In 2014 HEART UK published ‘Systematically Identifying Familial Hypercholesterolaemia (FH) in Primary Care’. The report showed how NHS Medway CCG more than doubled the number of people diagnosed with FH in the CCG by implementing two simple interventions.
This report was developed by HEART UK following the removal of a number of CVD indicators from the Quality and Outcomes Framework (QOF) after concerns were raised about how data relating to CVD and cholesterol is being collected. The report aims to look at current data collection practices and what barriers exist in utilising data in driving improvements in CVD patient management.
As part of the research undertaken for this report, HEART UK spoke to a series of experts on the importance of rigorous data collection, management and analysis. Freedom of Information (FOI) submissions were sent to CCGs to investigate their data reporting requirements and habits in the absence of QOF, as well as Health Check data management. In addition, HEART UK conducted a survey of GPs to gauge how the QOF changes might impact their practice in relation to cholesterol.
The report covers policy directives and strategies at a national level, the impact and opportunities that come with NHS organisational restructuring, and the ever-growing role of care and health at the community level in delivering long-term health improvement outcomes.
The recommendations within this report are important calls to action for a wide variety of stakeholders, from those working at the highest levels of Government making decisions on NHS strategy, to those managing public health within local authorities.
Health professionals commonly use risk calculators to assess the 10 year cardiovascular risk of patients to help them identifying the need for lifestyle change and medication.*
*Risk calculators should not be used for people already identified as at high risk such as those with diabetes or FH.
Cardiovascular risk scores
Risk calculators generate a “score” which estimates the probability of cardiovascular disease in individuals who have not already developed major atherosclerotic disease. These scores aid decision making in clinical practice and guide the type of interventions that doctors and other health care professionals advise and prescribe.
Risk Calculators have been developed based on the following:
Until recently, NICE recomended this equation for calculating cardiovascular risk.
Joint British Societies (JBS)
The official cardiovascular risk charts published in the British National Formulary (BNF) are based on those given in the JBS2 guidelines.
The Joint British Societies' consensus recommendations for the prevention of cardiovascular disease (JBS3) are now available and refer to lifetime risk as well as 10 year risk. The calculator can be downloaded at the following link: www.jbs3risk.com
Developed for use in Scottish populations ASSIGN includes risk factors, such as family history and social deprivation, not used by Framingham.
This risk algorithm has been developed by doctors and academics working in the UK and is based on routinely collected data from many thousands of GPs across the country. A version using lifetime risk is available at www.qrisk.org