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E-scooters at a crossroads
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Posts Tagged ‘Cardiovascular disease’

Addressing England’s cardiovascular disease emergency – learnings from the new ICS five-year plans

England’s Integrated Care Systems (ICSs) have published their five-year joint forward plans, setting out Integrated Care Boards (ICB)-led priorities to tackle physical and mental health challenges being faced in their populations. We are summarising the key priorities of ICS’s in a series of articles, based on data revealed in our interactive map. This map is free to use, supporting better engagement and collaboration with all stakeholders in the healthcare community – industry, patient organisations, and the NHS.

Here, we focus on ICS five-year plans tackling cardiovascular disease (CVD).

Cardiovascular disease continues to be a top priority

Cardiovascular disease (CVD) is the top priority in almost two-thirds of ICS plans, second only to cancer, and every ICS has identified it as one of their top priority clinical areas. And rightly so. CVD affects around 7.6 million people in the UK and is a significant cause of disability and death. Since the beginning of the COVID-19 pandemic, CVD-related excess deaths have spiralled and although we are seeing signs of recovery year on year – the number of deaths involving CVD has remained higher than expected.

So, what are the key approaches being taken to tackle CVD across the nation for the next 5 years? Prevention, targeting inequalities, moving care into the community, identifying risk, and using digital technologies.

Prevention. Every ICS emphasised the importance of CVD prevention. Most plans pledge to tackle modifiable risk factors such as smoking, alcohol, and inactivity. Case example: The Humber and Yorkshire ICB CVD Prevention and Detection Plan 2022-24 covers primary, secondary, and tertiary prevention tactics for CVD, in addition to proposed methods for risk stratification and early identification.

Targeting inequalities. People living in England’s most deprived areas are almost four times more likely to die prematurely of CVD than those in the least deprived areas. So it’s reassuring to see Core20PLUS5 features in every plan and that many ICS plans are tailoring community interventions to help those most deprived. Case example: Dudley is launching a mobile Healthy Hearts Hub to empower residents to manage their own CVD health and will be moving throughout the area to reach the most deprived communities.

Community services. Many ICSs propose to increase care in the community for people with CVD, reducing demand on hospitals and reaching more patients. Some plan to achieve this through Community Pharmacies and Neighbourhood teams, others through digital engagement. Case example: Black Country is expanding community pharmacy blood pressure services and further embedding personalised care at that level through Health and Wellbeing Coaches as part of the Healthy Hearts Project.

Identifying risk. Optimal management of cross-cutting risk factors like high blood pressure and high lipids, to prevent CVD, or diagnose and treat people earlier. In many ICBs, cardiac pathway reforms are being proposed to enable this shift. Case example: Suffolk and Northeast Essex is encouraging the use of Accelerated Access Collaborative pathways to simplify lipid management and encourage adherence to national guidance for optimal management of patients at high risk of CVD.

Digital technologies. Many plans emphasise the monitoring, treatment, and detection of patients with CVD-related conditions, tying into the imperative around community care. This is tied to a much broader drive to scale tech innovation in the NHS whereby each ICB has laid out an extensive digital strategy. Case example: Mid and South Essex is continuing with the successful national pilot BP@home, where residents are self-monitoring blood pressure; they are also rolling out mobile heart monitors allowing people to detect, monitor and manage heart arrhythmias.

What does this mean for industry?

We hope you found this useful – if you would like to discuss in more detail, please get in touch.

Further reading:

Five key takeaways: Engaging with ICS priorities panel session https://wacomms.co.uk/five-key-takeaways-engaging-with-ics-priorities-panel-session/

Engaging with Integrated Care Systems priorities https://wacomms.co.uk/engaging-with-integrated-care-systems-priorities/

What the new integrated care model means for specialised services https://wacomms.co.uk/what-the-new-integrated-care-model-means-for-specialised-services/

 

About WA Communications

WA Communications is an integrated strategic communications and public affairs consultancy. Our specialist health practice supports clients across a diverse range of diseases at the intersection of policy, government affairs and communications, to achieve their strategic objectives.

If you would like to discuss how to best work in partnership with Integrated Care Systems, and our analysis of their key areas of focus, contact Lloyd Tingley at  lloydtingley@wacomms.co.uk.

 

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The challenges that remain for tackling variation in CVD prevention in England

Cardiovascular disease (CVD) is one of the leading causes of morbidity, disability and health inequalities, affecting approximately 6% of the adult population in England.  

To provide greater understanding on the state of CVD prevention services across England, the NHS Benchmarking Network publishes an annual CVDPrevent audit report. The latest iteration is much more oriented to looking through the lens of health inequalities and regional variation in care, highlighting the significant issue of a postcode lottery in cardiovascular care across the country. This new angle of focus of putting inequalities in the spotlight in the CVDPrevent report rightfully signals that this is where the focus should be for both health system leaders and industry working in this space alike.  

The report indicates some positive highlights for example with the prescription of anticoagulation drug therapy for those with atrial fibrillation at high-risk of stroke rising to 88.9% – only 1.1 percentage point below the national ambition to reach 90% by 2029.  

However, there remains some distance to go on the road to recovery from the pandemic with hypertension services particularly lagging behind others and health inequalities and variation remaining prevalent. Notably, individuals from a Black, Asian or Minority Ethnic background were identified as being the least likely to be prescribed an appropriate drug therapy, receive monitoring, or be treated to target with similar issues present across sex, age and deprivation level.   

Alongside variation in treatment and management, there is also significant variation in local approaches to CVD prevention. Our research and analysis of ICS strategies, planning documents and data relating to CVD-prevention, has found that there is a significant level of variation present in the level of planning for CVD prevention services, as well in care and outcomes.  

It is therefore particularly welcome to see the recent prioritisation of CVD services on the national policy agenda through the intention to publish a Major Conditions Strategy later this year and more recently through the appointment of Professor John Deanfield as the first ever Government Champion for Personalised Prevention. Both developments recognise the issue of inequality and unwarranted variation in the absence of a dedicated Health Disparities White Paper.   

However, the test of any such policy is whether it can be implemented uniformly to impact change across the country and not exacerbate variation as well as whether it can truly trickle down and impact at the local place-based level. To do so these policies will need to balance national direction with a sufficient amount of autonomy to allow for population-based CVD prevention strategies, an ambition of newly formed integrated care systems.  

Although the report demonstrates that progress is being made in this hugely important disease area, it is clear to see that much work remains to be done. Promising policies with high potential are a welcome sight to see and only time will tell if they can truly make the impact they set out to achieve.  

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