Pharmacy health check services are being dropped by PCTs because of a lack of interest from contractors and cost concerns, with one senior executive calling on pharmacists to "change their mentality" towards service provision.

Pharmacy-delivered NHS health check programmes are in danger of being decommissioned by a number of PCTs and in some cases have already been cut, according to Julie Evason, managing director of Health Diagnostics, which provides software and support to PCTs commissioning the checks.

Ms Evason said 20 per cent of the 17 PCTs her company works with were either considering withdrawing health check commissioning from pharmacy providers or had already done so.

NHS health checks were launched by the government in 2009, when it promised that every patient aged between 40 and 74 in England would be able to access a free check, assessing their risk of developing cardiovascular and other diseases. Commissioning of the services through pharmacy has been patchy, but PSNC's local services database suggests that pharmacists are currently providing the services in more than 20 PCTs.

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	Ms Evason said pharmacy had initially been an "obvious choice" for many PCTs and that some pharmacies had been paid between £20-£35 per health check they conducted. "It sounded like a licence to print money for pharmacy, particularly when the PCTs didn't restrict the number of checks that could be conducted," she told C+D.

However, results from pharmacy services had been "very disappointing", she said, with many PCTs now looking for alternative providers. Pharmacy performance has previously been cited as a reason for decommissioning services and a C+D investigation last year found low uptake was a factor in more than a quarter of the 25 PCTs cutting or considering cutting pharmacy services.

Trusts contacted by C+D about health checks said pharmacy delivery had been a problem, with one warning that pharmacy services had not been cost-effective.

Mike Lavender, a consultant in public health medicine for NHS County Durham, said pharmacies in the region were not doing the "kinds of numbers they could be doing" with health checks. And another trust that asked to remain anonymous said it too had received a poor response from pharmacies invited to take part in a local pilot and called for the sector to change its mentality towards services (See Poor performance to blame in health check decision).

Many pharmacies had cited lack of time as a problem, Ms Evason said. And this was backed by a C+D poll, in which 47 per cent of respondents rated the health check service they provided as "poor", saying they were struggling to deliver it because of lack of time and/or patient interest. Only 6 per cent said they were happy with how they were delivering health checks.

But pharmacies were missing "a great opportunity", by not getting involved in the services, Ms Evason said, warning that their lack of interest could impact on future decisions for the delivery of other services. "My concern is that the negative feedback could mean that other commissioners decide against pharmacy as a provider."

PSNC head of NHS services Alastair Buxton said he was disappointed to hear about the demise of health check services, adding: "Where it does happen, I hope the LPC and commissioner can examine why the pharmacy activity level was not as desired in order that we can all learn lessons for the future."

Mr Buxton warned last month that LPCs "continued to report that locally commissioned services are at risk of being decommissioned".

However, there was good news from C+D's PCT Investigation 2011, which found that on average PCTs spent more on enhanced services in the last financial year than they had previously.

In 2010-11, each trust spent almost £400,000 on pharmacy enhanced services - up 8 per cent on the average of just below £370,000 spent in 2009-10. The average services income for individual pharmacies also rose last year, although less significantly, with almost £5,000 spent per pharmacy, up 1 per cent from 2009-10.

See how your local services measure up with our interactive maps and tables at www.chemistanddruggist.co.uk/pcti2011