CARDIOLOGY
Next steps for improving CVD outcomes
Cardiovascular diseases (CVDs) are the number one cause of death globally; more people die annually from CVDs than from any other cause. So, how can the NHS do more to improve outcomes and tackle the risk factors?
A recent Westminster Health Forum, ‘Cardiovascular disease in England: next steps for prevention, innovation and delivery of care’, highlighted the ambitions for the NHS going forward, the key challenges ahead and target areas for innovation. High on the agenda was the progress achieved, so far, for the NHS Long Term Plan for Cardiovascular Disease – first introduced in January 2019.
Cardiovascular disease causes a quarter of all deaths in the UK and is the largest cause of premature mortality in deprived areas. The Government has identified this as a key target area offering the most potential to save lives over the next 10 years. “We are aiming to prevent up to 150,000
heart attacks, stroke and dementia cases,” commented Dr. Nick Linker, national clinical director for heart disease, NHS England and NHS Improvement. “We are also looking to increase cardiac arrest survival, which needs to improve, along with cardiac rehabilitation.” The ambition, he pointed out, was to make England “as good as the rest of Europe” by 2028 and to tackle health inequalities, by reducing the gap in mortality between the most and the least deprived areas. “We are looking to increase the delivery of cardiac rehabilitation. This is not just about getting patients involved in a rehabilitation
programme; it is about ensuring that they benefit and continue with it. We know that patients often sign up to rehab programmes but do not continue. We also need to do more to identify and manage patients with heart failure and heart valve disease,” Dr. Linker explained. To support this ambition, NHS England and NHS Improvement is collaborating with the British Heart Foundation to increase public access to defibrillators. This is also
People who live in our poorest communities are four times more likely to be affected by cardiovascular disease than those in our most affluent communities. There is a great opportunity to make a difference to people’s lives – by reducing mortality and morbidity and getting to the heart of health inequalities
AUGUST 2020
being supported with increased funding and training of community first responders to deliver good quality CPR. These initiatives, according to Dr. Linker, have the potential to save more than 1,000 lives per year. In addition to investing in cardiac rehabilitation and cardiac arrest survival, NHS England and NHS Improvement is also increasing its investment in diagnostics – including testing of NT-proBNP. If a person’s NT-proBNP is found to be abnormal, they are considered to be at greater risk of heart failure. It is hoped that this will help speed up intervention and management for these patients and thereby improve outcomes. “We know that in order to deliver these targets we are going to need to invest in our workforce,” Dr. Linker continued. “This is not just in terms of additional people; it is about allowing people to work more smartly and how we can use the workforce in a better way.” Digital technology could provide a vital role in supporting people in cardiac rehabilitation, he pointed out. So, where are we now in progressing
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