Project Name: Bristol Heart Institute Nurse Led ASCV and Lipid Prevention Model of Care

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 optimization of patients with atherosclerotic cardiovascular disease (ASCVD) in response to the needs of the CW Partner.   

This project aims to implement a local secondary care led secondary prevention clinic, focusing on supporting the discharge and onward management of secondary prevention patients, including first dose medicine optimization, and subsequent transfer to primary care setting.

The CWP will be co-led by a Nurse band 7 and a Nurse band 6 alongside a multi-disciplinary team; including a consultant cardiologist (x2) and a Band 7 Management/Administrative Support, aiming to achieve:

  • Identification of sub-optimally treated ASCVD patients who are not achieving lipid levels as specified in local guidelines.
  • 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. 
  • Early identification of at-risk patients who have not had intervention in their health and wellbeing. 
  • 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.

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.

Anticipated benefits for organisation(s):

  • 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: 01/02/2023. 21 months. 

FA-11429909 | June 2025