Project Name: Mid and South Essex NHS Foundation Trust Lipid Clinic

Project Summary:

The CWP is structured such that a multi-disciplinary health professional team will provide tailored care for patients, aligned with the Primary Care Network (PCN) Contract Direct Enhanced Service (DES) and the Locally defined Cardiovascular plans.

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), FH patients who are at high risk of cardiovascular events and other primary prevention where appropriate, who are not achieving lipid levels as specified in national and/or local guidance, in response to the needs of the CW Partner. 

This PID has been amended due to the Mid and South Essex NHS Foundation Trust, on behalf of Southend University Hospital and Broomfield University Hospitals (CW Partner) requesting a six (6) month time extension to allow it to prepare a business case for funding of enhanced lipid service to the CVD Board, Hospital Trust and ICS board. This extension will allow the project to progress into the next financial year, whereby they can submit the business case through the triple process. The Triple process is an approval process from the NHS for funding, this requires the business case to be reviewed by CVD Board at the Hospital Trust, the Hospital Trust Board and the ICS (Integrated Care Systems – the commissioners of services at the Mid and South Essex NHS Foundation Trust)  for the approval of funding. 

Planned Milestones:

Collection of baseline data, in line with the above Project Outcome Measures & Data Collection table.

Confirmation of clinical and operational pathway, referral letter template to primary care, policy and protocol creation, and readiness to begin the clinical activity.

Confirmation of recruitment of band 7 nurse. 

Collection & submission of 3, 6, 9, 12 and 15 months clinical activity data and Project Review meeting at 3,6,9, 12 and 15 months to discuss project progress.

Submission of business case to the hospital Trust, plus the 

business case reviewed at ICB level to continue the service offered by this project.

Collection & submission of 18 months clinical activity data

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 CVD prevention as per National and local guidelines

Anticipated benefits for the organisations:

  • Increased proportion of ASCVD patients reviewed.
  • Increased proportion of ASCVD patients receiving expert and timely review
  • Increased proportion of patients receiving guideline-directed pharmacotherapy
  • 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: November 2023 for 21 months. 

FA-11458671 | June 2025

Project Name: Mid and South Essex NHS Foundation Trust Lipid Clinic 

Partner Organisation(s): Mid and South Essex NHS Foundation Trust, Nethermayne, Basildon, Essex, England, SS16 5NL, on behalf of Southend University Hospital and Broomfield University Hospitals 

Completion Date: 31/11/2025

Outcome Summary: 

This project successfully implemented a nurse-led strategy to optimise lipid management and review patients who had a previous cardiac event. 

A lipid lowering clinic commenced across Broomfield and Southend hospitals, through collaborative working with Novartis, as there was no service previously on these sites. This was for high-risk patients (those who had recently been discharged from hospital with a diagnosis of Acute Coronary Syndrome - ACS), it also increased patient engagement in their lipid and risk factor management across primary and secondary care.

Key Project Outcomes Data: 

  1. Identification of sub-optimally treated ACS patients who are at high risk of cardiovascular events and who are not achieving lipid levels as specified in national and local guidelines.
  • Baseline for both sites: 0
  • Southend 285 patients
  • Broomfield 126
  1. Increase in the number of patients who have attended a review appointment as part of the project
  • Baseline at both sites: 0
  • Southend 250
  • Broomfield 29
  1. Increase in the number of patients who have attended a lipid optimisation clinic as part of the project.
  • Baseline for both sites: 0
  • Southend 250
  • Broomfield 30
  1. Increase in the number of eligible patients offered and/or up titrated on appropriate NICE approved lipid lowering therapies within the duration of the project. 

Those patients that achieved a LDL below 2, as per guidelines:

  • Broomfield 74 patients, baseline 0
  • Southend 110 patients, baseline 0

Outcomes: 

For patients:

  • There was increased engagement from patients with both their lipid management and risk factor profile overall.   
  • Positive feedback from patients 

For healthcare professionals and organisations:

  • Increased engagement from healthcare professionals in secondary care with multiple education sessions reaching over 100 staff across the whole of the cardiac MDT.
  • Creation of overarching guidelines for management of lipids, published on Trust Intranet and GP Gateway
  • Upskilling nurses working in an outpatient environment to manage high risk patients. 

For population health:

  • A focus on prevention with an aim of reduced re-admission, but due to capacity issues of only having 0.4 WTE nurses on each site with no other support staff, this was not formally investigated. The true impact of reductions in re-admissions would need to be reviewed over a three-to-five-year time frame.
  • Which gives a 22% reduction in cardio

Conclusion: 

A greater patient population was optimised on lipid lowering therapies, in line with local and ESC guidance. The collaborative approach between MSE and Novartis allowed patient engagement, reduction in cardiovascular risk, and allowed a timely up-titration of appropriate therapies. This approach aligned with the ICBs and NHSE’s wider plan to improve CVD prevention. 

There was an issue referring out to Primary care as some GPs would not take on the continuation of injectable lipid lowering therapies. This resulted in secondary care keeping patients within the service for longer than the initial agreement. 

A business case has been written for discussion with the ICB for continued funding of these posts but unfortunately the service had to be stopped as the Trust’s financial status is not allowing for any business cases to develop in this financial year.  The patients already receiving injectable therapies are being continued within other services within the Trust. 

FA-11593956-1 | April 2026