Primary care resource centre
If you work in Primary Care, this area will give you information and resources to help you manage your patients who have altered lipid profiles. You can also download the below guidance from NHS England to support your practice and decision-making.
Lipid Management Pathway Statin Intolerance Pathway
Familial hypercholesterolaemia (FH)
FH affects around 1 in 250 people in the UK and can lead to premature coronary heart disease.
Practical steps you can take:
- Review all patients with a clinical diagnosis of FH
- Have they been genetically confirmed? If not, check against diagnostic criteria and refer to your local lipid clinic for genetic testing
Review all patients who have ever had a total cholesterol above 9mmol/l - If they don't already have a diagnosis of FH, refer to your local lipid clinic after excluding secondary causes
Review all patients who have ever had a total cholesterol above 7.5mmol/l - Assess patients against diagnostic criteria after excluding secondary causes, listed below
Secondary causes of high cholesterol
Common medications
- Diuretics
- Corticosteroids
- Immunosuppressants
- Anti-retroviral drugs
- Retinoids
- Oral oestrogen
- Beta-blockers
- Antidepressants
- Anticonvulsants
Health and other conditions
- Undiagnosed or poorly controlled Type 2 diabetes
- Hypothyroidism
- Menopause
- Pregnancy
- Chronic kidney disease
- Nephrotic syndrome
- Cholestasis
- Gout
NHS Long Term Plan
The NHS Long Term Plan, launched in 2019, sets out bold ambitions to tackle cardiovascular disease.
Key elements for lipids/CVD:
- Prevent over 150,000 heart attacks and strokes within 10 years
- Find 25% of people with familial hypercholesterolaemia (FH) within 5 years
- Launch the CVD PREVENT national audit to support continuous clinical improvement
CVD Prevent
CVD PREVENT is a national primary care audit that will automatically extract routinely-held GP data covering diagnosis and management of six high-risk conditions that cause stroke, heart attack and dementia:
Atrial fibrillation (AF), High Blood Pressure, High Cholesterol, Diabetes, Non-diabetic Hyperglycaemia, Chronic Kidney Disease
Read Dr Matt Kearney's blog about CVD PREVENT
Key principles and benefits:
Helps to support the ambition laid out in the NHS Long Term Plan to prevent 150,000 heart attacks and strokes over the next 10 years
The audit asserts zero additional burden on practices
Data on health inequalities and gaps in care will be highlighted to help support improvements in local practice
Visit the CVD PREVENT site
CDRC
The Clinical Digital Resource Collaborative (CDRC) is an NHS-funded, digital resource that enables individuals and organisations to deliver gold-standard patient care efficiently.
Primary care key benefits:
Integrated digital resources for SystmOne and EMIS
Quick identification of patients who are likely to benefit from a change in clinical management
More accurate data for QOF and QASI reporting
Examples of best practice
For this section, we've pulled together some examples of best practice. If you'd like to share examples from your area, please get in touch.
West Yorkshire & Harrogate Healthy Hearts
Clinical system searches and treatment guidance
Example treatment options and process