NHS Wirral Atrial Fibrillation Joint Working Executive Summary
Project title
A project to improve outcomes in untreated or sub-optimally treated Atrial Fibrillation (AF) patients in the Wirral.
Partners involved
- Boehringer Ingelheim Limited
- NHS Wirral Clinical Commissioning Group (CCG)
Project description
It is recognised AF is a significant burden on the NHS. AF in itself is an independent contributor to mortality, morbidity and impaired quality of life.1
What is the local picture in Wirral CCG?
- AF prevalence within Wirral CCG is 2.8% vs a national average of 2.4%.2
- According to the Quality Outcomes Framework (QOF) 2015/16, there was a total exception population of 700 (5.2% of AF population).3
- Of the 628 patients admitted as a result of a stroke in 2015/16 for Wirral CCG, a total of 163 patients had a confirmed prior diagnosis of AF. Only 33.7% of the 163 AF related stroke admissions were on any form of anticoagulation.4
This project is a joint working initiative between Boehringer Ingelheim Limited and Wirral CCG to improve outcomes for patients with AF.
Managing patients within the primary care setting and appropriately treating patients at risk of stroke is intended to contribute to the reduction of referrals and unplanned admissions into secondary care for AF related stroke.
Key objectives to:
- Build confidence in primary care to manage AF effectively as per local and national guidelines.
- Support General Practitioners (GPs) to identify untreated or sub-optimally treated AF patients and to set action plans to review and treat appropriate patients. AF audits to be run annually.
- Reduce unplanned admissions and referrals into secondary care.
- Reduce the number of AF related strokes.
Stakeholder benefits
Benefits for patients
- Improved counselling from Health Care Professionals (HCP’s) as to benefits and side effects of Non-vitamin K antagonist Oral Anti-Coagulant (NOAC) usage.
- Improved patient experience of an engagement with healthcare services.
- Increased percentage of patients being treated in line with national guidelines.
- Improved quality of care for patients with AF.
- Reduced number of patients being referred to secondary care.
- Reduced number of patients having unplanned admissions to hospital.
Benefits for NHS
- Improved Primary Care confidence in optimising the management of AF patients as per local and national guidelines.
- Early intervention in the care of AF patients will reduce pressures on NHS services further downstream.
- Reduced number of AF strokes within the Wirral.
- Reduced number of emergency hospital admissions relating to AF related stroke for Wirral CCG.
Benefits for Boehringer Ingelheim
- Improved understanding of the challenges and support needed to implement AF outcome improvements.
- Ability to share learnings from this project to other regions across the UK to support improved overall patient care.
- Recognition as a trusted partner in Joint Working projects.
- Increased appropriate use of AF treatments, which may include medicines manufactured by Boehringer Ingelheim.
Start date
April 2018
Expected duration
12 months
References
1. Thrall G, Lane D, Carroll D. et al Quality of life in patients with atrial fibrillation: a systematic review. Am J Med 2006; 119:448.e1-448.e19.
2. Commissioning for Value Long Term Conditions pack, Public Health England, NHS RightCare. Accessed on 01/11/2017; https://www.england.nhs.uk/rightcare/wp-content/uploads/sites/40/2016/08/cfv-wirral-ltc.pdf
3. Recorded disease prevalence, achievements and exceptions, Cardiovascular Group, GP practice level. QOF 2015/16. Accessed on 01/11/2017; http://digital.nhs.uk/catalogue/PUB22266
4. CCG & LHB results portfolio, Sentinel Stroke National Audit Programme. SSNAP 2015/16. Accessed on 01/11/2017. https://www.strokeaudit.org/results/Clinical-audit/Clinical-CCG-LHB-LCG.aspx
NP-UK-100761 | July 2019