Project Name: ASCVD Primary Care Lipid Management Collaborative Working Project

Project Summary:

The CWP is structured such that a multi-disciplinary health professional team will provide tailored care for patients. 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 Clinical Pharmacist alongside a multi-disciplinary team; including Clinical Pharmacist, Nurse, General Practitioner, Healthcare Assistant,Chemical Pathologist, aiming to achieve:   

  1. Identification of sub-optimally treated ASCVD patients who are not achieving lipid levels as specified in local guidelines
  2. Identification of ASCVD patients who have previously not tolerated or refused alternative lipid modification therapies  
  3. Review of treatment options and decision on next steps in collaboration with ASCVD patients
  4. Counsel and optimise ASCVD patients where appropriate  
  5. Early identification of at-risk patients who have not had intervention in their health and wellbeing 
  6. Identification of ASCVD patients, following risk assessment review, of ASCVD patients who are sub-optimally treated  
  7. 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 recruitment of Clinical Pharmacist
  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. Collection & submission of 15 months clinical activity data. Project Review meeting to discuss project progress
  9. Collection & submission of 18 months clinical activity data. Project Review meeting to discuss project progress
  10. Development of business case 
  11. 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 and PCNs. 

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: March 2023 for 24 months.

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