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Significant success in cardiovascular work

Written by: Noshina Kiani - 29th September 2023

Heart disease, including heart attacks and strokes, is a major health problem in the UK. It is one of the leading causes of death in the country and causes 1 in 4 deaths in England, putting immense pressure on the NHS. Over the past year, we have achieved significant success in our cardiovascular work. Noshina Kiani, Workstream Lead for cardiovascular disease, highlights the key successes and initiatives undertaken.

We have been implementing several national cardiovascular disease (CVD) programmes, focusing on improving lipid management, incorporating novel treatments, and optimising hypertension care. Through the National Lipids and Familial Hypercholesterolaemia (FH) programme, we aimed to enhance cholesterol management, increase FH detection, and optimise cholesterol-lowering medications. Some of the objectives included increasing cholesterol measurement, providing more treatment options for high-risk patients, reducing health inequalities through a national approach, and incorporating the latest approved treatments into lipid pathways.

The Blood Pressure Optimisation (BPO) programme made improvements, particularly in South Yorkshire, in transforming the prevention of CVD by optimising the clinical care and self-management of people with hypertension. Hypertension and high cholesterol, both leading risk factors for CVD, are often underdiagnosed and undertreated. The BPO programme has raised awareness about hypertension and provided a foundation for discussing other CVD conditions, such as lipids. This programme has supported Primary Care Networks (PCNs) in identifying more patients with hypertension by better utilising patient record searches and working more closely with community pharmacies. Additionally, the programme has focused on reducing health inequalities by targeting the most deprived populations.

The impact of the BPO programme

A notable case study from a practice in South Yorkshire highlights the success of this programme, where an opportunistic case-finding initiative led to 700 patients having their blood pressure checked during a flu clinic. Overall, the BPO programme has demonstrated progress in addressing hypertension and CVD prevention by enhancing clinical care, self-management, and targeted interventions for at-risk populations. This was extended for another six months which allowed for further improvements to be made.

A pilot project with the Wakefield PCN showcased an innovative approach. Aiming to effectively utilise Pharmacy Technicians to improve lipid optimisation, in July this year we ran a workforce redesign workshop which led to significant outcomes, such as identifying training opportunities and creating a well-defined process. This process empowers Pharmacy Technicians with specific roles and responsibilities, allowing them to play a crucial part in patient care. By integrating Pharmacy Technicians into the lipid management pathway, it ultimately enhances patient outcomes and ease the burden on clinicians, demonstrating the benefits of diversifying the healthcare workforce. Learning from this work will be shared with other ICBs through a case study once we have evaluated some of the improvements which are being made over the upcoming months.

Fostering a culture of collaboration

These local and national CVD programmes demonstrate a commitment to improving cardiovascular health through innovative solutions, early identification, and workforce development. Enhanced collaboration and knowledge sharing has also been central to some of the successes of these projects. By fostering a culture of collaboration among regional healthcare providers through regular workshops, webinars and events we have enabled healthcare professionals to stay updated on the latest research, treatments, and best practices in cardiovascular care which will help inform future prevention strategies.

The initiatives and projects over the last year have contributed to better health outcomes and reduced health inequalities in the region. By continuing to promote innovation, collaboration, and evidence-based care, we are well-positioned to drive further improvements in cardiovascular health across the three Integrated Care Systems (ICSs) in our region, Integrated Care Boards and PCNs in the years to come.

What’s next

Through the extension of the West Yorkshire Healthy Hearts project earlier this year, we have been building on the success of the programme allowing us to continue with a co-ordinated approach to CVD detection across West Yorkshire.

There is also some exciting work upcoming in collaboration with Health Innovation North East and North Cumbria as we trial a new innovative cholesterol test. A pilot with Affinity Care in Bradford will see these tests being used in a variety of different ways i.e.- self check rooms, Lipid Optimisation clinics and community pharmacy to gain better understanding of lipid management in a variety of scenarios. These tests will also be used as part of InHIP project in West Yorkshire, where high risk patients identified in deprived communities will be targeted through accessible testing in community settings to better understand some of the challenges and barriers they might face.

We are partway through a joint project with South Yorkshire and Humber & North Yorkshire ICBs as part of the Collaborative Lipid Fund, with a focus on enhancing lipid management and raising awareness of available treatment options, improving staff competence and confidence and addressing health inequalities.

In the coming months, we will be making some ambitious moves to improve cardiovascular health in our region. Through education, local engagement, and understanding barriers, we aim to empower our healthcare professionals and address unique challenges when it comes to lipid management and optimisation. Our focus will also be to build sustainable projects that adapt and thrive over time, leaving a lasting legacy of improved cardiovascular health for generations to come.