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Increasing detection and treatment for atrial fibrillation

We are working to prevent Atrial Fibrillation (AF) related strokes and associated mortality and morbidity by supporting clinical commissioning groups (CCGs) to improve care pathways for people with AF.

Our work aims to help prevent 150,000 heart attacks, strokes and cases of dementia over the next 10 years, through the early detection and management of atrial fibrillation, high blood pressure and high cholesterol.

What is Atrial Fibrillation?

  • AF is a common type of irregular health rhythm that can increase the risk of stroke.
  • AF is responsible for 1 in 3 strokes
  • AF affects around 1.2 million people in the UK and is associated with one in five strokes.
  • However, up to 25% of people with AF remain undiagnosed and there is variability in the proportion of people with AF who are prescribed anticoagulant therapy, which can help to reduce risk of stroke.

Our work in 2020/21

Our work in proactive long-term condition (LTC) management to optimise care in the high-risk conditions for cardiovascular disease includes the development of search and stratification tools, pathway development and workforce tools for the management of patients with AF on the GP register. View our long-term condition support package here.

Supporting Barking Havering and Redbridge CCGs (BHR)

We are working in partnership with Barts Health, to support BHR CCGs to rollout the ‘Redbridge model’ further. This model utilises pharmacists as part of a Multi-Disciplinary Team in primary care, delivering a 6% increase in the number of people receiving appropriate anticoagulation as well as antihypertensive and statins.   

The Redbridge model, supported by UCLPartners, led to:

  • the greatest improvement in treatment rates for people with AF in London,
  • the second highest improvement rates nationally, based on NHS data*. 

This model is now being rolled out further across Barking, Havering and additional practices in Redbridge.

*based on NHS Digital Quality and Outcome Framework data

Our past projects – 2019/20

In 2018 the North Central London CVD prevention steering group agreed to focus on AF by optimising atrial fibrillation (AF) management and ensuring treatment with appropriate medication to prevent a stroke.

North London Partners in Health and Care secured funding from NHS England to deliver a programme in 2019/20.

The five CCGs across north central London rolled out a virtual clinic model that had been successfully developed in Lambeth and Southwark.

Virtual clinics enable review of electronic medical records of undertreated patients. They also provide opportunities for frontline clinicians including GPs, practice-based nurses and pharmacists, to discuss complex patients with hospital specialists and to initiate anticoagulants where needed.  Additionally, the approach has helped to build confidence and capacity to manage patient living with AF moving forwards.

Since the delivery of the programme North London Partners in Health and Care is the most improved STP in England (the average improvement in England 2019/20 was 1.5%, north central London was 4.7%). Read more here.