Project Name: Collaborative Working Project: Integrated Lipid Optimisation

Project Summary:

The main objective of the CWP is to improve the quality of care for patients and support the early identification, review, and medical optimisation of patients with atherosclerotic cardiovascular disease (ASCVD) in response to the needs of the CW Partner.

The CWP will be led by a General Practitioner with Extended Role alongside a multi-disciplinary team; including Independent Presciber (Clinical Pharmacist / Nurse (Band 8a), Lipidologist (Chemical Pathologist), Administrative Support, Healthcare Assistant, aiming to achieve:

  • Early Identification of at risk and sub-optimally treated ASCVD patients who are not achieving lipid levels as specified in local guidelines, and offer a health intervention
  • Identification of ASCVD patients who have previously not tolerated or refused alternative lipid modification therapies
  • Review of treatment options and decision on next steps in collaboration with ASCVD patients
  • Counsel and optimize ASCVD patients where appropriate
  • Identification of ASCVD patients, following risk assessment review, of ASCVD patients who are sub-optimally treated
  • On-going ASCVD patients support and annual review to ensure CVD outcomes improve equitably 

Planned Milestones:

  1. Collection of baseline data, in line with the above Project Outcome Measures & Data Collection table
  2. Confirmation of clinical and operational pathway, policy and protocol creation.
  3. Confirmation of contracting of Independent Prescriber. Confirmation of readiness to begin the clinical activity (CW Partner shall ensure that the clinical staff covered by the Novartis Financial Contribution are in place, trained and ready to begin clinical activity).
  4. Collection & submission of 3 months clinical activity data. Project Review meeting to discuss project progress.
  5. Collection & submission of 6 months clinical activity data. Project Review meeting to discuss project progress.
  6. Collection & submission of 9 months clinical activity data. Project Review meeting to discuss project progress
  7. Collection & submission of 12 months clinical activity data. Project Review meeting to discuss project progress
  8. Development of business case  
  9. Analysis of CWP data, submission of Final Project Report, Submission of Outcomes Summary  

Expected Benefits:

Anticipated benefits for patients:

  • Improved access to lipid management care leading to optimal diagnosis and management of ASCVD treatments.
  • Enhanced experience around ASCVD with ongoing management of the condition.
  • Improved access to appropriate medication for suitable patients to preserve health and prevent long-term events
  • Easier access to lipid management care closer to home in the Primary Care setting
  • The additional capacity will provide additional time and support from HCPs with their lipid management, focusing on patients who may have previously not attended GP appointment or been lost to follow-up. Thus, levelling health inequalities within the Federation.

Anticipated benefits for partner organisation:

  • Increased proportion of ASCVD patients reviewed by primary care
  • Increased proportion of ASCVD patients receiving expert and timely review closer to home
  • Reduction in ASCVD referral rates to secondary care
  • Increased proportion of patients receiving guideline-directed pharmacotherapy
  • Insight into benefits of primary care pharmacist led lipid management clinics in primary care
  • Support aligned to NHS Long Term Plan, CVDPREVENT, and Network Contract DES

Anticipated benefits for Novartis:

  • Insight on the appropriate use of ASCVD licensed medicines in line with NICE guidelines, including Novartis’s medicine
  • Enhanced reputation, and supporting Novartis’ vision that no patient should have to wait for an extraordinary life, by supporting high quality Collaborative Working with healthcare organisations which addresses the problem of health inequalities
  • Ethical, professional, and transparent relationship between Novartis and the Healthcare Organisation

Start Date & Duration: December 2022 for 18 months.