Cardiovascular Disease (CVD) prevention

Lipid Management and Familial Hypercholesterolaemia (FH)

We continued to support local health systems to optimise lipid management for cardiovascular disease (CVD) prevention.

This included:

  • Developing education resources for the healthcare workforce to help better detect and treat patients with high cholesterol (including the genetic condition, familial hypercholesterolaemia) and associated CVD risk factors. Resources include webinars, podcasts, recordings of round-table clinical discussions, fact sheets and case studies.
  • Working in collaboration with the Midlands Long Term Conditions and Prevention Clinical Network, East Midlands Integrated Care Board CVD leads, and system leaders to plan improved familial hypercholesterolaemia detection and genetic confirmation referral pathways. This work is in early development and will continue into 2024-25 and beyond.
  • Supporting local adoption of lipid management pathways and NICE approved lipid lowering medications including Inclisiran, a novel injectable treatment for cardiovascular disease (CVD) which can be delivered in primary care.

Pharmacy-led lipid service

Through the Collaborative Lipid Fund (CLF), we supported a healthcare team in Derbyshire to set up a pharmacy led lipid service that was integrated across primary and secondary care based at the Derby Royal Hospital.

An independent evaluation of the service demonstrated service benefits and improvements in clinical capacity, NHS cost savings, streamlining of services and administration, patient satisfaction outcomes and increased workforce education.

Blood Pressure Optimisation

The Blood Pressure Optimisation programme (completed in September 2023) supported local systems to detect undiagnosed high blood pressure and optimise care and treatment for patients with diagnosed hypertension to reduce the incidence of heart attacks, strokes, and dementia.

We supported primary care staff to implement the Proactive Care Framework for hypertension to optimise clinical care and self-management for people with high blood pressure and other cardiovascular disease risk factors.

The Framework offers:

  • Risk stratification to prioritise which patients to see first.
  • Use of the wider workforce to support remote care and self-care.
  • Supporting patients to maximise the benefits of remote monitoring and virtual consultations where appropriate.

In addition, we worked with ICSs to improve existing case finding initiatives to increase the detection of people with hypertension.

Learn more about Cardiovascular Disease Prevention

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Impacts

194 health professionals accessed HIEM lipid management focussed education resources.

2,128 Inclisiran doses were prescribed in primary care in the East Midlands compared to 488 last year.

£85.83 saved per patient appointment seen in the pharmacy led lipid clinics at Derby Royal Hospital.

162 Derbyshire clinicians have attended lipid management education sessions as a part of the CLF programme.

57 Primary Care Networks implemented the Hypertension proactive care framework in at least one of their practices.

136 practices were implementing or had adopted the framework by September 2023, 39 of which were priority practices identified as having the highest levels of health inequalities.

Health Innovation East Midlands have influenced five ICBs with their CVD delivery during 2023-24, which covered 97 PCNs and 181,810 patients with known CVD and on lipid lowering therapy and 801,597 patients with registered hypertension (March 2023).

Next Steps

For 2024-2025 we have taken the learning from the three previous CVD programmes to create CVD Prevention – a new three-year programme working with primary care to identify patients at risk of CVD and optimise treatment.

Our aim is to support our local systems to detect, appropriately manage and optimise treatment for high cholesterol, hypertension and FH, and so reduce broader cardiovascular risk, prevent heart attacks, strokes, and dementia.

We have launched a new library of resources for health and care staff and for patients on our website.