The UK Government and NHS England have launched their cardiovascular disease (CVD) modern service framework (MSF). The new framework aims to reduce premature deaths from stroke and heart disease by 25% over the next 10 years.

What does this new framework mean for patients

If successful this will also have a significant knock-on effect in reducing related complications such as amputations, diabetic foot ulcers, kidney dialysis, heart failure, chronic limb ischaemia and dementia.

The framework represents a shift to a more joined up approach whereby chronic kidney disease (CKD), type 2 diabetes, high cholesterol, and hypertension are integrated into one holistic preventative pathway.

The future of cardiovascular care

The Government’s 71-page framework document sets out in detail how this important call to action will be achieved. The aim is to drive dramatic improvements in several areas where the evidence of impact on reducing premature mortality is strongest and performance is currently inconsistent.

To achieve this, the NHS aims to:

1. Find “the missing millions” with undiagnosed or unmanaged Cardiovascular-Kidney-Metabolic (CVKM) risk factors, including both behavioural risk factors like smoking, as well as the ‘ABCDE’ risks (atrial fibrillation, albuminuria, blood pressure, cholesterol, diabetes, excess weight and kidney function)

People at risk will be proactively identified using digital health data and neighbourhood outreach. There will be greater emphasis on routine NHS health checks, along with a drive to aggressively reduce the number of people with undiagnosed and untreated hypertension and high cholesterol.

Recourses will be directed to more deprived areas where premature cardiovascular death rates are highest.

Charities such as Diabetes UK are teaming up with the Government on this initiative to raise awareness of the links between cardiovascular disease and diabetes.

2. Start and optimise treatment, including supporting adherence for more people with high-risk conditions like high blood pressure, cholesterol, chronic kidney disease, diabetes and heart failure

A core priority is delivery of nine diabetes care processes (blood glucose, cholesterol and kidney function, blood pressure, urine ACR, feet examination, weight and eyes) to prevent complications and identify deterioration early.

3. Ensure timely, equitable, high-quality acute care for:

a. Stroke

b. ST segment elevation myocardial infarction (STEMI),

c. Intracerebral Haemorrhage

The aim is to reduce unwarranted variation and delays across urgent care pathways. For example, reducing delays in giving thrombolysis treatment for those with suspected strokes and ensuring rapid access to primary percutaneous coronary intervention (pPCI) for STEMI heart attacks.

4. Expand and strengthen long-term cardiac and stroke rehabilitation services so patients successfully return to everyday life.

Early and good quality stroke rehabilitation is key to optimising patient recovery from stroke and heart attacks. Access to rehabilitation varies depending on location and the aim is to eliminate those inconsistencies and drive-up standards.

Reducing poor outcomes and improving health

There is cause for real optimism here. Each year, there are around 33,000 early deaths from heart disease and stroke in people under the age of 75. The Government estimates that if the framework is successful then in the first three years there will be between 1,600 and 2,400 fewer deaths in those under 75 each year from heart disease and stroke, and between 3,850 and 4,900 fewer deaths annually after 10 years. The framework is data driven meaning that improvements will materialise if this joined up and targeted approach is adopted.

Reducing poor outcomes and improving health in a holistic manner would be a truly impressive outcome and one which is perhaps long overdue.

As a clinical negligence solicitor, I have seen first-hand the devastating effects that strokes have on clients who were previously completely independent with families, friends and careers. A stroke can take all of that away, leaving people in dire straits with poor quality of life and little hope due to lack of rehabilitation and suitable housing. Tragically, in some cases, it can lead to premature death. I therefore welcome this considered and muscular approach in trying to prevent people from suffering such life changing events.