Project Name: Willows Health: Accelerated Access ASCVD Prevention Project

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 Networks (PCNs) 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 and accelerated identification, review, and medical optimization of patients with atherosclerotic cardiovascular disease (ASCVD) in response to the needs of Willows Health PCN.  Novartis will contract with Willows Group Ltd as they are the legal entity contracting on behalf of Willows Health PCN.   

The CWP will be led by a Clinical Pharmacist alongside a multi-disciplinary team, including Pharmacy Technician, Healthcare Assistant, Administrative Support, General Practitioner providing clinical oversight aiming to achieve:

  1. Rapid access to ASCVD risk factor lowering strategies with an aim to see patients in a one-stop-shop CVD clinic to enable accelerated patient care.
  2. Population health management of patients dependent on their risks, targeting the most at risk first and seeing these patients within the new dedicated clinic.
  3. Identification of sub-optimally treated ASCVD patients who are not achieving recommended targets for lipid management as per European Society of Cardiology (ESC) targets.
  4. Identification of patients who have previously not tolerated or refused alternative lipid modification therapies.  
  5. Early identification of at-risk patients who have not had intervention in their health and wellbeing. 
  6. Review of treatment options and decision on next steps in collaboration with patients, counsel and optimize patients where appropriate.  
  7. Utilisation of combination lipid lowering therapies where applicable. 
  8. Management of additional CVD risk factors such as Blood pressure to further lower CVD risks.
  9. Adopting a holistic CVD risk reduction approach as set forward by NHS, by ‘making every contact count’ and utilizing appointments as further screening opportunities for Atrial fibrillation.
  10. Reduce health inequalities and improve access to healthcare to harder-to-reach populations/demographics by offering appointments away from Mon-Fri 9am-5pm normal hours.
  11. Allowing for convenient access to healthcare for patients via point of care testing for risk factors and subsequent management.

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. 

  • The additional capacity will provide additional time and support from PCN HCP with their lipid management, focusing on patients who may have previously not attended GP appointment or been lost to follow-up. Thus, leveling health inequalities within the PCN.  

Anticipated Benefits for organisations

  • 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 healthcare organisations. 

Start Date & Expected Duration: December 2025, 6 months clinical activity 

FA-11574846 | November 2025

Project Name: Willows Health: Accelerated Access CVD Prevention Project

Organisation(s): Willows Group Limited, trading as Willows Health, on behalf of Willows Health Primary Care Network

Completion Date: September 2026

Outcome Summary: 

This Collaborative Working Project aimed to improve the early identification, review and medical optimisation of patients with atherosclerotic cardiovascular disease (ASCVD) across Willows Health PCN. A pharmacist-led multidisciplinary model provided dedicated lipid management clinics, including out-of-hours access and point-of-care testing, to offer patients a more convenient and accelerated route from identification to review and treatment planning.

Key Project Outcomes Data:

By six months, 180 patients whose most recently recorded LDL level was above 2.6 had attended the clinic, compared with none at baseline. Over the same period, the backlog of patients awaiting pharmacist review was cleared, reducing from 289 to zero. The number of patients with an LDL level above 2.6 fell from 289 to 180, while the number meeting the broader threshold of an LDL level above 2.6 or total cholesterol above 4 fell from 289 to 120.

Outcomes: 

The project established a focused pathway for proactive ASCVD case finding and pharmacist-led review. Clinical activity increased progressively, with 52 patients seen by three months and 180 by six months. The elimination of the pharmacist backlog is a particularly positive operational outcome, demonstrating improved access and additional capacity. The reduction in the higher-lipid cohorts also provides an encouraging indication that patients were being identified, reviewed and supported through appropriate lipid-management interventions.

Conclusion: 

Overall, the project delivered positive outcomes for both patients and the PCN. It created additional review capacity, improved access to pharmacist-led lipid management and cleared the existing review backlog. The six-month data show meaningful movement in key risk cohorts and increased recorded use of lipid-lowering treatment options. The model provides useful evidence to support consideration of a sustainable, proactive CVD prevention pathway within Willows Health PCN.

FA-11819098 | October 2026