Cardiovascular disease and stroke 'key part of long-term NHS plan', say health leaders

Senior NHS officials outlined the approach to improving care for people with heart and circulatory diseases at the recent Health and Care Innovation Expo.

11 September 2018, by Siobhan Chan

A doctor takes a patient's blood pressure.

Health leaders have confirmed that prevention and treatment of cardiovascular disease (CVD) and stroke will form a key part of the long-term NHS plan for England.

Speaking at the Health and Care Innovation Expo event in Manchester on 6 September 2018, senior NHS figures highlighted the need to better diagnose and manage these conditions, and said healthcare professionals had ‘many exciting opportunities’ to improve care. 

Professor Stephen Powis, National Medical Director at NHS England, said: “I’m delighted that CVD and stroke have been recognised as distinct themes in the development of our long-term plan for the NHS.”

He added that seven million people in the UK are affected by CVD and it is one of the largest causes of premature mortality. 

Dr Matt Kearney, National Clinical Director for CVD Prevention at NHS England, said: “Treatment is effective at preventing disastrous events like heart attacks and strokes. But we’re not doing well enough.

“We’re developing the long-term plan to do things differently, so we can support GPs to diagnose conditions and improve the management of them.”

International context

Professor Powis said that compared to other countries, England has room for improvement in how CVD is diagnosed and treated. “As a country, we could do better. Of those people in England with high blood pressure, only 37% are controlled, compared to 53% in the US and 66% in Canada,” he said. 

“If we manage cholesterol levels to that achieved in Sweden, we would see an estimated reduction of 25,000 deaths a year.”

‘Best care in the world’

The national stroke strategy for 2010-17 led to ‘major improvement in national services’, Professor Powis said, and the long-term plan would continue this work: “Overall the number of strokes has been reduced from 110,000 in 2007 to 80,000 in 2016. But there’s so much more we can do.”

Professor Anthony Rudd, National Clinical Director for Stroke at NHS England, agreed, saying: “We have the opportunity to make stroke care the best in the world.”

But workforce issues mean that the NHS will have to be ‘more creative’ and work around the competencies of staff that are already in position, as well as restructuring services, he said. 

“We only have 80 interventional neuroradiologists covering the whole of the UK, but we need a minimum of 150. We have to concentrate resources into a smaller number of centres,” he said. 

Creative thinking

Professor Jamie Waterall, National Lead for CVD Prevention at Public Health England (PHE), said that although mortality from CVD has dropped in the last 20 years, the trend has ‘flattened’ recently.

“We need to be really cautious and not believe that CVD has been dealt with,” he said. “That means we need to think differently about how we deliver services.”

PHE will soon publish a ‘return on investment’ tool that it has been developing with partners including the BHF. This will help people to make the business case for preventing CVD in their areas, Professor Waterall said.

Dr Kearney added that groups other than healthcare professionals also had a big role to play in CVD prevention. “How can we mobilise the community? We’ve have been looking at ways to do that with the BHF. We need creative thinking to do this differently – it can’t be business as usual,” he said.

“We can do it, but we have to be clever, because the prize is huge,” he added.

Professor Rudd said: “A lot of what we’re talking about is not high-tech. It’s about picking up messages and persuading the health economies you’re working in that we can get a quick win that will have a big impact on mortality and morbidity. It’s about believing it can happen.”

To find out how we can tackle medical risk factors for cardiovascular disease in each of the four nations, take a look at our suite of resources on the CVD Challenge in the UK.

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