Atrial Fibrillation

Published on 1 December 2021

About the project

Atrial fibrillation (AF) is the most common type of irregular heart rhythm, and the cause of 20% of strokes.

Despite the serious impact, many people are unaware they have the condition and Public Health England estimates that 300,000 people in England have undiagnosed 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’.

Project ambitions

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 approach

Since 2017, the AHSN Network has been driving the spread and adoption of AF best practice across the country to improve care and outcomes for patients. This national programme of work has focussed on the three key elements of the AF pathway:

Detect

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.

Protect

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.

Perfect

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.

What is the impact?

Our interventions will:

  • Prevent over 4,000 strokes.
  • Save over 1,000 lives.
  • Represent NHS cost savings of over £84 million.
  • Represent social care cost savings of over £100 million.[Text Wrapping Break]

Find out more

Get in touch with a member of the project team below to find out how you can get involved.

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Project team

Lesley Devaney

Assistant Programme Manager

Nazish Khan

Cardiovascular Disease Clinical Lead

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