Brady also notes that patients are confused about why the service is necessary. "I don't think the public are absolutely clear when they get a letter inviting them to an NHS Health Check... to the full reason why. I don't think we're communicating risk very well." One sticking point here is individual versus population health, and the wider implications of ill-health risk for NHS capacity and finance. Waterall suggests there could be more information about why identifying early risk factors will avoid future cost to the NHS. "But that's quite a complex message to get across to the public," he says. Overall, though, Brady says, patients should be given more, and clearer, information. "From a nurse's point of view there needs to be more PR and information about the NHS Health Check from Public Health England specifically targeted at patients. Yates agrees: "It's a brilliant concept and it's got opportunity but how it's being marketed and delivered could do with further explanation incorporating user feedback And what about the effectiveness of the health checks themselves? Another element of the NHS Health Check (after at scale risk assessment, awareness an management is intervention where necessary, points out Waterall. Sometimes this will clinical, for example medicines, but more often it will be an for behavioural change out, as a limitation of their study, that there is a lac