Cardiovascular Disease Prevention Partnership Resource Pack
Introduction to Cardiovascular Disease (CVD) Prevention
CVD continues to be one of the main causes of morbidity and mortality and contributes towards health inequalities. The NHS Long Term Plan has identified CVD as one of its priority areas for action over the next ten years. Prevention of cardiovascular disease is a key priority in London. However, many adults living with Atrial Fibrillation (AF), hypertension (HTN) and Familial Hypercholesterolaemia (FH) remain undiagnosed. Without detection and medicine management, these conditions can increase the risk of having a stroke or heart attack, leading to higher mortality rates or greater disability. Ambitions for improving the detection and treatment of the 3 high risk conditions have been set nationally.
The CVD vision for London has been drafted by local system partners. Our regional data has been used to make sure the CVD ambition for London is aspirational but also achievable and clinically credible.
The proposed CVD vision and ambition for London state that by 2023 we will:
- Save an additional 400 lives each year by reducing the number of heart attacks and strokes
- Empower Londoners to take control of their circulatory health
- Work together with all our system partners to find and optimally treat Londoners with any of the three high risk conditions (high blood pressure, high cholesterol and atrial fibrillation).
Pan London ambitions:
- Detect 85% of expected population with AF without exceptions
- Protect 87% of all people with AF and a CHA2DS2Vasc score of 2 or more with anticoagulant therapy
- Perfect anticoagulant pathways to ensure 90% of people with AF are considered for anticoagulant therapy within one week of referral
- Detect 80% of expected population with hypertension
- Protect 80 % of all people with known hypertension by controlling BP to 140/90mmHg
- Find 25% of the expected population with FH.
The London Cardiovascular Disease Prevention Partnership (CVDPP) wants to help systems meet the regional requirement to produce a plan showing how, by the end of 2023, they will deliver on the vision and ambitions for CVD Prevention in London through the provision of this resource.
CVD Prevention Partnership Resource Pack
Regional level coordination for CVD prevention will promote clinical engagement and consensus amongst providers, commissioners and service users for systematic adoption of evidence-based interventions at pace and scale. It is to this end that the CVDPP has constructed a resource pack providing a multitude of diverse evidenced-based interventions, pilots and studies from across the country that have a promising or proven impact on CVD prevalence and prevention. This will provide NHS planning and commissioning bodies with the necessary tools to select targeted, evidence-based interventions to tackle cardiovascular disease across London.
Access it here: CVDPP Resource Pack
Atrial Fibrillation
Detect
Pulse checks
- Pulse Checks Graph East London
- AF Pulse Check Summary (2013)
- AF Pulse Check Study (2013)
- Opportunistic Pulse Checks BJGP (2018)
- Opportunistic Pulse Checks Summary
- Use of Pulse Checks for AF Detection Summary
- Use of Pulse Checks Wandsworth CCG Case Study
- Pulse Checks in General Practice Case Study
Detection devices
- AF Toolkit
- Description of Devices for AF Detection Summary
- HIN Detection Devices Appraisal Pack
- Mental Health Case Study
General practice and community pharmacy interventions
- Capture AF Project Summary
- Health Foundation Final Report Capture AF
- Rapid Referral to a One-Stop AF Clinic Summary
- Rapid Referral to a One-Stop AF clinic ESC CONGRESS (2019)
AHSN detection project
- Community Podiatry Case Study
- Lancashire Fire and Rescue Service Summary
- Innovation Agency: Lancashire Fire and Rescue Service is on the pulse of stroke prevention
- Mental Health Case Study
- SOS – AF Case Study
- Eastern Academic Health Science Network: Screening and optimising stroke prevention in atrial prevention
AF high impact intervention tool
Use of Commissioning Levers and Incentives
Protect
Virtual clinics
- Example Template Virtual Clinic for AF
- AF Virtual Clinic Procedure
- Pharmacist-led Virtual Clinics Summary
- Gov.uk pharmacist-led virtual clinics to optimise anticoagulation in AF
- Use of Virtual Clinics Southwark and Lambeth Case Study
- Use of Virtual Clinics Southwark and Lambeth Summary
- Improving the uptake of anticoagulation for prevention of atrial fibrillation related stroke – ESC Congress (2017)
- ESC Congress: Improving the Uptake of Anticoagulation
ICHP dashboard
Community pharmacy interventions
- Capture AF Project Summary
- Community Pharmacy Model Summary
- EJHP Community Pharmacy AF Prevention Service
- Health Foundation Final Report Capture AF
- Rapid Referral to a One-Stop AF Clinic Summary
- Rapid Referral to a One-Stop AF Clinic ESC CONGRESS (2019)
Implementing NICE PDA for patients not on anticoagulants
- NICE PDA Project Summary
- NICE: Reducing the risk of stroke in AF: using the NICE PDA with patients not currently treated with anticoagulants
- NICE: Patient decision aid: user guide for healthcare professionals. Implementing the NICE guideline on atrial fibrillation (CG180)
- NICE: Patient decision aid: Atrial fibrillation: medicines to help reduce your risk of a stroke – what are the options?
- DWAC Project Summary
- DWAC Document
General Practice Patient Database Searches
- CEG Tool Project Summary
- Queen Mary University of London: Clinical Effectiveness Group
- Active Case Finding Summary
- GRASP-AF Summary
- GRASP-AF Instruction Booklet
- Atrial Fibrillation Editorial (2019)
Novel clinics
- Gov.uk case study: Pharmacist-led virtual clinics to optimise anticoagulation in AF
- Pharmacist-led Virtual Clinics Summary
- Use of Virtual Clinics Southwark & Lambeth Summary
- Southwark and Lambeth Virtual Clinics
- Rapid Referral to a One-Stop AF Clinic Summary
- Rapid Referral to a One-Stop AF Clinic ESC CONGRESS (2019)
- One Stop AF Shop Blueprint
Perfect
Medication Adherence Reviews & Developing New Medicine Services
Anticoagulation Pathway Redesign
- Eastern Academic Health Science Network: Screening and optimising stroke prevention in atrial prevention
- SOS – AF Summary
- Excellence in Anticoagulant Care Summary
- Excellence in Anticoagulant Care Document
Primary Care Initiation of Oral Anticoagulation
- Use of Virtual Clinics Lambeth and Southwark Summary
- Use of Virtual Clinics Lambeth and Southwark Case Study
- Redbridge Pharmacist-led Model
- Redbridge Pharmacist-led Support Summary
Elements of an excellent anticoagulation service
Quality and Safety Audits of Prescribing Anticoagulation Therapy in Primary Care
Hypertension
Detect
Community Detection Initiatives
- The Impact of Interventions by Pharmacists in Community Pharmacies on Control of Hypertension Study
- The Impact of Interventions by Pharmacists in Community Pharmacies on Control of Hypertension Summary
- Community Pharmacy Tackling High Blood Pressure Summary
- PharmacyVoice CPS Report
NHS Health Checks
- Impact of NHS Health Check on Cardiovascular Risk Summary
- Impact of the National Health Service Health Check
- NHS Health Check Best Practice Guidance (2017)
- Top Tips for Improving the Uptake of NHS Health
Digital Detection
General Practitioner Training and Education
Case Examples and BHF Detection Pilots
- Bradford Healthy Hearts Programme Case Study
- C&M Halton HLP Case Study
- C&M Fire Services Case Study
- C&M Wellpoint Kiosk Case Study
- Gov.uk case study: Blood pressure testing outside of general practice
- Gov.uk case study: Blackpool: identify and treat people with undiagnosed high blood pressure
- Gov.uk case study: Stockport: ‘Know your numbers’ blood pressure campaign
- Stockport: ‘Know your numbers’ blood pressure campaign
- Blackpool Identify and Treat People with Undiagnosed High Blood Pressure Case Study
- Greenwich Community Pharmacy Interventions (BHF bid) Case Study
- BHF Blood Pressure Pilots Special Issue Feb (2019)
- BHF Blood Pressure Pilots Special Issue Feb (2019) Summary
Protect
Lifestyle Intervention Referrals
- Exercise on Referral Summary
- Mells et al., (2013) Study
- Webb et al., (2016) Study
- West Yorkshire & Harrogate Healthy Hearts Case Study
Patient Self-Management Interventions
- Kaambwa et al., (2014) Telemonitoring Study
- Kaambwa et al., (2014) Telemonitoring Summary
- Self-monitoring Blood Pressure Systematic Review (2017)
- Self-monitoring Blood Pressure Systematic Review (2017) Summary
- Gov.uk case study: Stoke-on-Trent: telehealth helps patients manage their own conditions
- Stoke-on-Trent: telehealth helps patients manage their own conditions
Development of Community Pharmacy Services
- The Impact of Interventions by Pharmacists in Community Pharmacies on Control of Hypertension Study
- The Impact of Interventions by Pharmacists in Community Pharmacies on Control of Hypertension Summary
- Community Pharmacy Tackling High Blood Pressure Summary
- PharmacyVoice CPS Report
Upskilling of General Practitioners
- NICE NG136 Hypertension Management Guideline
- NICE NG136 Visual Summary
- NICE NG136 Patient Decision Aid
- NICE NG136 Baseline Assessment Tool
- NICE Guidelines General Practitioner Upskilling Case Study
- Hypertension Online Training Resource Summary
Virtual Clinics
Perfect
Community Pharmacy Initiatives
- Pharmaceutical Services Negotiating Committee: Getting a pharmacy service up and running
- Supporting Adherence for People Starting a New Medication for a Long-Term Condition Through Community Pharmacies (2015)
- Supporting Adherence for People Starting a New Medication for a Long-Term Condition Through Community Pharmacies (2015) Costs Table
- Supporting Adherence for People Starting a New Medication for a Long-Term Condition Through Community Pharmacies (2015) Summary
Use of Integrated Self Care Component CQUIN
- Prescribed Specialised Services Self Care CQUIN Guidance Document
- Prescribed Specialist Services CQUIN Template
- Prescribed Specialised Services Self Care CQUIN Summary
Use of Commissioning Leversand Incentives
Familial Hypercholesterolaemia
Detect
Electronic Case Finders and GP Data Extraction Tools
- Familial Hypercholesterolaemia – a Primary Care Perspective Presentation (2019)
- Familial Hypercholesterolaemia – a Primary Care Perspective Presentation Summary (2019)
- Improving identification of familial hypercholesterolaemia in primary care Journal Article (2015)
- Improving identification of familial hypercholesterolaemia in primary care Journal Article Summary (2015)
NHS Health Checks
- NHS Health Check Best Practice Guidance (2017)
- Impact of NHS Health Check on Cardiovascular Risk Summary
GP Education and Awareness
- Lipids for Medics Presentation (2018)
- Lipids for Medics Presentation Summary (2018)
- British Heart Foundation Evaluation Report (2016)
- British Heart Foundation Evaluation Report Executive Summary (2016)
- Royal Society of Medicine’s Lipid Forum Meeting on Familial Hypercholesterolaemia Invite (2020)
- Familial Hypercholesterolaemia, Genomics and the NHS Summary
- Familial Hypercholesterolaemia, Genomics and the NHS
- Systematically Identifying Familial Hypercholesterolaemia in Primary Care Summary
- Systematically Identifying Familial Hypercholesterolaemia in Primary Care
- Heart UK Statement of Care Summary
- Heart UK Statement of Care
Familial Hypercholesterolaemia Minimum Dataset
- Familial Hypercholesterolaemia Minimum Dataset Cover Letter
- Familial Hypercholesterolaemia Proposed Minimum Dataset v2.1
Planning and Commissioning Familial Hypercholesterolaemia Services
- British Heart Foundation Planning and delivering FH services
- British Heart Foundation Evaluation Report (2016)
- British Heart Foundation Evaluation Report Executive Summary
- NHSE Business Case Derbyshire
- NHSE Business Case Lincolnshire
- NHSE Business Case LLR
- NHSE Business Case Northamptonshire
- NHSE Business Case Nottinghamshire
- Northampton Service Business Case Summary
- West-Midlands Familial Hypercholesterolaemia Service Specification Draft
- Familial Hypercholesterolaemia Implementing a Systems Approach to Detection and Management Summary
- Familial Hypercholesterolaemia Implementation Guide (PHE)
Cascade Testing
- British Heart Foundation Cascade Testing Services for Familial Hypercholesterolaemia (2014)
- British Heart Foundation Cascade Testing Services for Familial Hypercholesterolaemia (2014) Article Summary
Protect
Implementing Nurse-led Services
- Familial Hypercholesterolaemia Service Fixed Costs Example
- West-Midlands CCG Collaborative Commissioning Paper Familial Hypercholesterolaemia (2016)
- NHSE Business Case Derbyshire
- NHSE Business Case Lincolnshire
- NHSE Business Case LLR
- NHSE Business Case Northamptonshire
- NHSE Business Case Nottinghamshire
- Northampton Service Business Case Summary
- West-Midlands Familial Hypercholesterolaemia Service Specification Draft