health Check include a prostate check or an eye test?
No. Eyes, teeth, hearing, prostate, mental health and skin are all outside the NHS Health Check. They are handled by other services, or by a separate conversation with your GP, so ask for them by name rather than waiting to be asked.
My results were called normal. What should I ask for next?
Ask for the numbers rather than the verdict. Blood pressure as two figures, total cholesterol with HDL and non-HDL, the overall cardiovascular risk estimate, and whatever blood sugar and kidney figures were produced. Record them with their units, and add the questions you did not get to.