Dr Pete Green is the new Chair of HEART UK
I would like to introduce myself to you.
I have been a GP in Medway, North Kent, for over 30 years. I see the role of a GP as helping people to stay well, to reassure them when worried and to help make people better when they are unwell. I have always been interested quality of care and systems that can be developed to support this. General Practice, like many jobs, can be difficult at times but the easier we can make it the safer we can make it.
I became aware in part through the work of HEART UK that Familial Hypercholesterolaemia was, and still is, underdiagnosed in the UK, leading to undertreatment, premature heart disease, earlier deaths and also tragically in children who have two abnormal FH genes of deaths in teenage years. All of which is potentially preventable.
So as a GP, and Clinical Lead for Medway Clinical Commissioning Group, and with HEART UK we set out to demonstrate that we could systematically identify patients at risk of FH, and then confirm a clinical diagnosis from the information already held in the GP patients records. We succeeded. This has then influenced NICE guidance in supporting systematic identification and influenced the development of the NHS CVDPrevent a national audit of primary care records that will support systematic identification.
So that is how I got involved.
I think HEART UK is a great charity and has really achieved a lot, but there is still lots that needs doing.
I hope that over the next three years as Chair of HEART UK I can help HEART UK continue to build and support all the parts of the system the NHS, voluntary sector, public, and other organisations to be fully able to identify and manage cholesterol and lipid related risks to patients. We all have a role to play.
We already have some of the component parts in place
· An ambition in the NHS Long Term Plan to identify 25% of patients with FH through a genetically confirmed diagnosis by January 2024.
· The existing genomic services in England are being reorganised into seven hubs to provide nationwide access to genetic testing. Services are already available in Scotland, Wales & Northern Ireland.
· CVDPrevent a new national audit of primary care (coming soon) that will help identify those at risk at a GP practice level and help monitor management.
This will help identify and diagnose patients with FH, but also raise awareness of other lipid disorders.
Unfortunately, but understandably, the COVID pandemic has meant that national priorities have needed to reprioritise, but we have also seen that patients with pre-existing heart disease have poorer outcomes if they do develop COVID. So, the need to address lipid disorders and manage them well is if anything more important.
So where would I like us to be in three years (or sooner).
1. For people to understand that cholesterol is an asymptomatic risk of developing premature heart disease, but a treatable risk.
2. For people with raised cholesterol, or other lipid disorders, to understand that there may be genetic reasons for this and if that is the case treatment should start at a much younger age and children should be tested. (HEART UK will continue to push for a national child parent cascade testing programme for FH)
3. For clinicians, particularly GPs, to think when a patient has a raised cholesterol is this genetic and if so, refer the patient for genetic testing. If it is not genetic then to ensure that patients understand their risks and work with them to optimise their treatment and minimise their risk.
4. For clinicians to have clear pathways to identify patients in primary care and refer patients who may be at risk of FH, or other inherited lipid disorders, for genetic testing, and if a genetic cause is identified appropriate management for them and cascade testing for families.
This is what we will be striving to do.
But I would also ask you what you can do to help. As a small charity donations help, but these can be in the form of old, but wearable, clothes donated through iCollect, or setting up your Amazon orders through Amazon Smile. (details of both are on the website provide link) neither of these cost you. Donations, sponsorships, legacies all also help support the work we are doing.
But equally important is the conversation. We know that many people are not aware that high cholesterol can be genetic and that if it is treatment should be started at a much younger age and family members checked. Have the conversation. FH is nothing to be ashamed of, diet helps but it is mostly what you inherited in your genetics that is the problem. (Diet, keeping healthy and not smoking are also all important). Having the conversation and raising awareness will help other people ask the right questions, direct them to the resources on the HEART UK website, and if their doctor or healthcare professional is not taking their concern seriously, use the resources on the HEART UK website, or contact the helpline, to make sure your concerns are addressed.
Raised cholesterol is an asymptomatic risk of premature heart disease, but it is an identifiable risk and a treatable risk.
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