Project Name: East Birmingham Connect BEAT CVD: A Collaborative Working Project to Improve Cardiovascular Disease Prevention and Management with Novartis Pharmaceuticals UK

Project Summary:

The purpose of this Collaborative Working Project (CWP) is to improve the quality, consistency and equity of lipid management across the East Birmingham locality by supporting the earlier identification, assessment and optimisation of patients at increased cardiovascular disease (CVD) risk, in line with local priorities and national lipid management guidance. The project aims to improve cardiovascular prevention outcomes through a proactive, data-driven approach to medicines optimisation and lipid management whilst reducing unwarranted variation and addressing health inequalities.

Delivered in partnership across approximately 39 GP practices across six Primary Care Networks (PCNs), the CWP will implement a risk-stratified population health approach to proactively identify, invite and review patients with established atherosclerotic cardiovascular disease (ASCVD) and other high-risk cardiovascular conditions who are not achieving recommended lipid targets. Population health analytics, NHS-owned reporting tools and digital solutions will be utilised to support patient identification, prioritisation, clinical review, treatment optimisation, patient engagement and medicines adherence.

The project will be delivered through a multidisciplinary model comprising General Practitioners, clinical pharmacists, pharmacy technicians, practice nurses and administrative teams. Services will be delivered primarily through five hub-based clinics referred to as GP Caseloads in this CWP, with practice-level reviews undertaken where clinically appropriate. The model will support structured clinical review, shared decision-making and optimisation of lipid-lowering therapies in accordance with local and national guidance.  The CW Partner retains full clinical responsibility and decision making authority.

In addition to improving outcomes for eligible patients, the CWP will support workforce development, pathway redesign and shared learning across participating practices. The project is intended to establish a sustainable and scalable model for lipid optimisation that can be embedded within routine primary care services beyond the lifetime of the CWP, supporting continued improvement in cardiovascular prevention and patient outcomes. 

Expected Benefits: 

Anticipated Benefits for Patients:

  • Earlier identification of patients at high cardiovascular risk, enabling timely intervention and treatment
  • Improved access to lipid optimisation and evidence-based care, supporting achievement of recommended lipid targets.
  • Personalised care and shared decision-making, ensuring treatment decisions reflect individual clinical needs and preferences.
  • Improved patient understanding, self-management and treatment adherence through education, follow-up support and digital tools
  • Improved cardiovascular health outcomes, with the aim of reducing future cardiovascular risk and preventable events

Anticipated Benefits for CW Partner:

  • Improved identification and management of high-risk cardiovascular patients through a proactive, population health approach to lipid optimisation
  • Increased primary care capacity to deliver lipid optimisation services through dedicated clinical resource, multidisciplinary working and structured patient review processes
  • Enhanced workforce capability and confidence in cardiovascular prevention and lipid management through education, training and shared learning across participating practices and PCNs
  • Reduced unwarranted variation and improved health equity by implementing a consistent approach to patient identification, review and optimisation across the locality.
  • A sustainable and scalable lipid optimisation pathway embedded within routine primary care, supported by agreed processes, governance, clinical leadership and population health analytics.

Anticipated Benefits for Novartis:

  • Enhanced understanding of barriers, opportunities and best practice in delivering lipid optimisation and cardiovascular prevention within primary care.
  • Strengthened collaborative relationships with NHS stakeholders through a shared commitment to improving patient outcomes.
  • Generation of insights and learnings that may help inform future service improvement initiatives and collaborative working projects.
  • Enhanced reputation by supporting high-quality collaborative working that addresses unmet needs and reduces health inequalities. 
  • Development of an ethical, professional and transparent partnership with the healthcare organisation, founded on shared objectives and mutual benefit for patients.
  • 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 optimised patient care

Start Date & Expected Duration: September 2026 for 17 months 

FA-1178403 | September 2026