Guidance

Cardiovascular disease prevention: applying All Our Health

Updated 10 March 2022

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This publication is available at https://www.gov.uk/government/publications/cardiovascular-disease-prevention-applying-all-our-health/cardiovascular-disease-prevention-applying-all-our-health

The Public Health England team leading this policy transitioned into the Office for Health Improvement and Disparities (OHID) on 1 October 2021.

Why promote CVD prevention in your professional practice?

Over the last few decades, great strides have been taken in reducing premature deaths due to cardiovascular disease (CVD) in England. However, CVD still remains a significant cause of disability, death and health inequalities.

Nearly 7 million people are living with CVD in England, and it contributes to over a quarter of deaths each year. People from our most deprived populations are nearly 4 times more likely to die prematurely from CVD, compared to those from the most affluent populations.

Health and social care costs in England relating to CVD are estimated at £7.4 billion each year, with wider costs to the economy estimated at £15.8 billion annually.

Heart attacks and strokes are highly preventable through population level measures and support for individual behaviour change. The NHS also has a crucial role in identifying individuals who have developed high-risk CVD conditions. These include atrial fibrillation (AF), high blood pressure and raised cholesterol, which have been shown to significantly increase the risk of CVD events such as heart attack, stroke and dementia.

Optimal treatment of AF, high blood pressure and raised cholesterol is highly effective in preventing CVD events. However, a large proportion of those living with these conditions remain undiagnosed, and of those with a diagnosis, a large number are not receiving optimal treatment. For instance, over 40% of people with high blood pressure remain undiagnosed. Of those people diagnosed with high blood pressure, only 67% are optimally managed.

Access the cardiovascular disease prevention e-learning session

An interactive e-learning version of this topic is now available to use.

OHID and Health Education England’s ‘e-Learning for Healthcare’ have developed this content to increase the confidence and skills of health and care professionals, to embed prevention in their day-to-day practice.

Taking action

If you’re a front-line health professional:

There are several opportunities to identify CVD risk factors:

  • access training to become more confident in identifying and managing high risk conditions for CVD – especially high blood pressure and atrial fibrillation
  • support patients with information to lower their risk of CVD
  • check if patients have been offered an NHS health check, if aged between 40 to 74 years of age
  • ask patients if they know their recent blood pressure reading and offer a blood pressure check
  • ask patients if they have recently had their cholesterol checked and offer testing where appropriate
  • discuss with patients the importance of knowing and understanding their CVD risk

Managing CVD high risk factors

Provide information to patients on the benefits of treating and managing CVD high-risk factors.

Familiarise yourself with the referral and management pathways for:

It is also helpful to:

  • discuss with patients the benefits of behaviour change in reducing CVD risk – this includes lifestyle factors such as smoking, physical activity, obesity and alcohol consumption
  • provide support for behaviour change on the lifestyle factors identified above
  • familiarise yourself with the heart age test as a motivational tool and route to support behaviour change

If you’re a team leader or manager:

  • ensure the teams you lead are aware of latest guidance and interventions on CVD prevention within your local area
  • provide learning and development opportunities on CVD prevention for team members
  • ensure there are clear local referral and management pathways for CVD conditions

If you’re a senior or strategic leader:

  • it is important to know what success looks like within your organisation – and create opportunities to share learning
  • ensure that your organisation is represented in the membership of relevant prevention, or CVD disease oversight boards
  • seek opportunities to work collaboratively with local partners including sustainability and transformations partnerships (STPS) and integrated care systems (ICS) on CVD prevention initiatives
  • ensure there is clarity on shared priorities with local partners

Understanding local needs

OHID provides intelligence and data through the National Cardiovascular Intelligence Network (NCVIN). This information is useful to identify how well people are being diagnosed and treated for CVD.

It includes updates and additions to:

NHS RightCare focus packs (CCG level) provide data and intelligence to highlight variation in performance.

Other useful data and information sources include:

Measuring impact

As a health professional, there is a range of reasons why it makes sense to measure your impact and demonstrate the value of your contribution. This could be about sharing what has worked well in order to benefit your colleagues and local people or to support your professional development.

The quality and outcomes framework (QOF) is a voluntary annual reward and incentive programme for all GP surgeries in England, detailing practice achievement results. It is not about performance management but resourcing and then rewarding good practice.

The public health outcomes framework examines indicators that help us understand trends in public health such as premature mortality in individuals with CVD.

Further reading, resources and good practice

Advice for patients and the public

  • NHS UK topic on cardiovascular disease
  • the Heart Age Test tells you your heart age in comparison to your real age and explains why it is important to know your blood pressure and cholesterol
  • Better Health contains information and applications to support healthy lifestyle choices on diet, exercise and alcohol consumption
  • find out what your blood pressure reading means with the NHS high blood pressure tool

Professional resources and tools

The NHS Long Term Plan sets out clear milestones for CVD prevention in ‘Chapter 3: Further progress on care quality and outcomes’ (pages 63 and 64).

To complement the NHS Long Term Plan, OHID and over 40 partners launched new CVD ambitions for England to improve the detection and management of AF, high blood pressure and cholesterol, and reduce health inequalities. The CVD ambitions for England publication is available at preventing cardiovascular disease: saving hearts and minds together

The National Institute for Health and Care Excellence (NICE) website has a range of tools and resources covering:

The NHS provides a RightCare cardiovascular disease prevention pathway resource.

NHS RightCare toolkit: physical ill-health and CVD prevention in people with severe mental illness (SMI) (PDF, 1.14MB) is also available.

The NHS health check best practice guidance is a document to support local public health commissioners and providers of the NHS health check programme with the information needed to commission and deliver a high-quality programme.

OHID resources

OHID produce a range of resources and tools to support the planning and delivery of CVD prevention – to improve outcomes and reduce variation and health inequalities.

These include:

Good practice examples

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