Stroke Prevention

Atrial Fibrillation (AF) is the most common cardiac arrhythmia affecting around 1.73% of the population in England¹,². Across London AF is under-detected, with an estimated 69,000 adults currently undiagnosed¹, AF is a major risk factor for stroke, with untreated AF increasing the risk of stroke fivefold. Strokes associated with AF, are often more severe, with higher mortality and greater disability.

A reduction in stroke can be achieved through improving detection of the condition, initiating anticoagulation therapy where appropriate and optimising treatment of the condition. We aim to work with local CCGs and providers to:

  • Support improved detection of AF in the population
  • Improve the quality of life of adults with atrial fibrillation
  • Promote initiation of appropriate anticoagulant therapies in those at risk of stroke
  • Optimise anticoagulation therapy to ensure maximum reduction in stroke risk with minimum risk of bleeding and allow patients to be involved in decision making as per NICE guidance (QS93 July 2015)²
Sources
QOF Quality and outcomes framework data 2015-2016
NICE quality standards for AF

Health Innovation Network were awarded a BMS-Pfizer Alliance Medical Education Goods and Services (MEGS) grant for £100,000 for a project on improving the diagnosis and management of AF in older adults with additional needs. The project has four distinct components:

  1. Use of innovative longer-term ECG monitoring technologies in patients post stroke or TIA, where paroxysmal AF is the suspected underlying cause and the delivery of traditional methods of longer-term ECG monitoring is challenging
  2. Review of patients who are housebound or in nursing homes and residential care to maximize detection of AF and initiation of anticoagulation
  3. Review of housebound or nursing home patients or those in residential care who are already receiving anticoagulation to ensure treatment is appropriate and optimized
  4. Support older adults with additional needs with adherence to and persistence with anticoagulant therapy through developing tools and services.

The Health Innovation Network has no influence over the medicines prescribed to treat AF in south London.

Projects

Single time point case finding for Atrial Fibrillation: A review of methods of delivery and devices

Community of Practice series

Commissioning of an effective anticoagulation patient pathway

Local CCG support and case finding

AF Awareness Raising

Pan-London AF Programme and Toolkit

The Team

Laura Semple

Programme Director, Diabetes and Stroke Prevention

Laura studied modern languages at Cambridge and joined the NHS as a management trainee in 2009. Since then she has held various hospital management roles as well as working in commissioning and at the Department of Health. Laura recently volunteered for six months at Connaught Hospital Freetown with the King’s Sierra Leone Partnership.

Julia Prudhoe

Project Support Officer, Stroke Prevention

Julia graduated from the University of Nottingham with a degree in Sociology and Social Policy. Previously, she worked as an Engagement and Liaison Officer at Healthwatch Northumberland. Julia looks forward to learning more about technology, and developing skills to provide project support. She loves to travel, and has recently returned from South America.

Helen Williams

Clinical Director, Stroke Prevention

Helen is the Consultant Pharmacist for Cardiovascular Disease (CVD) across the South London. She is involved in developing services such as pharmacist-led clinics to manage hypertension, hyperlipidaemia and heart failure, supporting implementation of the NHS Health Checks programme and providing education and training to healthcare professionals involved in the management of CVD.

Nadya Hamedi

Primary Care Pharmacist, Stroke Prevention

Nadya is currently a Pharmacist for Cardiovascular Disease (CVD) in primary care working across South London and the HIN. Her journey through community pharmacy, secondary care and primary care led to successfully completing a Darzi fellowship, which has enabled her to co-design and test a new referral pathway for people with atrial fibrillation with the aim of optimising adherence.

Faye Edwards

Senior Project Manager, Stroke Prevention

Faye began her career as a Podiatrist and during her clinical role she had a specialist interest in Diabetes wound management. She has worked in a service improvement role for the Royal Marsden, and the South West London Cancer Network. Since starting at the HIN Faye has led projects in type 1 diabetes and also also works on the Pan London Atrial Fibrillation project.

Alex Lang

Darzi Fellow, Stroke Prevention

Alex is the Darzi Fellow in the Stroke Prevention team and is leading the mobile ECG device project across South London. Prior to this secondment, Alex is a stroke specialist dietitian working at St Thomas’ Hospital over the past 9 years. He is a dietetic manager, lecturer and represents the British Dietetic Association at the RCPs Stroke Working Party.

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