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Specialist nurses to help spot untreated heart disease to cut strokes

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Specialist nurses will be at the forefront of a new initiative to help spot heart conditions earlier as part of a drive to prevent strokes and save lives, NHS England has announced.

The £9m scheme will see specialist nurses and clinical pharmacists identify patients who are at a greater risk of having a stroke, and are not receiving treatment for it, following a successful pilot in south London.

 “Tackling heart disease and stroke is a top priority in the NHS Long Term Plan” 

 Stephen Powis

The idea is that patients with the heart condition atrial fibrillation, which increases the chances of having a stroke, will receive targeted checks and treatment as part of the NHS Long Term Plan’s focus on preventing and tackling killer conditions.

Under the new scheme, clinicians will identify patients in each surgery who have the condition and are not being treated for it.

Those recognised by specialist nurses as being at risk will be offered a personalised treatment plan developed with their GP.

The programme will be put in place across 23 areas of the country and will give funding for specialist clinical pharmacists.

The new scheme, which will run until next March, is intended to treat more than 18,000 people and aims to prevent around 700 strokes.

It also aims to save an estimated 200 lives, as well as putting a stop to long-term health problems among thousands of people, according to NHS England.

The government arms’-length body noted that anticoagulation drugs reduced the risk of stroke by two-thirds in people with atrial fibrillation.

However, only half of those with the condition who go on to suffer a stroke had been prescribed the drugs, it said.

It highlighted that the new scheme builds on a successful pilot programme in South London between 2015 and 2016.

“By targeting help at people most at risk of illness, and training up specialist clinicians, the NHS in England will help families across the country”

Professor Stephen Powis

During the pilot at Lambeth and Southwark Clinical Commissioning Groups, GPs and specialist anticoagulation pharmacists discussed patients with atrial fibrillation using a virtual clinic model – which can be carried out remotely via skype or telephone, or face to face.

The clinicians discussed treatment options with the patient to ensure that their condition was being managed as effectively as possible.

Over a 12-month period, 1,500 patients were reviewed across 92 practices, 947 of whom were identified as not currently receiving anticoagulants.

In total, 1,200 of those patients are now anticoagulated, preventing an estimated 45 strokes a year. The two CCGs have since seen a 25% reduction in the rate of atrial fibrillation related stroke.

Following the success of the pilot, the new scheme will now be rolled out and will see CCGs in selected parts of the country give extra training to health professionals, including specialist anticoagulation pharmacists.

NHS medical director, Professor Stephen Powis, said: “Tackling heart disease and stroke is a top priority in the NHS Long Term Plan which will save thousands of lives by better diagnosis and treatment for people with killer conditions.

“By targeting help at those people most at risk of illness, and training up specialist clinicians, the NHS in England will help families across the country avoid the pain and loss associated with stroke,” he said.

“Not only is stroke one of the biggest killers in our country, but it leads to life-changing and often devastating long-term harm for many others,” he said. “By spotting the risks early, the NHS will not only prevent serious harm to the people affected, but avoid the need for aftercare which puts additional pressure on the health service.” 

Helen Williams, consultant pharmacist for cardiovascular disease, Lambeth and Southwark CCGs, said: “As a result of the virtual clinics delivered across Lambeth and Southwark CCGs, we have seen a substantial increase in the number of patients with atrial fibrillation who are prescribed anticoagulant therapy, and an associated reduction in AF-related strokes.

“We are delighted that NHS England is investing in rolling out this model to a further 23 CCGs so that more patients across the country can benefit,” she said.

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