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Innovative action leads to fewer strokes

Innovation Agency Atrial Fibrillation Team check the pulses of bus drivers at Stagecoach Bus Depot in Gilmoss.
Wendy Westoby(AF Ambassador) tests John Rice.

AROUND 140 strokes will be prevented in the North West Coast in the coming year, thanks to a programme to detect and treat irregular heart rhythms.

The Innovation Agency, the Academic Health Science Network for the North West Coast, says it has exceeded its targets to detect people in the region with atrial fibrillation (AF).

AF is responsible for approximately 20% of all strokes, which can leave survivors with devastating disabilities.

In the UK, one million people are known to be affected by AF and an additional 422,600 people are undiagnosed. Treating the condition costs the NHS over £2.2 billion each year.

Making sure people with AF are given the best treatment – usually blood-thinning medication to prevent clots (anticoagulants) – can more than halve their risk of having a stroke.

In 2015, the Innovation Agency set ambitious targets to improve the detection, diagnosis and treatment of patients with AF.

North West Coast data showed that:

  • 24,210 people were estimated to have undetected AF.
  • 76% of people with high-risk AF were treated with anticoagulation therapy.
  • The latest Quality Outcome Framework (QOF) data for 2018 to 2020 revealed an 87% detection rate – and a similar number of the region’s high-risk AF patients are now receiving anticoagulation therapy – an increase of 11% since 2015/2016.

Since 2015 the Agency says it contributed to the avoidance of 715 strokes, including 179 deaths avoided and savings of £16M to health and social care.

The Innovation Agency adopted a partnership approach to engage the whole healthcare system in helping to detect people with AF and improve care, including:

Distributing over 500 mobile ECG devices to healthcare teams across primary care and community services to facilitate opportunistic pulse testing.

Training over 70 volunteer AF Ambassadors to test pulses in their communities.

Training fire and rescue services in Cheshire, Merseyside, Lancashire and Cumbria to perform pulse checks during community safe and well visits, resulting in over 10,000 opportunistic pulse tests and over 1,000 people being signposted for further investigation.

Implementing two AF Collaboratives involving 136 GP practices and nine CCGs to deliver a quality improvement programme to primary care. This has resulted in 2,300 people being diagnosed with AF and given anticoagulation therapy.

Bruce Taylor, Cardiovascular Disease Primary Care lead for the Cheshire and Merseyside Strategic Clinical Network, said: “Thanks to an innovative and collaborative approach across the health and care system, we’ve seen fantastic and sustainable results in better care for patients with AF in the region. This programme has already saved lives and will continue to do so, as well as freeing up valuable resources in health and social care.”

Dr Julia Reynolds, Associate Director and Head of Programmes at the Innovation Agency, said: “We are delighted that all the hard work in our region in testing pulses, has resulted in more people being identified with AF and treated to prevent potential strokes. We have already started to see a reduction in AF-related strokes.”

What is atrial fibrillation?

  • Atrial fibrillation (AF) is the most common heart rhythm disturbance (arrhythmia) encountered by doctors. It results from uncoordinated electrical activity within the upper chambers of your heart and leads to your heart beating in an irregular rhythm. If left untreated, AF can lead to serious complications, such as heart failure or stroke.
  • It is estimated that in the North West Coast region there are over 10,000 people who have the condition but are either not identified or not well managed on treatment.
  • Detect, Protect, Perfect
  • The AHSN Network’s Detect Protect Perfect campaign has prevented 3,165 strokes and saving 791 lives from 2018 to 2019 in the UK.
  • Pulse checks for over 65s, mobile ECG devices for GP surgeries and pharmacies, and new ‘virtual clinics’ involving specialists working with GPs to advise on the best treatment for people with the condition, were among the activities undertaken nationally as part of this life-saving work.
  • As a result, last year over 61,000 people were diagnosed with AF for the first time and almost 80,000, including some who were previously diagnosed, were given appropriate medication.
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