Over-40 health check: what should it include?

Turning 40 is a reasonable point to ask what a health check should actually cover, because it is also when the NHS starts offering one. The NHS Health Check answers a narrower question than a private assessment does. For a doctor-led examination, ECG and a broader laboratory panel in one visit, compare the Essential and Advanced tiers of the full body MOT at Medical Express Clinic.

What does the NHS Health Check cover from age 40?

The NHS Health Check is a free cardiovascular risk assessment offered to adults aged 40 to 74 in England, repeated roughly every five years. It focuses on blood pressure, cholesterol and BMI, with blood sugar checked where appropriate, gathered through a lifestyle questionnaire and a simple blood test. It is designed to spot early signs of stroke, kidney disease, heart disease, type 2 diabetes and dementia. It does not include a doctor's physical examination, an ECG or the wider organ-function panel that a private MOT covers. If you are eligible, it is worth having: it is free and it looks at the risks that matter most at this age. Our sister clinic Health Screening Clinic sets out how a health MOT over 40 differs from one taken earlier.

What does a private over-40 health check add?

A private health check adds a GP consultation and physical examination, a 12-lead ECG, and a substantially wider blood panel read together by a doctor rather than screened by questionnaire alone. The Essential MOT at Medical Express Clinic is built as a doctor-led baseline for adults from 18, and at 40 it covers the NHS Health Check measurements plus a broader set of blood tests and a doctor's examination.

The table below sets the two out plainly.

Comparison of what each check actually includes.

What is in the Essential MOT specifically?

The Essential MOT includes a GP consultation, a structured physical examination, a 12-lead ECG, body composition analysis and urinalysis, plus 60+ laboratory markers covering full blood count, iron and inflammation, cholesterol and triglycerides, glucose and HbA1c, liver function, kidney function including eGFR, uric acid, calcium and bone markers, and basic thyroid function. Results are usually ready within 3 to 5 working days, and you return for an included in-person review where your GP explains each finding and agrees any next step.

Your doctor places every result against you specifically, not against a printed reference range in isolation. Dr Mohammad Bakhtiar, the clinic's screening clinical lead, puts it this way: "the right MOT is not automatically the one with the longest list. We look at age, symptoms, family history and what the patient wants answered, then choose the level of investigation that is likely to be useful." That is worth knowing before you pay for more tests than your situation needs.

Is the Advanced MOT worth the extra cost over 40?

The Advanced MOT is worth the extra cost if a respiratory, hormone or ongoing-GP-access question applies to you specifically, not simply because the list of tests is longer. On top of everything in Essential, Advanced adds a chest X-ray reported by a radiologist, spirometry (lung function testing), a VO2 Max fitness assessment, a full male or female hormone profile (LH, FSH, prolactin, testosterone, oestradiol, SHBG and FAI), an advanced thyroid panel with antibodies, and vitamin B12 and D. It also includes one year of follow-up GP access: four consultations, unlimited in duration, for use over the following 12 months, for the person who had the MOT rather than as family cover.

That combination suits current or former smokers, anyone with respiratory symptoms, women with hormonal questions around perimenopause or PCOS, men with symptoms of low testosterone, and anyone who wants ongoing private GP access built into the price rather than booked separately each time.

How common is an abnormal result at this age?

Findings that need a conversation are common rather than rare. In a recent snapshot of Medical Express Clinic MOT results completed between April and August 2026, 47% of screenings that included cholesterol markers had at least one high cholesterol-related finding. This is a clinic figure describing what the clinic sees, not a national statistic, and a high cholesterol-related result on its own is not a diagnosis of cardiovascular disease; results outside the reference range can be temporary, need no treatment, or be affected by medicines and supplements. What it does show is that the included results consultation is doing real clinical work, not just handing over a printed report. Where a treatment plan is clinically appropriate, it is agreed at that same appointment at no additional consultation cost; prescriptions, medication and any repeat testing are separate.

Does an over-40 check include a PSA test for men?

No, PSA is not included in the Essential or Advanced MOT. There is no national PSA screening programme in the UK. On the NHS, men aged 50 or over, or 45 or over if they are at higher risk (for example Black men, or men with a father or brother who had prostate cancer), can ask their GP for a PSA test after talking through the pros and cons: a raised PSA is not always cancer, and a normal PSA does not rule it out. At Medical Express Clinic, PSA is included in the Elite MOT for men over 40, and separate doctor-led prostate screening starts from £349 with a GP examination and in-person review of the result. If prostate health is your main reason for booking, say so, so your GP can have that discussion with you first.

Do I need the physical examination and ECG, or would a blood profile do?

A blood profile alone is a reasonable choice if you specifically want laboratory markers without a doctor's physical examination or an ECG, for example as a faster or lower-cost top-up between full checks. Medical Express Clinic's blood test profiles range from general health packages to 18 clinical profiles for specific concerns, and many single blood results are ready within 24 hours. The trade-off is that no GP examines you, listens to your heart and lungs, or records your ECG, so anything those checks might catch is not covered.

How do I choose between Essential and Advanced at 40?

Choose Essential if you want a doctor-led baseline (blood pressure, ECG, cholesterol, glucose, liver, kidney, thyroid and a physical examination) without imaging, hormone testing or extended follow-up. Choose Advanced if a chest X-ray, lung function test, hormone profile or a year of GP access would answer a real question for you, whether that is a family history of respiratory disease, symptoms suggesting a hormonal change, or simply wanting private GP cover already paid for. Neither tier is a substitute for assessment of new or worsening symptoms; those need a GP appointment rather than routine screening, and chest pain or signs of a stroke need 999.

How does the appointment work at Harley Street?

Appointments run Monday to Friday at 117a Harley Street. Essential takes 45 to 60 minutes on the day; Advanced takes roughly 60 to 90 minutes because of the added chest X-ray, spirometry and VO2 Max testing. Continue your regular medicines unless told otherwise, arrive hydrated, and fast only if the clinic gives you a specific instruction for the tests you have chosen. Once results are back, usually within 3 to 5 working days, you attend an included in-person review where your GP goes through the findings and agrees next steps; further GP appointments beyond that review, outside the Advanced tier's year of access, are booked separately.