16649 Commissioning Newspaper-A4_Layout 1 04/08/2015 15:46 Page 19
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“HEART UK supports GPs and clinical commissioning groups
throughout England to establish programmes to improve
diagnosis and management of FH” Jules Payne, Chief Executive HEART UK
Familial hypercholesterolaemia
(FH) is an inherited lipid
disorder that confers a risk of
premature coronary heart
disease (CHD) because of
lifelong exposure to high
concentrations of low-density
lipoprotein cholesterol (LDL-C).
FH is a readily preventable
cause of CHD, and treatment
with lipid-lowering therapies
reduces LDL-C concentrations
and improves CHD outcome
and survival.
Only around 15,000 people are
diagnosed FH in the UK, leaving more
than 100,000 people undiagnosed,
untreated and at risk of early
cardiovascular
disease.
This
substantial
under-diagnosis
represents a major gap in CHD
prevention in the UK, especially when
it is proven that exposure to lower
LDL-C early in life is associated with a
large reduction in CHD.
In 2014, HEART UK published
‘Systematically Identifying Familial
Hypercholesterolaemia in Primary
Care: An Audit within the Medway
Clinical Commissioning Group’, which
described one CCGs approach to
improving diagnosis of FH.
The Medway study was conducted in
two stages, first an FH Audit Tool was
implemented in GP practices and
secondly a FH Nurse Advisor
Programme was established. This
systematic approach identified new
index cases of FH from data already
available within GP systems and
these two simple interventions
doubled the number of FH patients
diagnosed in Medway CCG.
“The Medway audit is a huge step
forward and offers a model that could
be implemented within other CCGs in
England; to systematically identify
people at risk of FH and offer them
appropriate treatment.”
Professor Huon Gray, National Clinical
Director for Heart Disease
The Medway FH Audit Tool is
compatible with most GP electronic
record systems and is loaded
remotely, requiring no additional
work for the practices or clinicians. At
a practice level individual patient data
can be reviewed, audits can be
conducted daily, if necessary and
audit list generated.
At a CCG level the software enables
GP commissioners to extract and
analyse near real-time data from GP
systems without adding extra burden
on GP practices.
The Medway FH Audit Tool identifies
all patients already with an FH
diagnosis and identifies a group of
people with elevated total cholesterol
and/or LDL-C potentially at risk of FH.
Electronic flags are added to these
records prompting assessment when
the patient next visited the practice.
Training materials will be provided by
HEART UK to participating CCGs.
A resources pack for primary care is
available from HEART UK, supporting
practices to diagnosed and manage
FH.
patients diagnosed with FH and ‘at
risk and unscreened’, after which the
FH Audit Tool triggers and prompts to
diagnose and manage FH will be
activated.
Measuring outcome. Measurements
of the number of FH diagnosed and
changes in lipid levels will be
assessed at the CCG level at three
months intervals for 12 months. As
part of any project CCGs would agree
to provide audit information to HEART
UK and support the publication of the
study results in an annual report and
in peer-reviewed publications.
For an informal discussion about
Medway study and The Medway FH
Audit Tool call Simon Williams at
HEART UK on 01628 777046
A Seminar at project launch,
arranged by HEART UK for
participating GP practices to discuss
the importance and benefits of
diagnosing FH, the Medway model,
audit participation, and impact on
workload
HEART UK- The Cholesterol Charity
aims to prevent premature deaths
caused by high cholesterol and
cardiovascular disease. HEART UK
works to raise awareness of the risks
of high cholesterol, lobbies for better
detection of those at risk, provides
advice and information to patients
and clinicians, and supports
healthcare professional training.
Establishing the baseline number of
FH patients. Initially the FH Audit Tool
will establish the baseline number of
Sanofi provided supported for HEART
UK’s stand and Q&A Session at the
Commissioning Show.
GENERAL PRACTICE NEEDS TO SCALE UP AND
PROVIDE A MULTI-PROFESSIONAL SERVICE
Getting the skill mix right and
good leadership are key for )ѡ