Clinical interventions table

Highest to lowest impact on reducing Potential Years of Life Lost (PYLL)

Intervention (hyperlinked to relevant factsheets on each intervention) Net cost (per100k population) No. lives saved (100k pop) <75 Total lives saved (100k pop) PYLL (100k pop) <75
Implement British Thoracic Society Care Bundle for community acquired pneumonia £79,869 2.53 5.83 83
Support for GPs to recognise symptoms of cancer
Early diagnosis cancer Improved access to diagnostics
Improved hospital treatment
1.33 2.76 29
Increase prescription of anti-thrombotics (warfarin) by supporting GPs to identify patients with atrial fibrillation (increase proportion of patients clinically indicated as being eligible from 54% to 100%)
NICE CG36: Atrial Fibrillation
£48,580 1.60 3.95 28
Intermittent Pneumatic Compression to prevent post stroke Deep Vein Thrombosis (DVT) Not available* 0.81 1.87 14
Increase uptake of cardiac rehabilitation (to 65% from 44%) for people with coronary artery disease and (from ~4% to 33%) following acute heart failure
NICE CG48: Secondary prevention of AMI
£7,434 0.54 0.56 10
Increase bystander initiated CPR (to 42% from 32%) by increasing proportion of population trained in CPR from 3.8m people to 5 million nationally 0.28 0.56 6
Extend provision of Early Supported Discharge schemes (from 20% to 40%) following a stroke
NICE CG68: Stroke
£15,064 0.14 0.32 3
Increase proportion of patients with TIA treated within 24 hours (increase from 71% to 100%)
NICE CG68: Stroke
-£7,457 0.12 0.28 3
Greater provision of angioplasty following STEMI and reduced door to balloon times (increase rates of reperfusion from 70% to 100%)
NICE CG in development for STEMI;
NICE CG48: Secondary prevention of AMI
£16,194 0.21 0.29 1
Ensure all patients transferred to a cardiac centre within 72 hours following nSTEMI (assumes increase from 92% to 100% of patients) 0.05 0.11 1
Optimise / reconfigure acute stroke services to ensure 24/7 access to specialist care (incl. thrombolysis) and acute stroke units along the lines of the London model of centralised hyper-acute stroke services High set up costs recoupment estimate for London network, 6 years 1.22 2.82 TBC
Implementation of NICE guideline on Acute Kidney Injury
NICE CG169: Acute Kidney Injury
NICE (ave. 4.7 fewer hospital days & less chance of chronic kidney injury) but additional costs. Benefits vary significantly 18.70 Unknown (PYLL reduction for all ages estimate is 160.55)
Implementation of the ‘Sepsis Six’ care bundle £309,637 18.49
Prevention of Venous Thromboembolism 0.54 1.68