On 16th June, the second national CVDPREVENT audit report was published, providing public health professionals with the latest insight and information on the impact of the COVID-19 pandemic on cardiovascular disease (CVD) prevention in primary care.
What is CVDPREVENT?
CVDPREVENT is a national primary care audit that automatically extracts routinely held GP data covering diagnosis and management of six high risk conditions that cause strokes, heart attacks and dementia: atrial fibrillation (AF), high blood pressure, high cholesterol, diabetes, non-diabetic hyperglycaemia and chronic kidney disease.
What has been published?
The most recent publication from CVDPREVENT is the second audit report since the data collection began. The report, written by NHS Benchmarking, comes six months after the publication of the first and presents analysis of GP recorded data for relevant patient cohorts up to March 2021. The latest report focuses on the impact of the pandemic on CVD prevention in primary care analysis across a variety of health inequality dimensions, including deprivation, age, sex, and ethnicity.
What have we learned?
1 – COVID had an impact on diagnosing high-risk conditions
At the start of the COVID-19 pandemic, the clear directive to GPs was to operate remotely in order to reduce the risk of infection across patients, which had a direct impact on the diagnosis and recording of CVD risk factors, such as high blood pressure.
2 – Recovery after lockdown is lagging
After the initial lockdown in 2020, the number of new diagnoses did bounce back, but there is still some way to go. In particular, the recovery of new diagnoses for patients with high blood pressure appears to be slower than for other conditions like chronic kidney disease and atrial fibrillation.
3 – Fewer people are monitoring their blood pressure
Again, due to the pandemic, fewer known high blood pressure patients have had their condition monitored and recorded in their GP record, increasing the likelihood of patients who may need treatment and advice flying ‘under the radar’.
4 – There is a reduction in the number of patients recorded as ‘treated to target’
The pandemic had a negative impact on the number of blood pressure patients recorded as ‘treated to target’ (i.e. their blood pressure is well controlled) across all demographics analysed: age, levels of deprivation and ethnicity. There was a greater reduction for one group in particular: adult females (aged 18 to 79).
5 – Thousands of potential patients are ‘hiding in plain sight’
New indicators highlight that thousands of patients are likely to have risk conditions like high blood pressure or chronic kidney disease who are ‘hiding in plain sight’ with no recorded diagnosis found in GP records.
From Dr Mel Roche, Public Health Consultant, Lead for the Collaborative’s High Blood Pressure and Cardiovascular Disease Prevention Programme and adviser to the ICS’ High Blood Pressure and Cardiovascular Disease Prevention Recovery Programme.
The publication of the second CVDPREVENT national audit report provides local health professionals with a wealth of insightful and useful data to help us to understand where to focus CVD prevention interventions, including those that support the detection and management of high blood pressure. Themes from the national report can be further explored locally through the CVDPREVENT Data and Improvement Tool, which allows sub-analysis by Integrated Care System (ICS), Place, (Primary Care Network), or even practice level. Together, these resources will really help local system partners to work together reduce the number of patients who suffer from heart attacks, strokes, and other related diseases, and to reduce unwarranted variation and inequalities.
This report highlights what many of us already knew; that the pandemic and subsequent lockdowns would negatively impact our work and take us a few steps back when we want to march forward.
However, there are many reasons to be optimistic, and one thing that really stands out from this publication is the opportunity to empower more at-risk patients to take control of their health and routinely monitor their blood pressure from home. A shift to this new way of working (remote and digitally enabled- blood pressure monitoring) has huge potential to support our aim in Cheshire and Merseyside to recover and strengthen high blood pressure care and control for patients, and to prevent complications such as heart attacks and strokes.
In Cheshire and Merseyside, the Collaborative is working with numerous partners, including the local ICS, the Innovation Agency, the Digital First in Primary Care programme and the Cheshire and Merseyside Cardiac Network to increase the rollout of our BP@Home Programme, as well as introduce other innovative projects and programmes that will create many positive impacts for our local people.
Do you have an example of how CVDPREVENT reports and data tools are being (or will be) used locally to add value to CVD prevention, quality improvement or the reduction of inequalities? If so, it would be great to hear from you!
Please send all feedback and case studies to email@example.com so that we can capture and share learning and best practice across Cheshire and Merseyside