An innovative collaboration between the NHS and Bayer is supporting GPs in Buckinghamshire to prevent strokes in patients with atrial fibrillation (AF).
The ‘Excellence in AF’ initiative, led by Oxford AHSN and the Bucks Clinical Commissioning Groups, is a collaborative approach which brings together clinical and quality improvement expertise from a range of organisations to help GPs identify and treat patients with AF who are not receiving anticoagulation therapy (or whose treatment is not optimised).
The aim is to identify and review around 1,500 high risk patients in Bucks to understand why they are not currently receiving anticoagulation therapy and, if appropriate, start anticoagulation treatment. Based on these numbers around 20 strokes could be prevented by this project in 2017/18. With each stroke costing the NHS around £25,000, this represents a potential saving of £500,000 – on top of the significant patient benefits.
A clinical audit to identify relevant patients will be carried out by Interface Clinical Services, an independent organisation. Specialist pharmacists from Buckinghamshire Healthcare NHS Trust will support GPs in reviewing patients.
Quality improvement support, to ensure that improvements are sustained, will be provided by Oxford AHSN through a joint working agreement with Bayer. The project is based on the successful ‘Don’t Wait to Anticoagulate’ campaign developed by the West of England AHSN and Bayer.
A joint working agreement was signed between the Oxford AHSN and Bayer in January 2017. As a result a full-time quality improvement support manager has been seconded from Bayer to work on the Excellence in AF project until April 2018. This has significantly increased overall capacity for quality improvement support to GP practices who are being helped to critically review systems and processes, identify change and embed those changes in a sustainable way to benefit patients.
Dr Raj Thakkar, a GP, Clinical Commissioning Director for Planned Care at Chiltern Clinical Commissioning Group and Cardiac Lead for the Oxford AHSN, said: “AF is a national priority. For the whole system to own the problem and really deliver on a solution we recognised that key elements need to be in place. These include achieving high prevalence, a high anti-coagulation rate, sustainability and culture change.”
Hannah Oatley, Clinical Innovation Adoption Manager at the Oxford AHSN, said: “This project will deliver significant value to the NHS – general practice is under tremendous pressure at the moment and this approach, which has sustainability at its core and comes with tailored support for individual GP practices, is really appealing.”
Dr Alexander Moscho, CEO, Bayer UK & Ireland / Managing Director, Bayer Plc, of Bayer, said: “Our commitment to working collaboratively with the NHS as a trusted partner is a red thread that runs through the Bayer organisation. As demonstrated by the successes already seen working with the West of England AHSN , we are excited about creating new, innovative and effective partnerships with the NHS, to help deliver against national priorities and ensure that Bayer is able to support practices in identifying and treating AF. Prevention of strokes is possible in these patients and working in partnership with Oxford AHSN we aim to improve outcomes for those most in need.”
UPDATE May 2017: 30 of the 52 GP practices in Bucks have signed up to this project.