The Scalpel's Blog

06.06.18

The impact of NICE on cardiovascular disease prevention

Professor Gillian Leng, deputy chief executive and director Health and Social Care at NICE, looks into what can be done to decrease cardiovascular disease nationally and how to prevent missed opportunities in the future.

Cardiovascular disease (CVD) accounts for just over a quarter of deaths and affects around 7 million people in the UK. Risk factors for CVD include smoking, obesity, mental illness, physical inactivity, and long-term factors like diabetes, high cholesterol and high blood pressure. These can all be addressed with the right care and support.

 The new NICE impact report on CVD prevention explores how our guidance helps to tackle these risks. While the data suggests NICE is having a positive impact in key areas, it presents a clear case for wider implementation of our recommendations, which offer effective, evidence-based advice to prevent CVD and reduce mortality.

 For example, data from the Public Health Outcomes Framework (PHOF) shows smoking levels in 2016 fell to 15.5% of the adult population. To encourage this, we recommend offering patients in hospitals, mental health, and maternity services advice on quitting. But despite an audit of 15,000 patients finding that of the 73% that had their smoking status recorded, only 28% were asked if they would like to quit. This suggests key opportunities are being missed to further tackle smoking rates. On early prevention, data shows that more could be done to implement NICE’s recommendations in schools— with some 40% of pupils not receiving the right level of education on the risks of tobacco use, as advised by NICE.

 The impact report also looks at six conditions that are major causes of CVD including high blood pressure, high cholesterol, atrial fibrillation, chronic kidney disease, high blood sugar and diabetes. Diagnosing and managing these conditions is vital to preventing CVD events such as heart attacks and strokes. NICE is working with Public Health England and NHS RightCare to embed our guidance in the CVD Prevention Pathway, which aims to give CCGs the tools and resources to detect and treat these conditions at a local level.  

 For high blood pressure, data shows that just 60% of people under 80 achieved the NICE recommended target blood pressure. Our guidance on high blood pressure aims to highlight the importance of physical activity, and encourages people to increase levels of activity to manage their condition. However, data shows only 9% of people with high blood pressure aged 16-74 had their physical activity assessed in the last 12 months. This indicates that we are not doing enough to encourage people to exercise more, and thus to reduce risk of CVD.

 Atrial fibrillation (AF) is associated with a higher risk of stroke, and the CVD Prevention Pathway highlights that 30% of people with the condition are undiagnosed. Of those diagnosed, over half are not getting the right care and treatment. NICE recommends offering anticoagulants for AF to prevent blood clotting and reduce stroke risk. The National Stroke Audit has shown steady increases over the years of prescribing these medicines but the most recent figures show only 53% of patients had received anticoagulants before they had a stroke, highlighting that people at high risk of stroke may not be getting the care they need. The national audit says anticoagulants could prevent around 6,000 strokes each year in patients with AF, so there are clear benefits of prescribing them.

 Our latest impact report offers useful insight into the positive effect NICE is having on CVD prevention across the health and care system. But there is a familiar pattern of potential missed opportunities to improve patient care and save lives. We know only too well the challenges the system faces to deliver high quality care. When the evidence shows that using NICE guidance works, we need to make sure it is at the heart of local strategies to reduce premature deaths from CVD and preventable illness.

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

Struggling NHS hospital considers appealing to Tottenham Hotspur to ease financial struggles

22/10/2018Struggling NHS hospital considers appealing to Tottenham Hotspur to ease financial struggles

A struggling NHS hospital is considering appealing to a Premier League football club for financial support after ending the year with a £29... more >
NHS trusts stuck in ‘unsustainable cycle of severe winter pressures’ fear winter worse than last year

22/10/2018NHS trusts stuck in ‘unsustainable cycle of severe winter pressures’ fear winter worse than last year

There are “clear warning signs” that the coming winter will be even worse for NHS trusts than last year, a new report from NHS Provid... more >
A goal without a plan is just a wish

22/10/2018A goal without a plan is just a wish

CIPFA’s health and social care policy manager, Dr Ellie Roy, makes the case for a long-term funding plan for social care, and welcomes the ... more >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital e... read more >

last word

Hard to be optimistic

Hard to be optimistic

Rachel Power, chief executive of the Patients Association, warns that we must be realistic about the very real effects of continued underfunding across the health service. It’s now beyond doubt or dispute, other than in government, that the NHS is inadequately funded. Even the secretary of state has argued that it will need more mon... more > more last word articles >

the scalpel's daily blog

A goal without a plan is just a wish

22/10/2018A goal without a plan is just a wish

CIPFA’s health and social care policy manager, Dr Ellie Roy, makes the case for a long-term funding plan for social care, and welcomes the Public Accounts Committee’s (PAC) latest findings. The UK Government has committed to the goal of better integration of health and social care, but the financial squeeze and lack of clarity... more >
read more blog posts from 'the scalpel' >
332 304x150 NHE Callout banner.

comment

Recoup and recover

10/10/2018Recoup and recover

The ease and round-the-clock nature of making cashless payments has transformed the way we pay for goods and services – and, from now on, t... more >
The clinical voice at the heart of procurement

10/10/2018The clinical voice at the heart of procurement

Jo Gander, director of the Clinical and Product Assurance (CaPA) team, talks about their role as part of the new NHS Supply Chain. NHS Suppl... more >
Deal or no deal?

10/10/2018Deal or no deal?

Dr Andrew Dearden, BMA treasurer and Brexit lead, takes a look at what different Brexit scenarios could means for both patients and healthcare pr... more >
A push for digital in mental health

10/10/2018A push for digital in mental health

Sean Duggan, chief executive of NHS Confederation’s Mental Health Network, argues that mental health services could hugely benefit from dig... more >

health service focus

View all News

interviews

Duncan Selbie: A step on the journey to population health

24/01/2018Duncan Selbie: A step on the journey to population health

The NHS plays a part in the country’s wellness – but it’s far from being all that matters. Duncan Selbie, chief executive of Pu... more >
Cutting through the fake news

22/11/2017Cutting through the fake news

In an era of so-called ‘fake news’ growing alongside a renewed focus on reducing stigma around mental health, Paul Farmer, chief exec... more >
Tackling infection prevention locally

04/10/2017Tackling infection prevention locally

Dr Emma Burnett, a lecturer and researcher in infection prevention at the University of Dundee’s School of Nursing and Midwifery and a boar... more >
Scan4Safety: benefits across the whole supply chain

02/10/2017Scan4Safety: benefits across the whole supply chain

NHE interviews Gillian Fox, head of eProcurement (Scan4Safety) programme at NHS Supply Chain. How has the Scan4Safety initiative evolved sin... more >