The challenge

The NHS Long Term Plan states that the biggest area where the NHS can save lives over the next 10 years is in reducing the incidence of cardiovascular disease (CVD). CVD causes one death every three minutes in the UK, with those in the most deprived areas four times more likely to die. For the first time in 50 years, deaths from premature cardiovascular disease are on the rise. CVD is the single biggest area where the health service can save lives over the next 10 years through targeted approaches to reduce the widening of health inequalities.

To address this the AHSN Network is delivering a national lipids optimisation programme, which commenced in 2020/21, that will run for three years.

The aim 

The programme aims to improve the management of cholesterol, increase the detection of those with Familial Hypercholesterolaemia and optimise the use of all medicines for patients on the cholesterol management pathway.

Objectives 

  • Increase the number of people with measured cholesterol and to identify those with conditions that increase familial risk of hypercholesterolemia
  • Provide more treatment options to high-risk patients who remain at risk despite maximum tolerated statin therapy
  • Reduce health inequalities by ensuring a consistent, national approach to lipid management, using a NICE-endorsed clinical pathway
  • Reduce the risk of heart attacks and strokes occurring
  • Reduce the risk of admissions and re-admissions associated with CVD.


Who we work with

We work with NHS trusts and primary care services across England to improve the offer to people with known or previously unknown high risk of cardiovascular disease, to ensure their blood cholesterol levels are understood and that the patient receives the appropriate treatment along the pathway. This could include statins, high intensity statins, ezetimibe, bempedoic acid, inclisiran within primary care and PCSK9i within secondary care, as clinically appropriate.

Our approach

We have three focus areas within our lipids programme:

  1. Familial Hypercholesterolaemia (FH) detection and lipid management optimisation to reduce death and disability due to premature CVD. This includes expanded access to genetic testing for FH via screening of electronic records and piloting a process of child-parent screening to enable early diagnosis and treatment for those at genetic risk of sudden cardiac death as per NICE clinical guidelines (CG71) and Quality Standards (QS41).
  2. Working in partnership with the Accelerated Access Collaborative (AAC) Rapid Uptake Products (RUP) lipid management programme to improve patient access to appropriate medicines to enable lipid treatment using the NICE-recommended clinical pathway, with a focus on secondary prevention and including novel therapies. Further information on this element of our work programme can be found on our prescribing pathway webpage.
  3. In partnership with HEARTUK, we are delivering the Tackling Cholesterol Together education programme and the Cholesterol Now campaign. The Education Programme aims to provide clinicians and managers with the opportunity to learn about different elements of the lipids pathway, from internationally regarded experts in the field and supports the broader objectives of our lipids national programme.

 

Our lead AHSN for this programme, AHSN North East and North Cumbria works in partnership with the AAC and a group of NHS clinicians, patient groups and industry to deliver the different components of our lipids optimisation programme across the AHSN Network.

Contact us 

To get involved or for further information, please contact us using our contact form for the programme.

 

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