Project overview:

We would like to support your practice in a statin optimisation programme that aims to increase statin uptake and reduce cardiovascular risk for your patient population, following the model of a successful local initiative.

This will involve identifying and automatically engaging with patients identified as benefiting from lipid-lowering therapy to offer them atorvastatin, as the initial treatment of choice.

This will be conducted in a phased approach across the Deep End practices across Cambridge & Peterborough.

WHY: Through our Health Inequalities work at ICB, we have identified that your practice serves a community who are in the 20% most deprived circumstances in C&P. This is known as a ‘Deep End Practice’.

Your practices & communities are a priority for our ICS, as we know that due to the wider determinants of health, including increased behavioural and clinical risk factors for disease, that there is a reduced life expectancy for your patients, which is a ‘system priority’ to address.

Cardiovascular disease is the biggest cause of premature morbidity and mortality and yet that in addition to addressing the various risk factors, taking a ‘Statin’ tablet can reduce the risk of future cardiovascular events and/or ensure that any event has a smaller infarction, or scar, of the tissue affected (e.g. brain or heart).

HOW: Patients will be contacted by SMS on your practice’s behalf by Eclipse, directing them to a lander page outlining the benefits of atorvastatin and guiding them to access their secure patient portal (using their NHS number).

Patients can answer a few questions which will enable Eclipse to segment this population into different cohorts for you to consider prescribing a statin.

COHORTS:

The first group that will be contacted will be patients who already have established cardiovascular disease, including those coded with a cardiovascular event (ischaemic heart disease, stroke/TIA, peripheral arterial or vascular disease).

The second group will include those advised for primary prevention doses of lipid lowering therapy, as per NICE guidance: Lipid modification - CVD prevention | Health topics A to Z | CKS | NICE

·         Patients with a QRISK3 score >10% (including those with type 2 diabetes)

·         Patients with type 1 diabetes and aged >40

·         Patients with CKD

COMMERCIALS: For those practices who want to be part of this programme:

Through Eclipse, you will have access to lists of patients who have responded to the patient engagement:

• Patients that would like to start a statin – primary prevention dose

• Patients that would like to start a statin – secondary prevention dose

• Patients that have declined a statin

• Patients that are unsure and would like to have a consultation with a healthcare professional

• Patients that would not like to start a statin but may be interested in an alternative medication

Please note that the prescription will be at the clinical discretion of the prescriber.

Practices will be paid per patient reviewed, and will also contribute towards QOF indicator CHOL001. Reviews can be via:

• Direct prescription (for those consented patients with no contra-indications) - £5 per review

• Virtual/telephone appointment - £10 per review

• Face-to-face appointment - £15 per review

The method and outcome of a patient review can be noted within Eclipse to trigger these payments. 

EVALUATION: The pilot will run for 6 months after which a full evaluation will be completed. If the pilot proves successful, we will present a business case to the ICB for future funding to roll the project out to further practices. As well as quantitative data, which will be collected via Eclipse, patient reported outcomes and perceptions of the new pathway will be collected through patient questionnaires.

ACTION: By focussing the pilot on our most deprived practices in the areas of greatest CVD mortality, this programme aims to decrease the number or effect of future events on your patients.

If your practice would like to take part: Please complete the below pro forma, expressing your interest and consent for patient engagement.