Introduction: The NHS Long Term Plan identifies CVD as the single biggest area where lives can be saved. Primary care provides a crucial role in the management of patients at risk of CVD. Offering a programme can help empower and improve confidence and management of high-risk conditions among clinicians.
Methods: We held series of monthly clinical webinars over seven months for healthcare professionals in south London. Topics included: atrial fibrillation (AF), lipid management, AF case studies. Alongside this, the fellows undertook an improvement project. This concluded with a showcase and learning event where case studies were shared, learnings discussed, future CVD work considered, and fellows encouraged to continue their work.
Results: In total, there were 19 educational sessions over 17 hours of lectures. One hundred and four fellows signed up to the programme – 85 (81%) were upskilled in different clinical aspects of CVD prevention; 54 fellows submitted final reports on their improvement projects. There were:
- 4 projects in atrial fibrillation, impacting 8 GP surgeries;
- 19 projects in hypertension, impacting 21 GP surgeries;
- 14 projects in lipids, impacting 22 GP surgeries;
- 3 projects in familial hypercholesterolaemia, impacting 7 GP surgeries; and
- A survey conducted at the end of the fellowship with feedback from 47 fellows. This revealed that as a result of the fellowship:
- 97% felt they were supporting colleagues more with CVD care;
- 97% felt more confident in delivering CVD care;
- 74% felt their PCN/practice has improved the way it manage patients as risk of CVD; and
- 95% felt their patients at risk of CVD have benefited.
Conclusions: Overall, primary care practitioners considered the fellowship program as relevant and beneficial to patient care. The high-risk conditions for cardiovascular disease, atrial fibrillation, high cholesterol and hypertension can be asymptomatic. They are often underdiagnosed and undertreated. Earlier recognition and management may improve long term outcomes. Following the educational sessions, a number of QI projects were undertaken in these fields, addressing areas of CVD prevention and management locally. Small improvements may have long term impact. Primary health care is a complex environment that may benefit from structured systems of education to aid the adoption of best practice. With so many competing demands there remain gaps between CVD management guidelines and practice in primary care. Although substantial challenges remain in implementing change, this programme was seen as a beneficial and helpful method of facilitating long term improvement of the management of patients with or at risk of CVD. ❑
