Project Name: Nephrology Led CRM Pathway: Treatment Optimisation for High-Risk Patient Groups in Salford Royal

Project Summary:

The Collaborative Working Project (CWP) within the Northern Care Alliance's Cardiovascular, Renal, and Metabolic (CRM) services has been established to introduce a service to improve the identification, review, and optimisation of secondary prevention lipid patients who are not achieving guideline-recommended lipid target.

The CWP will include the funding of a 1 FTE Band 8a Advanced Clinical Practitioner (ACP) for 12 months to support the identification, review and optimisation of secondary prevention lipid patients who are not achieving recommended lipid targets in line with national and local guidance.

The CWP aims to enable the CW Partner to:

  • Identify high-risk patients across Renal, Cardiology, Vascular, Diabetes and Stroke services.
  • Establish referral pathways to improve patient access to lipid management.
  • Provide ongoing support for secondary prevention patients, including repatriation to primary care with clear and comprehensive discharge plans.
  • Improve education, awareness and empowerment within primary care.

The CWP aims to improve patient outcomes, reduce variation in care, and strengthen collaboration between primary and secondary care to support effective cardiovascular risk reduction.

Expected Benefits:

Anticipated Benefits for Patients:

  • Increased patient access to structured lipid review and secondary prevention optimisation for eligible patients.
  • Earlier identification of eligible patients who may benefit from lipid management review and optimisation and access to ASCVD diagnosis and treatments.
  • Improved patient outcomes and experience through the integration of primary and secondary care pathways.
  • Reviewing available treatment options and engaging in collaborative decision-making with secondary prevention lipid patients regarding next steps.

Anticipated Benefits for the Organisation(s):

  • Improvement in capacity for HCPs in ASCVD services through improved referral processes, treatment pathways, and better-informed patients.
  • Identification and management of sub-optimally treated ASCVD patients who are at high risk of cardiovascular events and who otherwise may have been missed or left untreated.
  • Upskilling primary care in the management and treatment of ASCVD patients enables suitable patients to be treated closer to home, reducing demand on secondary care services, improving pathway efficiency, and increasing specialist capacity for higher-acuity cases.
  • Secondary Care Pathway Development: Creation of a replicable pathway and referral template for specialties including, Renal, Cardiology, Vascular, Diabetes, Stroke.

Anticipated Benefits for Novartis:

  • Better understanding of overall healthcare system needs, service pathway challenges, HCP and patients’ needs within ASCVD.
  • Novartis is likely to see positive outcomes as a result of the CWP.  As more patients are reviewed there is a potential for greater utilisation of Novartis’s licensed medicines, in line with national and local guidelines, where appropriate, leading to improved patient care.
  • Enhanced reputation supporting Novartis' vision to provide high-quality Collaborative Working with healthcare organisations, to help address some of the issues surrounding health inequalities.

 

Start Date & Expected Duration: September 2026, 18 months with 12 months of clinical activity.

FA-11782206 | September 2026