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Oliver Brady, our Programme Director for Diabetes and Mental Health, celebrates Cholesterol awareness month with his reflections on what we have learnt so far from innovating to reduce the risk people face from raised cholesterol levels.

Over the last year the Health Innovation Network, along with all of the other AHSNs across the country, have been working to reduce the risk of raised cholesterol to our populations. Cardiovascular disease (CVD) causes one death every three minutes in the UK and costs the UK economy £7.4 billion per year. The NHS Long Term Plan identifies cardiovascular disease as the single biggest area where lives can be saved over the next 10 years and set the NHS a target of preventing 150,000 strokes, heart attacks and dementia cases.

Through identification and treatment of three key cardiovascular conditions we can significantly reduce the number of these cardiovascular events that occur – these three conditions are Atrial Fibrillation, high Blood pressure, and raised Cholesterol (also known as the ABC of CVD). We’ve already done a significant amount of work on Atrial Fibrillation in South London, and we have now started to focus on raised cholesterol. We will also be working on high blood pressure in the near future so watch this space!

So how can we start to have an impact on the risk our population experiences from raised cholesterol? It is a complicated task and there is a role to play for people across all healthcare settings, and this is reflected in our approach which has covered a number of different types of innovation.

Medicines

The first area we are looking at is the uptake of medicines that can lower cholesterol. We have worked with partners across the healthcare system to identify barriers to the uptake of NICE-approved medicines including high intensity statins, Ezetimibe, and PCSK9 inhibitors, supporting our members to improve pathways that ensure as many people as possible benefit from these medicines (where they are eligible.) Recently a new medication known as Inclisiran has been approved by NICE and we will be supporting the roll-out of this across south London to ensure people who have are at increased risk of cardiovascular disease from cholesterol are able to benefit from this new treatment as soon as possible.

Tools for clinicians

Navigating the NICE guidance around cholesterol is a complicated task and one that largely falls on colleagues working in Primary Care. Fortunately, there are a number of innovations that attempt to simplify the task for Primary Care. One of the key innovations we have shared with healthcare professionals in south London has been the proactive care frameworks developed by our friends at UCL Partners AHSN in North London. These frameworks support primary care teams with the tools and resources they need to manage patients with long term conditions in a prioritised and efficient way – including applying the NICE guidance around cholesterol management. Through our work we have also spoken to a number of digital health innovators working to develop clinical decision support tools to assist clinicians at the point of care with identifying patients who could benefit from help managing their cholesterol. I am really interested to see how software produced by companies we have spoken to such as Metadvice, Patient Leaf, and Abtrace can help us to maximise the impact we have on cholesterol management and reduce variation in care.

Community

We know that the last 18 months has been especially difficult for those working in primary care and so we have aimed to promote innovations that help manage cholesterol risk across the healthcare system. One of the key ways we can do that is by working directly with our communities and identifying people at risk from cholesterol outside of NHS settings. We are building on the fantastic work being rolled out in south west London to deliver community health clinics to offer point of care testing for cholesterol for the first time from next month, with the aim of this testing being carried out across a number of community venues over the next year.

Technology

We have also been in touch with a number of industry partners providing innovations in this area including VitalSigns Solutions, who have been part of our DigitalHealth.London accelerator with their innovation PocDoc this year, and Thriva, who offer at home blood testing. We have heard about the ambition in the future to use this kind of testing in combination with an analysis of polygenic risk scores, which help clinicians to predict a person’s genetic risk to a disease, to provide personalised treatment plans to individuals based on their genetics, which could change the way we look at cholesterol management in the years to come.

Education

The final area of our work I wanted to highlight is innovations that support education for patients and staff. The AHSN Network have been working with Heart UK to develop online training materials on cholesterol management for healthcare professionals and members of the public, which you can find here. We are also in the process of developing a local training programme for healthcare professionals in primary care who want to learn more about CVD prevention, and we will be launching this in 2022. Get in touch if you’re interested in knowing more.

Hopefully innovations that are emerging, such as the ones above, will help us identify the people who are at most risk from raised cholesterol early, ensure they get the treatment that will prevent them from experiencing heart attacks and strokes, and save lives. At the Health Innovation Network we look forward to supporting health and care professionals across south London to take action on raised cholesterol over the next few years and ensure people across south London benefit from these potentially life-saving innovations.