East London pharmacy initiative to relieve pressure on hospital cholesterol clinics
A grandmother-of-two from Chadwell Heath is one of the first to be treated as part of a new pharmacy initiative for people living with high cholesterol in East London that aims to reduce hospital waiting times and improve access to treatment.
The pilot, funded by us and run by Barts Health NHS Trust and UCLPartners, aims to help reduce the months-long waiting times for a hospital lipid clinic appointment by giving a cholesterol-lowering injection called inclisiran at local pharmacies instead.
"So much easier"
Ashleen Back, 70, was one of the first to receive her six-monthly injection at Rohpharm Pharmacy in Ilford.
She said “It’s made my life so much easier. I was getting my treatment at Bart’s Hospital before, which would pretty much take up a whole day with travel and waiting for hours at the hospital. It only took 10 minutes to get to the pharmacy and the whole thing was done in 20 minutes.
“My mum needs a lot of care after she had a stroke, and I help look after my two grandchildren, who are 9 and 10, so time is really important to me. I’m very happy that this new scheme has given me my day back.”
The idea is part of a wider program of work led by the Barts Health team to test new ways to improve prevention of heart disease across East London (ELoPe-CVD).
Closer to home
Professor Riyaz Patel, Consultant Cardiologist at Barts Heart Centre, who is leading the pilot, said: “The people who will be joining the study have heart disease and are all in great need of more cholesterol-lowering therapy, beyond tablets, to reduce their risk of future problems, but also often find it difficult to attend hospital appointments to receive these advanced treatments.
“By bringing care closer to home for patients like Ashleen through local community pharmacies, we can reach people faster, reduce waiting times, free up hospital appointments, and address inequalities in access to cardiovascular care.”
The research team with Ashleen. L-R Kalpesh Patel, Farhan Moulana, Ashleen Back, Jagjot Chahal and Professor Riyaz Patel
Selected community pharmacies across East London will be delivering twice-yearly injections of the recently approved cholesterol-lowering medication inclisiran, which until now for many patients could only be accessed and delivered in hospital lipid clinics.
These lipid clinics are already stretched to capacity – the clinic at St Bartholomew’s Hospital serves patients from a population of 2.5 million people in East London. There is a growing waiting list for inclisiran treatment in the area, and repeat appointments being needed every six months has placed further strain on the service.
Reducing cholesterol
Inclisiran, which is given as an injection under the skin, usually around the stomach, has been shown in clinical trials to lower levels of low-density lipoprotein (LDL, or ‘bad’) cholesterol by around 50 per cent. Lowering LDL cholesterol levels is known to reduce a person’s risk of a heart attack or stroke and the treatment is approved by NICE to use in patients with heart disease who meet certain criteria.
Judy O’Sullivan, our director of health partnerships and programmes, said: “High cholesterol is a major risk factor for heart attacks and strokes. It is so important that people with stubbornly high cholesterol get the treatment they need to lower it as soon as possible.
“We’re proud to support programmes like this, which are reaching out into communities that may find it harder to access healthcare, to make sure everyone gets a fair opportunity to improve and maintain their heart health.”
Ashleen Back, from East London, who is now receiving her six-monthly inclisiran injections at a local pharmacy as part of the study
Ashleen said, “High cholesterol and heart problems run in my family. I was told I had high cholesterol when I was in my late thirties. I tried everything to get it down – diet, tablets, the lot, but nothing really worked.
“In January last year I had to have heart bypass surgery to treat coronary heart disease. Luckily the operation went well but it was serious surgery, and it took me a while to recover. I have much more energy now though. I’m 70 and still partying!
“I walk a lot more steps each day and I don’t get breathless as easily. I even walked 30 miles in March this year to raise money for charity.
“I had my first inclisiran injection in the middle of last year at St Bartholomew’s Hospital. After that my cholesterol level dropped way down and it’s been low ever since, which is great. I’m just glad I’ve been able to get it under control.”
Local pharmacies
As well as Ashleen, at least 180 other people with high cholesterol will be referred to their local pharmacy for treatment over a 14-month period.
The first three pharmacies taking part in the pilot scheme are Anjis Dispensing Chemist in Waltham Forest, Rohpharm Pharmacy branches in Ilford and Plaistow. Further pharmacies will be joining soon, giving patients access to cholesterol-lowering medication closer to home.
If the scheme is successful, the clinicians running it hope that it can inspire similar programs in other NHS trusts across the country. Ashleen said, “I think it should be rolled out as much as possible. Especially for people who aren’t as mobile, it’s really important they get the treatment they need.”
Chris Laing, Chief Executive Officer at UCLPartners, which is working with Barts Health to deliver the pilot, said: “Bringing inclisiran into community pharmacies is a great example of health innovation working in practice. By working with our partners to adopt and test new approaches in real clinical settings, we build the evidence and experience needed to help make effective treatments available to patients closer to home.”