The importance of CVD prevention during the coronavirus pandemic is well recognised. COVID-19 presents a particular risk for cardiovascular disease (CVD) patients, who are less likely now to access the care they need, and are more likely to experience worse outcomes from COVID-19, particularly in black, Asian and minority ethnic (BAME) populations and in those from the most deprived communities.
National developments
Nationally, the NHS Long Term Plan aim to prevent up to 150,000 heart attacks, strokes and dementia cases by 2029 remains. NHS Health Checks have had to pause, but objectives to support delivery against the national ambitions for detection and management of atrial fibrillation (AF), high blood pressure (BP) and high cholesterol, have been adapted to the new context.
Primary Care Networks will be supported to deliver effective CVD prevention in general practice by a number of new initiatives. Development of the CVD prevention Direct Enhanced Primary Care Network Service (DES) specification has commenced and is on target for delivery in 2021/22. The first data extract reports from ‘CVD PREVENT’ (a new centralised primary care audit) will be available early in 2021, in time to support the DES. UCL Partners are working on adapted remote care pathways for AF, BP and cholesterol, and these are anticipated to be available this summer.
In relation to specific risk factors, a Virtual AF Clinic Demonstrator project was completed in March 2020, and the qualitative evaluation is expected early 2021. For high BP, a new centralised national procurement system for remote blood pressure monitoring is proposed (including validated home BP monitors and free access to an IT platform) for shielded patients until March 2021. For high cholesterol, the launch of a new genomics hub has been delayed, but a Familial Hypercholesterolaemia (FH) strategy is due to be revealed shortly.
A national CVD communications campaign, with key messages for patients and healthcare professionals, is coming soon, and sharing of innovation and best practice will be supported by a new NHS Futures professional cardiac forum.
Cheshire and Merseyside progress
Many people across C&M are affected by conditions that increase the risk of heart attack and stroke, such as atrial fibrillation (AF), high blood pressure (BP) and high cholesterol. CVD prevention, including achievement of the national ambitions for these conditions, remains a population health priority for the Cheshire and Merseyside Health and Care Partnership (C&M HCP).
A C&M HCP CVD Prevention Subgroup [COVID-19] has been established to drive an adapted CVD prevention agenda over recent and coming months, including delivering on the new national CVD prevention objectives. The key focus of the C&M subgroup is on:
1.Promotion of Health and wellbeing measures to minimise population CVD risk
2.Empowering self-management of CVD risk factors at home
3.Supporting remote CVD risk management in primary care
4.Raising awareness to seek medical review for acute CVD symptoms
5.Addressing CVD inequalities that COVID-19 may exacerbate through bespoke and targeted approaches
The Happy Hearts website (www.happy-hearts.co.uk) is a cross-cutting enabler for delivery against these objectives.