Atrial Fibrillation Awareness Week
In celebration of Atrial Fibrillation (AF) Awareness Week (November 19-25) KSS AHSN is working with a pilot group of GP surgeries in Surrey to support practice staff in better identifying and treating high risk patients with AF.
KSS AHSN is collaborating with Oberoi Consulting to implement an innovative new Stroke Prevention in AF (SPAF) Audit and Case Finding Service in GP surgeries.
The system integrates with the GP clinical system to push out alerts to appear on the electronic record of patients requiring further intervention, and prompts are triggered when a high-risk patient is identified.
Practice staff are then encouraged to check the patient's manual pulse and if it's irregular or they are unsure, the prompt advises to use a Lead 1 ECG device. The GP will review the Lead 1 ECG trace, diagnose the heart rhythm and discuss treatment options and anti-coagulation therapy.
The innovative service comprises of a range of audit resources and onsite training developed to enable a Local Health Economy to systematically identify appropriate patients and manage the care of patients efficiently, with minimum impact on practice resources.
Early detection vital
Jen Bayly, Cardiovascular Lead at KSS AHSN, said: "It is important to identify AF early, as people with undetected AF are at risk of experiencing an AF related stroke, which may lead to death or significant disability. However, if AF is detected early on, anticoagulants can significantly reduce the risk of stroke by preventing clots from forming."
Experts estimate that more than 25,000 people across Kent, Surrey and Sussex have undetected, and the KSS Alliance for AF has been running for two years with a key focus on:
- Detect: Increase prevalence of AF – distribute 560 Lead 1 ECG devices
- Review: Increase anticoagulation – implement timely anticoagulation clinic reviews delivered by prescribers.
- Protect: Increase optimal anticoagulation – ensure patients are safe and receiving appropriate care
- Data: Measure the impact in the three key focus areas – implement in GP Practices an innovative AF & Audit Case Finding Service.
A new project plan, based on learnings so far, is set to be rolled out. The work is still focussed on the three key areas of Detect, Review and Protect. However, the approach is supported by an innovative AF and audit case finding service that will demonstrate how the services that GP Practices deliver improved quality, reduce variation, place patients at the centre of change and deliver value for money.
Following the on-going distribution of the 560 Lead 1 ECG devices, the alliance is now tracking results from their use to date. By the end of September 2018, 3,567 traces have been taken, detecting 316 possible AF results, thereby avoiding 13 AF-related strokes. As well as avoiding debilitating effects on individuals and their families, this will also represent a cost reduction of more than £580,000 for the NHS.
In Phase 1 of our AF project (Dec 16 – May 18) the Alliance collaborated with three independent review organisations to work in 29 GP Practices across KSS, looking at the Known AF population. The review identified 1,390 patients eligible for anticoagulation therapy. By the end of May 2018, 503 individuals had had their medicines optimised by their GP Practice, thereby avoiding 14 AF-related strokes. As well as avoiding the debilitating effects on individuals and their families, this will also represent a cost reduction of more than £380,000 for the NHS. This work is to be scaled up, with prescribing clinicians set to deliver anticoagulation review clinics.
The primary target to benefit from this project is the patient, and the Alliance aims to provide Primary Care with a variety of interventions and education around stroke prevention, to sustain the learning and close the AF prevalence gap described by Public Health England across Kent, Surrey and Sussex (KSS).
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