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Cardiovascular - Achievements

Diabetes
  • NHS Diabetes Prevention Programme (NDPP) – co-ordinated a successful expression of interest on behalf of 11 clinical commissioning groups. Our network is leading implementation as a first wave NDPP site to commence in April 2016.
  • Produced comparative information for clinical commissioning groups to highlight trends and variation in foot amputation rates.
  • Completed a review with providers, Mansfield & Ashfield and Newark & Sherwood Clinical Commissioning Groups and clinical commissioning groups in South Nottinghamshire. This has provided an in-depth review of the current pathway and recommendations for action to address identified gaps.
  • Developed standardised information leaflets for patients with input from the East Midlands Diabetic Foot Care Network to inform diabetic patients of their level of risk. Leaflets are to be made available to patients through podiatric and primary care services.
  • Completed a baseline survey of pathways for patients with Type 1 diabetes and a report of the results shared with providers and commissioners to inform development of services
  • Held a successful “Call to Action” workshop in December 2015 to explore with stakeholders what the key issues related to improving the management of young people with type 2 diabetes aged under the age of 40 are. The agreed action plan included:
    > Development of a consensus statement on the clinical management of young people with Type 2 diabetes to provide advice to clinicians
    > Extraction of data from the National Diabetes Audit 12014-15 and pilot an audit within a number of clinical commissioning groups to provide a health needs assessment of young people with Type 2 diabetes and to identify gaps in current management. This will be shared with other clinical commissioning groups in East Midlands to highlight gaps in provision for young people with Type 2 diabetes.

Chronic kidney disease and  acute kidney injury
  • Supporting the national ASSIST-CKD programme to implement EGFR surveillance
  • Supported providers to implement improvements in acute kidney injury diagnosis and management through provision of an acute kidney injury innovation fund
  • Supported eight clinical commissioning groups to implement chronic kidney disease and acute kidney injury improvement programmes including GP and practice nurse upskilling
  • Implementation within 18 clinical commissioning groups of information for patients on medicines and their effects on kidneys to support the prevention of acute kidney injury
  • Provided innovation funding to eight acute trusts to implement improvements in acute kidney injury detection and management to increase the number of acute providers with key pathway elements in place.
Stroke prevention in atrial fibrillation
  • Updated atrial fibrillation slide sets to provide comparative information for clinical commissioning groups and continue to make the case to improve diagnosis and management of atrial fibrillation
  • Supported implementation of pilot of safe2screen atrial fibrillation screening kiosks in five GP practices in East Midlands
  • The East Midlands atrial fibrillation component has prevented an estimated 159 strokes and 53 deaths, reducing hospital admission costs by approximately £1.89m over two years. 7,017 additional patients have been diagnosed with atrial fibrillation (9.7% increase) and 5,898 additional high risk atrial fibrillation patients have been anticoagulated (22.4% increase). The anticoagulation uptake across clinical commissioning groups in East Midlands has increased from 64.3% in March 2013 to 74.1% in March 2015
Blood pressure
  • Developed bespoke infographics for clinical commissioning groups to highlight variation in the diagnosis and management of blood pressure to support them to prioritise this area
  • Supported clinical commissioning groups and public health to develop action plans to improve blood pressure diagnosis and management
Renal transplants
  • A multi-disciplinary Transplant Improvement Group continues to meet regularly to discuss unwarranted variation and areas of improvement
  • Sustainable improvements have been made in the following areas by establishing task and finish groups to standardise practice in access to transplant list/live donation and response to kidney offers.
Cardiac services
  • Engagement with all cardiology heads of service to inform a cardiology services stocktake
  • Re-establishment of Cardiac Services Clinical Advisory Group
Stroke
  • A Stroke Clinical Advisory Group continues to meet quarterly to continually develop and improve stroke services across the region
  • A task and finish group has developed options for delivery of Mechanical Thrombectomy to patients for whom it is suitable for consideration by commissioners.
Familial hypercholesterolaemia
  • Collaborating with Heart UK , the national cholesterol charity to pilot a primary care familial hypercholesterolaemia identification service in the East Midlands using a robust online software tool to identify patients with high probability of familial hypercholesterolaemia who are supported by familial hypercholesterolaemia specialist nurses. Funding for both the software tool and familial hypercholesterolaemia nurses has been provided by Heart UK. 
  • Adoption of best practice leading to earlier diagnosis and integrated care for familial hypercholesterolaemia patients and relatives