UCLPartners is both an Academic Health Science Centre (AHSC) and Academic Health Science Network (AHSN). Our AHSC cardiovascular programme is focussed on developing innovative approaches to prevent heart disease and creating new medicines and devices that will benefit of patients with or at risk of heart disease or stroke. Our AHSN cardiovascular programme compliments this by working to improve the cardiac health of our patient population through partnerships that make a real difference in population and place-based care.
Cardiovascular programme (AHSC)
Our cardiovascular programme aims to achieve maximum global, national and regional impact for the benefit of patients with or at risk of heart disease or stroke.
The cardiovascular programme draws on a multitude of skills and resources that exist within the partnership. Specifically it brings together the research strengths of UCL and Queen Mary University London (QMUL); the translational infrastructure of University College London Hospital (UCLH), Moorfields Eye Hospital NHS Foundation Trust, Great Ormond Street Hospital for Children NHS Foundation Trust and Barts Health NHS Trust; and the clinical expertise of three specialist cardiac hospitals (UCLH’s Heart Hospital, Barts Heart Centre at St Bartholomew’s Hospital and the Royal Free Hospital).
The cardiovascular programme has two workstreams:
Joint Translational Cardiovascular Institute (JTCI)
The JTCI will bring together the world-leading faculty from the William Harvey Research Institute at QMUL with pioneering clinician-scientists from the UCL Institute of Cardiovascular Science. The aim of this institute is to deliver an internationally leading translational academic strategy. This strategy will accelerate diagnostic and therapeutic innovation originating from the universities into cardiovascular clinical care for the benefit of patients.
Progress to date
A site has been identified for a devices facility and a bid of £10.2 million has been submitted to support this, match-funded by Barts Charity.
Barts Heart Centre
This state-of-the art heart centre brings together specialist cardiovascular services with many co-located academics and clinical teams from three hospitals (the London Chest Hospital, UCLH’s Heart Hospital and Barts Heart Centre at St Bartholomew’s Hospital). The centre provides a focussed translational research environment and has over 80,000 patient episodes per year.
Progress to date
Barts Heart Centre at St Bartholomew’s Hospital was opened in May 2015. The National Institute for Cardiovascular Outcomes Research (NICOR) has also relocated to the new campus. NICOR helps the NHS, the government and regulatory bodies improve quality of care by checking that the care received by heart disease patients meets good practice standards. Being located on the Barts Heart Centre campus ensures cardiovascular clinicians have greater access to data.
Professor Steffen Petersen, Professor of Cardiovascular Medicine, Queen Mary University of London
Cardiovascular disease programme (AHSN)
Two thirds of premature deaths in the UCLPartners population of around six million people are caused by cancer or heart disease. The AHSN cardiovascular disease (CVD) programme is working with Barts Health NHS Trust to support their transformation and prevention agenda, and to deliver improved heart failure services. It is also partnered with London AHSNs, the London Clinical Networks and the AF Association on a Pan-London Atrial Fibrillation (AF) programme. These key partnerships will impact on CVD outcomes across London and beyond.
The objective of the CVD programme is to support the our partners transformation towards place based systems of care that will deliver improved population health and greater sustainability by focusing on cardiovascular prevention and new models of care.
This programme has five workstreams. These are:
- Barts Heart Centre Board cardiovascular prevention programme
- Atrial fibrilation (AF) programme
- Heart failure programme
- London Hypertension Leadership Network
- Root cause analysis study
Barts Heart Centre Board cardiovascular prevention programme
This workstream is supporting the Barts Heart Centre Board to lead the transformation in cardiovascular outcomes across UCLPartners. This work includes the development of a new cardiovascular prevention programme to lead a system-wide transformation of cardiovascular services which prioritise prevention and wellbeing at population level.
Atrial fibrilation (AF) programme
The aim of the AF programme is to support clinical commissioning groups (CCGs) to lead local improvements to the care pathway for people with AF, to prevent AF-related strokes and associated mortality, and to realise savings for the care economy through:
- Increasing detection of those with undiagnosed AF
- Protecting those with diagnosed AF through effective treatment
- Optimising the treatment of people on anticoagulation
We are working in partnership with the AF Association, Health Innovation Network (the South London AHSN) and Imperial College Health Partners to scale up delivery of the AF programme across UCLPartners geography, and throughout London.
Progress to date
Our AF programme was officially launched across London in June 2016 and expects to prevent 1,777 stokes and save up to 450 lives in London over the next five years. This pan-London collaboration will implement a toolkit for early detection, increased anti-coagulation and improved adherence and self-management and draws on improvement work underway nationally. It includes:
- Project plans for each improvement activity
- Checklists and ‘myth busters’ for specific topics (eg: anticoagulation)
- Signposting to validated tools (eg: patient decision aids)
- Guidance on IT systems and data (eg: metrics to track improvement)
- Best practice examples
- Evidence reviews (eg: various detection devices).
A series of quarterly improvement collaborative events will support clinicians to deliver the improvement work and implement the toolkit locally by mid-2017.
Heart failure programme
This programme aims to achieve an increase in recorded heart failure prevalence, a decrease in emergency hospital admissions and improved health outcomes for people with heart failure. Many patients with heart failure remain undiagnosed and are therefore unable to access appropriate healthcare, leading to adverse health outcomes.
Progress to date
We have collated publicly available data sets to deliver a baseline assessment of heart failure services across the CCGs served by UCLPartners. These utilise core whole system metrics such as, prevalence, heart failure admission rates and prescribing. Using this data, we create bespoke data packs for each locality. We are now working with our partners to drive positive quality changes in heart failure.
We’re testing the feasibility of integrated heart failure pathways within Barts Health and its three surrounding boroughs. This project was launched in July 2016 and is in the scoping phase of identifying and engaging key stakeholders. This project will ensure optimally efficient and clinically effective care for the benefit of people with heart failure.
London Hypertension Leadership Network
This network aims to accelerate the hypertension agenda across London by raising the profile of hypertension in the NHS Sustainability and Transformation Plans (STPs) and supporting and influencing primary care practitioners, commissioners and other stakeholders to increase levels of hypertension prevention, detection and management in London.
Progress to date
The London Hypertension Leadership Network held its first event in July 2016. This was a workshop designed to allow deeper discussions of hypertension best practice and evidence. It provided an opportunity to build up key relationships to support and influence primary care practitioners, commissioners and others to increase levels of hypertension prevention, detection and management in London.
Root cause analysis study
In collaboration with Camden CCG, UCLPartners led and managed a research study, Root cause analysis of cardiovascular disease prevention and risk factor management failure in Camden patients. This study aimed to investigate people admitted to hospital with a stroke or acute cardiac syndrome ie: heart attack or unstable angina, to establish what if any types of services might have prevented their CVD. The root cause analysis methodology was applied to evaluate medical interaction and intervention in the preceding five years of people with CVD in Camden in an attempt to:
- Identify emerging or consistent themes and exemplar cases of CVD prevention failure
- Identify gaps and barriers to optimal primary and secondary prevention of CVD in Camden
- Recommend primary and secondary prevention strategies
Progress to date
The study findings and recommendations are currently being reviewed and there are plans for academic publication in the near future.
- Dr John Robson, Primary Care Lead
- Sotiris Anotniou, Pharmacy Lead
- Dr Simon Woldman, Clinical Heart Failure Lead
Documents for download
- Barts Health Charity bid
- Heart failure programme overview
- Action on cardiovascular disease: getting serious about prevention (Public Health England, September 2016)
For more information about this programme, please contact the programme team: