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Over 3,000 strokes prevented and 800 lives saved through national drive to detect and treat irregular heart rhythm

Published and last updated by Rahel Gerezgiher

Over 3,000 strokes prevented and 800 lives saved through national drive to detect and treat irregular heart rhythm

Recently released figures reveal that a programme rolled out across the NHS to reduce strokes related to an irregular heart rhythm prevented 3,165 strokes and 791 lives last year (2018/19). 

The NHS initiative focussed on improving the detection and treatment of Atrial Fibrillation (AF) – the most common type of irregular heart rhythm that can increase risk of stroke. In the UK, one million people are known to be affected by AF and an additional 422,600 people are undiagnosed. This irregular heart rhythm is responsible for approximately 20% of all strokes, which can leave survivors with disabling consequences. Treating the condition costs the NHS over £2.2 billion each year. 

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

AHSNs have played a key role in this nationwide initiative. Pulse checks for over 65’s, 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 amongst the varied activities undertaken 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. 

Professor Gary Ford, Chief Executive of Oxford Academic Health Science Network and Consultant Stroke Physician said “Spotting the risk of stroke early and taking preventative measures can help to reduce risk of premature death and reduce the number of people who experience life-changing, long-term disability due to stroke. Identifying people who have AF and ensuring they are provided with the most appropriate anticoagulant (blood thinning) therapy can more than halve their risk of having a stroke.

“Since 2016 AHSNs have worked tirelessly with others across the healthcare system to reduce the burden of stroke. This recently released data illustrates the significant impact our work has made, improving lives and reducing cost to the NHS.”

What has stroke prevention in south London looked like? 

During the 2018-19 financial year, the Health Innovation Network’s Stroke Prevention in Atrial Fibrillation programme achieved success in improving the detection and treatment of AF in south London through the spread and adoption of digital innovation in high-impact settings.  

The team’s Mobile ECG Devices Project  report, released in September 2019, describes how from January 2018 to March 2019 a total of 400 mobile ECG devices—Kardia Mobile, WatchBP and MyDiagnostick—were distributed across the 12 south London boroughs, resulting in the recording of 14,835 pulse rhythm checks and the detection of nearly 600 possible cases of AF, potentially preventing 23 strokes with estimated savings of £309,000 to health services.  

AF checks in the identified high impact settings – flu vaccination clinics, community podiatry clinics and all three mental health trusts – are now in active implementation. This significant progress falls in line with the data collected since 2015, which shows that the number of strokes caused by known AF in south London has significantly reduced. The latest national stroke audit data has now been published and shows that in the two-year period from April 2017-March 2019 there were approximately 150 fewer AF-related strokes in South London than would have been expected from the previous years’ data. This is particularly impressive in the context of the increasing population age. 

HIN’s AF team is continuing to support these high-impact settings and we would be delighted to hear from member organisations interested in getting involved in this life-saving work.

Contact HIN AF Project Manager Alex Lang

Digital innovation in cardiac rehabilitation services; the time has come…

Published and last updated by Rahel Gerezgiher

Digital innovation in cardiac rehabilitation services; the time has come…

Health Innovation Network partnered with the British Heart Foundation and the London Cardiac Rehabilitation Network to create an Innovation Exchange event where clinicans and innovators could discuss how digital solutions can help improve uptake of cardiac rehabilitation services, and the result was overwhelmingly positive, says Anna King.

More and more, I am approached by NHS clinical leaders looking for digital solutions to help them transform their services. Gone are the days when clinicians rejected the idea that patients would use technology. Gone are the days when they believed technology could not improve outcomes. And gone are the days when clinicians worried about their job being taken by a robot. Now instead, clinicians are asking whenthey will get the digital tools they need to improve outcomes, efficiency and patient care. Well, at least this was the fantastic response we had from the London Cardiac Rehabilitation Network members’ recent Innovation Exchange event.

At the event, the challenges that cardiac services are facing were clearly set out by key opinion leaders Sally Hinton (BACPR Executive Director) and Patrick Doherty (Director of the National Audit for Cardiac Rehabilitation), along with patient representative Rob Elvins. The challenges they all raised were uptake and access. But they also highlighted the benefits of improving outcomes and uptake in this area too.

The NHS Long Term Plan (LTP) sets cardiac rehabilitation out as an intervention that can save lives, improve quality of life and reduce hospital readmissions. It’s also recommended by NICE. However, uptake of cardiac services currently varies widely across England and only 52% of the 121,500 eligible patients per year are taking up offers of cardiac rehabilitation. If we can increase this uptake to 85% by 2028, as set out by the LTP, it will prevent 23,000 premature deaths and 50,000 acute admissions over 10 years. Furthermore, it would make the NHS amongst the best in Europe. This suggests to me there is plenty of scope to improve services to the standard we all aspire to.

Many of the cardiac rehabilitation services present at the Innovation Exchange believed – as I do – that digital solutions are the only way they will manage to significantly increase uptake with current resources. Especially as uptake is lower in women, the young and those for whom it is their only health condition; a group of patients who might find digital or hybrid rehabilitation opportunities very attractive.

Many innovators applied to contribute to the event, which demonstrates the high level of interest and potential in this area. The selected innovators proved that many of these valuable digital solutions are not only already available, but they are comprehensive rehab programmes that are well-evidenced and could bolt onto existing services right now. There were also innovators with systems in other similar areas of care, that were willing to co-develop solutions for cardiac rehab. It was fantastic to see the energy that came from get all the innovators both from services and those with potential solutions together. I am looking forward to seeing how the plans made develop over the coming months.

The Exchange closed with the panel discussing the way ahead for cardiac rehabilitation and the technology they would implement. Patrick Doherty summed discussions up by saying that you could no longer consider that you run a good cardiac rehab service unless you offered digital and home-based options for patients too. I don’t think anyone will have left the event without thinking the time has come for all cardiac rehabilitation services to have digital components, and many more of London’s cardiac rehabilitation services will be taking those important steps towards implementation.

Find out more about the companies who participated in the Innovation Exchange:

The showcasing innovators:

The exhibiting innovators:

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About the author
Anna has been Commercial Director at the Health Innovation Network since July 2013. Prior to her current role Anna was the Commercial Programme Director at the London Commercial Support Unit (Commissioning Support for London, NHS London and NHS Trust Development Authority).

Hundreds of Londoner’s have pulse check after Mayor Sadiq Khan urges #knowyourpulse

Published and last updated by Rahel Gerezgiher

Hundreds of Londoner’s have pulse check after Mayor Sadiq Khan urges #knowyourpulse

With 60,000 undiagnosed with the most common type of irregular heartbeat Atrial Fibrillation (AF) that can lead to a stroke, it’s important to #knowyourpulse.

The mayor’s message was backed by NHS England Medical Director Sir Bruce Keogh who issued a video message that can be viewed here urging people to #knowyourpulse. This campaign was backed up by the three London Academic Health Science Networks who ran free drop-in pulse check’s across the capital.

A simple, 30 second pulse rhythm check – either performed manually or using one of a range of new devices – can identify AF so that treatment can be provided.

The call comes after the Mayor had a test himself for Global AF Aware Week (20-26 November). The Mayor’s message can be viewed here.

At least 9,000 people were directly alerted to the campaign through Facebook and Twitter and the video messages have been viewed more than 1,000 times.

Over 150,0000 Londoners are affected by AF and of these an estimated 60,000 remain undiagnosed. Nationally, as the most common type of irregular heartbeat, AF is responsible for approximately 20% of all strokes. Stroke survivors must live with the disabling consequences and treating the condition costs the NHS across England over £2.2 billion each year.

This year’s Global AF Aware Week message was ‘Identifying the Undiagnosed Person with AF’. Londoners are being encouraged to spread the word about irregular heartbeats and urge friends and family – particularly those aged over 65 – to check their pulse and see a GP if it is irregular.

Pulse checks can be done manually (a British Heart Foundation video and guide shows how here) or through technology, with irregular rhythms investigated further by healthcare professionals.

The Mayor of London, Sadiq Khan, said:

“More than 150,0000 Londoners have the most common type of irregular heartbeat, which is called Atrial Fibrillation or AF, and are at higher risk of a stroke. Not everyone with AF has symptoms and a simple pulse rhythm check could save their life.

“I’m urging Londoners to have a free, 30-second pulse check this week during international AF Awareness Week. You can do this at one of the many awareness events happening across the capital this week, or ask your doctor or nurse.”

Professor Gary Ford, Stroke Physician and Chair of the AHSN Network Atrial Fibrillation Group, said:

“More than 60,000 Londoners are unaware they have Atrial Fibrillation which is responsible for 1 in 5 strokes. We have highly effective treatments that reduce the risk of stroke in people with AF.

“During Global AF Aware Week I am urging everyone, but particularly those over 65 to have their pulse rhythms checked. This simple check could prevent a stroke, which can have a devastating impact on their lives.

“I fully support the Mayor of London in his call for Londoners to have a simple check so that we can prevent strokes and ultimately, save lives and prevent long term disability.”

AHSN’s feature at Patient-Centred Pharmacy event

Published and last updated by Rahel Gerezgiher

AHSN’s feature at Patient-Centred Pharmacy event

It’s fast approaching the Pharmacy Management National Forum which has chosen Patient-Centred Pharmacy as its theme. The forum, which is free to NHS delegates, focuses not only on the use of medicines but also their impact on patient care and the resources of the NHS. The event, which is in its sixth year, is on 10 November and returns to the Novotel Conference Centre in West London

The forum is supported this year by a number of contributions from Academic Health Science Networks around the country. The day allows a choice of Satellite Sessions from a selection of 24, plus ample time in the Innovation Zone where colleagues will be demonstrating their advances.

The Health Innovation Network is providing the following sessions:

  • Patient Centred inhaler technique assessment and adherence support led by pharmacists using RightBreathe – Mandeep Butt and Dr Azhar Saleem
  • AF work being developed nationally by all the AHSNs – Helen Williams
  • An experience based co-design approach to pharmacy services – Catherine Dale
  • “Walk in my Shoes” – an experiential learning exchange project between GPs and Pharmacists – Cleo Butterworth

Yorkshire and Humber AHSN:

  • Polypharmacy Project (Funded by the Health Foundation) – Tony Jamieson & Chris Ranson

Innovation Agency:

  • Electronic Transfers of Care to Community Pharmacy – Learning from regional adoption – Andrew Shakeshaft (Head of Programmes, Innovation Agency, Academic Health Science Network for the North West Coast); Hassan Argomandkhah (NHSE and Chair of LPN Merseyside); Matt Harvey (Chief officer, Liverpool Pharmaceutical Committee); Kevin Noble (Managing partner Pinnacle Health Partnership) and Sally Wright (Researcher, Liverpool John Moores University)

The full list of the sessions can be found here.