Guidance

NHS Abdominal Aortic Aneurysm screening: vascular nurse specialist guidance

Updated 2 June 2025

Applies to England

1. Introduction

This guidance provides a standardised framework and guidelines for the role of the Abdominal Aortic Aneurysm (AAA) vascular nurse specialist across England to ensure that men with screen detected aneurysms receive a consistent level of support and guidance.

The vascular nurse specialist provides emotional support, health and lifestyle advice to men (and their partners) with screen detected aneurysms, at specific points within the AAA surveillance pathway.

Men with aneurysms require close monitoring, ongoing support and secondary prevention. This is to reduce their overall vascular risk and anxiety, and to improve health outcomes.

2. Qualifications and experience

The vascular nurse specialist must be a registered general nurse (RGN) with a minimum 3 years’ post registration experience, one of which must be in vascular services. This must include the management, surveillance and treatment of men with abdominal aortic aneurysms.

The vascular nurse specialist:

• must practice within the Nursing & Midwifery Council (NMC) code of conduct. This presents the professional standards that they must uphold and is structured around four themes – prioritise people, practice effectively, preserve safety and promote professionalism and trust
• is expected to be working within the Society of Vascular Nurses’ vascular staff nurse competencies document, which sets out the minimum standard required to deliver enhanced or specialist roles within vascular nursing, bringing together the skills, knowledge and behaviours needed to be effective in the role and can be used to identify training requirements[i]
• must have a job description that includes their role in the NHS AAA Screening Programme[ii] and shows the clinical responsibility and accountability structures within the local provider
• must demonstrate links with key clinicians involved with providing care to men with cardio-vascular disease, including smoking cessation, vascular surgery, and radiology
• must demonstrate knowledge of the NHS AAA Screening Programme and population screening

3. Vascular nurse specialist role requirements

The recommended whole time equivalent (WTE) for the vascular nurse specialist is 0.1 WTE per 800,000 total population.  However, local service circumstances may dictate different requirements.

The vascular nurse specialist:

• must have protected time to undertake their role within the screening programme
• must be integrated within the screening programme; this includes regular contact with the programme manager or co-ordinator and invitations to local AAA team meetings and programme board meetings as appropriate
• should be supported in linking with key clinicians and local wellbeing services involved with providing care to men with cardiovascular disease, including smoking cessation, vascular surgery, and radiology

4. Vascular nurse specialist responsibilities

As clinical experts in the management and surveillance of men with abdominal aortic aneurysms, the vascular nurse specialist should:

• assist in the provision of education, training, and professional development of screening technicians where appropriate
• provide independent nurse-led assessment clinics for all men (and their partners) on surveillance within the programme
• Initially offer a face-to-face appointment, however, video or telephone are acceptable, if this is more suitable for the person concerned
• consult with the local programme co-ordinator/manager to ensure accessible and equitable clinics are booked appropriately
• ensure men who screen positive for AAAs understand the issues and consequences associated with AAA management and surveillance (specifically, providing support, advice, secondary prevention, and referrals if appropriate)
• use the national IT Screening Management and Referral Tracking (SMaRT) system appropriately and to record all nurse assessment findings within five working days (this task must not be delegated)
• be responsible for actioning any ongoing local lifestyle or wellbeing lifestyle referrals.
• attend any education and networking events hosted by the NHS AAA Screening Programme

If the vascular nurse assessment appointment highlights any clinical concerns regarding the man, these must be reported to the director/clinical lead and programme co-ordinator/manager.

The vascular nurse specialist must not:

• undertake screening unless they have successfully completed the NHS AAA screening programme accredited training course.
• clinically sign-off screening technician scans or assessments as competent unless they have an appropriate ultrasound qualification and have attended the appropriate NHS AAA screening programme training course.
• clinically cease or stop surveillance of men on the programme without discussion with the director/clinical lead and programme co-ordinator/manager

5. Operational requirements

To ensure the effectiveness of the vascular nurse specialist role, all screen positive men should be contacted and offered a face-to-face appointment with the nurse specialist. The appointment should be within 12 weeks of the initial scan. The timeliness of the nurse consultation is measured as a pathway standard for the NHS AAA screening programme screening standard (effective from April 2020).

A 30-minute face-to-face time slot is ideally recommended for each man. Administration time needs to be built into clinic schedule and overall time requirement to fulfil the role.

Men should be offered a second opportunity for a face-to-face appointment if they do not accept their first invite.

If a man is unable or unwilling to attend a face-to-face consultation, they must be offered a telephone/ video consultation with the vascular nurse specialist.

If they decline a face-to-face and telephone assessment this should be recorded by selecting the ‘Declined’ option in SMaRT.

Appointment ‘Not Required’ is only used for anything outside of the normal pathway, for example if a man specifically requested an additional appointment but then changed their mind. This can be selected at the time of being scanned or afterwards.

A screenshot showing the selection of ‘Not Required’ for a nurse appointment.

‘Declined’ must be used to reflect a man’s decision for audit purposes. This will then show on subject status.

SMaRT users are then able to undertake a search and report how many followed the pathway and were marked ‘Not Required’ or ‘Declined.’

A screenshot showing how to include ‘Not Required’ or ‘Declined’ in a search.

Once a man’s AAA diameter reaches 4.5cm or more and requires 3-monthly surveillance, they must be offered an additional appointment with the vascular nurse specialist before the next 3-monthly surveillance appointment.

A man can request additional appointments if they wish to discuss specific issues or are anxious about their AAA.

6. Vascular Nurse Specialist assessment

During the assessment, the vascular nurse specialist must:

• measure and record height and weight
• calculate and record body mass index (BMI) using National Institute for Health and Clinical Excellence (NICE) guidelines
• measure and record blood pressure.  Advise on blood pressure optimisation (urgent or routine) as per NICE guidelines
• ascertain existing co-morbidities i.e., heart disease, diabetes etc.
• review current prescribed medication
• ascertain whether they are currently taking statins. If so, which?
• ascertain whether they are currently taking an antiplatelet medication e.g. aspirin, clopidogrel or anticoagulants
• establish if they are prescribed anti-hypertensive medication
• determine smoking status (never smoked, previously smoked, currently smoking)
• provide smoking cessation advice as appropriate. Offer onward referral to local smoking cessation services
• provide a full explanation of the man’s AAA condition and its evidence-based management and if appropriate, a brief overview of the interventional options
• provide reassurance regarding AAA presence, size, and growth rates
• check the man’s understanding, concerns and expectations regarding their AAA diagnosis, current health, and the way forward with regards to their management
• establish if there is a familial AAA history
• assess cardiovascular risks factors with the man. Consider diet, exercise/ activity levels, alcohol intake as well as their smoking status, BMI, BP, and current medications, as detailed above
• address any concerns men may have regarding working, driving, the need to contact the Driver and Vehicle Licensing Agency (DVLA), travel and travel insurance
• give details of the local surveillance programme and a contact number for the local AAA screening office
• summarise individualised advice and actions recommended/ agreed, ensuring understanding regarding the agreed way forward, to conclude the consultation
• ensure all measurements and recommendations are recorded directly onto the SMaRT system, including any prescription medicines recommended to a man’s GP as part of best medical therapy

Any concerns highlighted during the vascular nurse assessment regarding a man’s suitability for continued surveillance must be discussed with the programme co-ordinator/ manager and director/clinical lead in the first instance.

7. Communications

A letter generated from SMaRT should be sent to the man’s GP within one week, communicating the nurse specialist assessment findings, advice given and any recommendations that the GP may wish to consider.

A copy of the SMaRT generated letter should be sent to the man.

8. Role of the Screening Technician in the Vascular Nurse Assessment

Screening technicians should encourage the man to accept the offer of a vascular nurse assessment following a positive screen for AAA. The screening technician should advise that the appointment will be within 12 weeks of the scan and explain why it is important to attend. Screening technicians should have the opportunity to attend vascular nurse clinics and therefore have a good understanding of their value and benefit within the AAA Screening Programme.

The scope of practice for screening technicians in the NHS AAA Screening Programme does not include physiological measurements, including height, weight, and blood pressure. Screening Technicians should be familiar with the ‘Making Every Contact Count’ (MECC) agenda and be able to give straightforward healthcare advice regarding reducing cardiovascular risks or signpost men with AAA, to appropriate local services such as smoking cessation services for support.

If local services incorporate physiological measurements as extended roles for screening technicians, they are responsible for ensuring competency. This includes initial training and annual competency review, adhering to relevant NHS and NICE guidance.

The local AAA screening service is fully responsible for the clinical governance of staff working outside of their scope of practice. Detailed standard operating procedures should be in place within the service to document pathways and responsibilities.

9. References

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[i] Vascular Specialist Nursing Capability Framework 2023

https://svn.org.uk/wp-content/uploads/2023/12/SVN-capability-document-final.pdf

[ii] AAA screening programme guidance

AAA screening: standard operating procedures - GOV.UK