Cardiovascular disease (CVD)

Our ambition for CVD prevention

The NHS Long Term Plan identifies cardiovascular disease as a clinical priority and the single biggest condition where lives can be saved by the NHS over the next 10 years. The Plan sets the ambition for the NHS to help prevent over 150,000 heart attacks, strokes and dementia cases over the next 10 years and outlines how we, and partners in the voluntary and community sector and in other national organisations will meet this ambition.

About CVD

Cardiovascular disease (CVD) is a general term for conditions affecting the heart or blood vessels. CVD includes all heart and circulatory diseases, including coronary heart disease, angina, heart attack, congenital heart disease, hypertension, stroke and vascular dementia.

  • CVD affects around seven million people in the UK and is a significant cause of disability and death
  • CVD is responsible for one in four premature deaths in the UK and accounts for the largest gap in health life expectancy. Those in the most deprived 10% of the population are almost twice as likely to die as a result of CVD, than those in the least deprived 10% of the population
  • You are more at risk of having CVD if you have atrial fibrillation (AF), high blood pressure, or high cholesterol. These are known as the ‘high risk conditions’
  • You are more at risk of CVD if you have diabetes or a family history of heart disease, if you are a smoker, or are from a black, Asian, minority ethnic (BAME)  background
  • There are significant health inequalities for people living with severe mental illness (SMI). Life expectancy is 15-20 years lower than the general population. People with SMI have a 53% higher risk of having CVD and 85% higher risk of death from CVD

Our work on CVD

The national CVD Prevention programme has been set up to develop targeted interventions to optimise care by maximising diagnosis and treatment to minimise both individual risk factors, and population risk.

The programme aims to deliver the commitments set out in the Long Term Plan through:

  • Improving and increasing early detection and treatment of CVD to help patients live longer, healthier lives. We will work towards people routinely knowing their ‘ABC’ numbers – (AF, blood pressure and cholesterol)
  • Improving the effectiveness of approaches such as the NHS Health Check to rapidly treat those identified with the high-risk conditions, including AF, high blood pressure and high cholesterol
  • Expanding access to genetic testing for Familial Hypercholesterolaemia (FH); enabling us to diagnose and treat those at genetic risk of sudden cardiac death
  • Supporting pharmacists and nurses in Primary Care Networks to find and treat people with high risk conditions and offer treatment in a timely way
  • Commissioning a new national CVD prevention audit for primary care this audit is called ‘CVDPrevent’ and will extract routinely recorded but anonymised GP data, making it easier for practices and Primary Care Networks to systematically identify people whose treatment could be improved and risk reduced
  • Working with our partners to improve the response of the public to somebody having a cardiac arrest out of hospital and build defibrillator networks, making it easier to map and access defibrillators to improve survival from out of hospital cardiac arrest
  • Working with partner organisations to increase the number of people who know their ABCs
  • Increasing the proportion of patients with heart failure and heart valve disease who complete a course of cardiac rehabilitation, a programme of exercise and information to help people recover following a heart attack, heart surgery or procedure.

In February 2019, NHS England published the new GP contract; the first step in the implementation of the Long Term Plan. As well as the commissioning of CVDPrevent, the contract includes CVD specific announcements around CVD case finding and Quality and Outcomes Framework (QOF) changes for blood pressure control.

How we are working with partners

The national CVD Prevention programme is developing a clear approach, to improve outcomes for people with CVD and meet the Long Term Plan ambitions.

We are working with partners, including the British Heart Foundation, the Stroke Association, Academic Health Science Networks (AHSNs), Public Health England (PHE) and other arm’s length bodies and third sector organisations to deliver the national programme of work.

In February 2019, as part of the Cardiovascular Disease Prevention System Leadership Forum we published new national ambitions for the detection and management of the high risk conditions. The ambitions complement the Long Term Plan and commit to a whole system approach to supporting England to be world leading in the prevention of CVD.

If you would like to find out any more about our work on CVD, please contact england.clinicalpolicy@nhs.net

Resources