The challenge:

High cholesterol is recognised as a significant risk factor for CVD with two thirds of those at risk being undertreated.  For patients with hypercholesteremia, one of the ABCs of CVD (atrial fibrillation, high blood pressure, high cholesterol), we know that for every 1mmol/L reduction in low density lipoprotein cholesterol (LDL-C) there is a reduction of them possibly having a cardiovascular event of about 23%.

Lipid optimisation is therefore an important aspect of our CVD Prevention work.

Primary and secondary prevention

Primary prevention is activity that takes place before an event has occurred such as reducing the likelihood of a stroke or heart attack, whereas secondary prevention is immediate action after an event such as a stroke or heart attack has occurred.  A lot of our work focuses on secondary prevention and supporting the management of patients post CVD event; however, we recognise primary prevention is equally as important.

Current lipid projects:

Bristol, North Somerset and South Gloucestershire (BNSSG) Collaborative Lipid Fund (CLF)

We are running a project until the end of October 2024, in collaboration with BNSSG ICB and One Care CIC to support the implementation of the UCLP Proactive Care Frameworks (UCLP) in Primary Care with a focus on lipid optimisation for high-risk patients. This project has been funded as part of the Collaborative Lipid Fund (CLF) which is part of a wider national programme of work around secondary prevention lipid optimisation.

Five Primary Care Network’s (PCN’s) within BNSSG with a notable Quality and Outcome Framework (QOF) treatment gap for cholesterol management, combined with treating patients from local underserved communities are receiving enhanced support, through a funding allocation to  support patient case finding using the UCLP proactive care frameworks followed by consultation for optimising treatments in line with the NICE lipid management pathway for secondary prevention.

The project will be subject of an evaluation report scheduled for publishing in the early in the new year.

For further information on this project please contact Amy Bowden, Senior Project Manager.

Resources:

We have pulled together a number of key resources to support such as pathways, case finding tools and webinar recordings.

Pathways:

  • The NICE endorsed AAC Summary of National Guidance for Lipid Management for Primary and Secondary Prevention of CVD, includes additional medication to use alongside statins and other lipid-lowering drugs, including novel therapies such as PCSK9i’s and Inclisiran. This pathway unifies multiple NICE guidance and technology appraisals into a single document to support clinical decision making on lipid management.
  • The Health Innovation Network has published a clinically approved pathway to support secondary care clinicians to optimise lipid management following an acute cardiovascular event. The pathway provides clear and unified guidance for clinicians on how optimal lipid management may be achieved, to reduce the risk of further cardiovascular events. Access the pathway for secondary care clinicians.

Tackling Cholesterol Together – a free education programme for primary care

Tackling Cholesterol Together is a professional education programme to support healthcare professionals in addressing under-diagnosis and under-treatment at scale and using new models to manage cholesterol – all underpinned by the updated NICE-endorsed pathway.

Tackling Cholesterol Together will be delivered through videos, podcasts, webinars, expert clinics and online modules. For more information and access to content please visit Tackling Cholesterol Together.

Case finding tools: