Prevention is at the heart of the NHS Long Term Plan. In addition to substantial commitments to tackle obesity, alcohol and smoking, the Plan includes a major ambition to prevent 150,000 strokes and heart attacks over the next ten years by improving the treatment of the high-risk conditions – hypertension (high blood pressure), high cholesterol and atrial fibrillation (AF).
Individuals with these common conditions are more at risk of developing cardiovascular disease (CVD) which includes heart attack, heart failure and stroke, and many cases of dementia. Despite the impact of treatment on outcomes, large numbers of people are undiagnosed or under treated, partly because these conditions often have no symptoms to alert the patient and clinician to, and partly because treatment decisions are complex.
To help tackle this, and to support the Long Term Plan ambition, NHS England and NHS Improvement will commission a national primary care audit – CVDPREVENT.
What is CVDPREVENT?
CVDPREVENT is a national primary care audit that will automatically extract routinely held GP data covering diagnosis and management of six high risk conditions that cause stroke, heart attack and dementia: atrial fibrillation (AF), high blood pressure, high cholesterol, diabetes, non-diabetic hyperglycaemia and chronic kidney disease.
CVDPREVENT will provide a foundation for professionally led quality improvement in individual GP practices across Primary Care Networks (PCNs). It will support primary care in understanding how many patients with the high-risk conditions are potentially undiagnosed, under treated or over treated.
The audit will provide data to highlight gaps, identify inequalities and monitor improvement and impact on inequalities, as well as enabling and guiding opportunities for improvement. It will generate quarterly, anonymised data at national, regional, PCN and CCG practice level, across a broad range of metrics. Locally based QI audit tools based on the CVDPREVENT business rule set will enable practices and primary care networks to systematically identify individuals whose clinical risk factors are sub-optimally managed so that they can be offered treatment that will minimise their risk of life changing heart attack or stroke.
When will CVDPREVENT be available?
A first data extraction using NHS Digital’s GP Extraction Services (GPES) is planned for summer 2020 with initial analysis being undertaken in 2020/2021.
The CVDPREVENT Implementation Steering Group
A number of partner organisations are involved in the work, including RCGP, NHS Digital, NICE, Public Health England, NHS England and NHS Improvement, British Heart Foundation, Royal Pharmaceutical Society, Primary Care Cardiovascular Society and GP representatives.
Working with PRIMIS, and funded by the British Heart Foundation, the group has developed a draft business rule set for condition specific metrics. The final business rule set will be published by NHS Digital.
PRIMIS has also conducted a feasibility report which concluded that the audit is feasible and that the optimal route for extraction of the audit dataset would be via the NHS Digital GP Extraction Service (GPES).
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