Atrial fibrillation (AF) is the most common type of irregular heart rhythm.
In England a large number of individuals are unaware they have AF, and some people with known AF do not receive optimal treatment, resulting in avoidable strokes. AF-related strokes represent a significant burden to patients, carers, the NHS and social care.
The AHSNs collectively identified that the spread and adoption of AF best practice across the AHSN Network could make a stepped improvement in care outcomes, leading to a reduction in AF-related strokes across England.
Based on proven best practice across the AHSNs in recent years, 14 initiatives have been selected for spread and adoption through our national AF programme, supported by our community of practice of regional AF clinicians and managers to share learning and amplify impact.
Spanning the AF clinical pathway, our national programme is drawing on this shared experience and intelligence to ‘detect, protect and perfect’.
We are rapidly increasing the detection of AF through the use of manual pulse checks or mobile ECG devices. Early detection of AF will allow the initiation of protective anticoagulation therapy.
AHSNs are distributing more than 6,000 mobile electrocardiogram (ECG) units to GP practices, pharmacies and other community settings across England. This technology detects irregular heart rhythms quickly and easily, enabling NHS staff to refer patients for the appropriate follow-up and treatment.
We are increasing anticoagulant therapy, in those diagnosed with AF and who are clinically indicated, to reduce the risk of stroke.
A ‘virtual clinic’ approach targeting AF patients on GP registers who were not receiving anticoagulation, initially led by Lambeth and Southwark CCGs and King’s College Hospital, is now being rolled out by a number of AHSNs. In this model, specialist anticoagulant pharmacists are commissioned to deliver virtual clinics in primary care, to support the GPs with evidence-based decision making regarding anticoagulation for patients with AF.
Scaling up this local pharmacist-led model across England, could prevent an estimated 3,000 AF-related strokes and save 750 lives.
We are optimising anticoagulation therapy in people newly diagnosed and those with existing AF.
The three London AHSNs have worked collaboratively with the London Clinical Network to develop an online interactive toolkit. This guides healthcare professionals and commissioners through the entire AF-pathway, providing a range of resources to improve the detection and treatment of people with AF. The toolkit can be found here.
By the end of 2019/20 we aim to have detected an additional 134,000 people with AF across England, with an additional 100,000 people with AF being newly prescribed appropriate anticoagulation therapy.
Our interventions will: