Survey into the diagnosis, management and treatment of patients with Atrial Fibrillation

Transcription

1 FREEDOM OF INFORMATION RESPONSE Reference: From: Commercial organisation Date: 20 May 2011 Subject: Atrial Fibrillation REQUEST / RESPONSE FREEDOM OF INFORMATION REQUEST Survey into the diagnosis, management and treatment of patients with Atrial Fibrillation May-June 2011 Strategy 1. Does the PCT have a strategy on Atrial Fibrillation? 2. Please attach the strategy. There is not a specific strategy for AF within the PCT; however plans related to AF are captured within the local stroke strategy, the local community CVD service and the local CVD Community of Practice.

2 3. Does AF feature in the PCT s top 10 priorities? 4. If YES, what number is it? CVD is the PCTs top priority and improving AF identification, treatment and management forms a part of the overall strategy in preventing CVD and reducing CVD premature mortality. 5. If NO, what plans does the PCT have to include it as a priority? N/A 6. Does the PCT have in place a multi-disciplinary Atrial Fibrillation/stroke committee/team responsible for the management of patients with Atrial Fibrillation? CVD CoP 7. If NO, please indicate why: n/a 8. How is the NHS Improvement guidance on Risk Assessment and Stroke Prevention for Atrial Fibrillation (GRASP AF) being implemented in the PCT? A pilot is currently being undertaken within 5 GP practices across Knowsley with a view to commencing full implementation during 2011/12 (refer to Q23). Implementation of Guidelines and Guidance 9. NICE Clinical Guideline 36, on the management of Atrial Fibrillation (AF) cites an electrocardiogram (ECG) should be performed in all patients, whether systematic or not, in whom atrial fibrillation (AF) is suspected because an irregular pulse has been detected. How is the PCT implementing the guideline? The 3 Knowsley PBC consortia have commissioned a borough wide community cardiovascular service, which incorporates a consultant led diagnostic & treatment service in community clinics,

3 empowered to assess diagnose & treat in a single visit where possible,- criteria includes suspected AF 10. Has there been an evaluation or audit of the PCT s implementation of NICE Clinical Guideline 36? 11. What is the percentage per year of suspected AF patients who receive an ECG in line with the guidelines? This is unknown 12. What is the percentage per year of patient records with a new diagnosis of AF made following an ECG made on the basis of detection of an irregular pulse? This is unknown- 13. The National Stroke Strategy advises PCTs that treatment of risk factors, including AF, in line with clinical guidelines is one of ten priorities nationwide. What is the PCT doing to implement this advice? Stroke, and also separately, CVD is amongst the organisation s highest priorities, reflected in Operating Plan, Public Health Report and PBC Commissioning plans. The organisation has a Stroke Strategy Implementation Group which fully documents progress towards implementing the strategy. The organisation also has a Knowsley at Heart Board and CVD Community of Practice which reflects the implementation and clinical guidance strategies underpinning the priority to improve stroke care and outcomes for Knowsley population 14. Has the PCT put in place steps to implement NICE Technology Appraisal Guidance 197 on Dronedarone? If YES please explain what steps have been taken. - Implemented via medicines management processes: 15. How many patients in the PCT had an ablation last year? Data is coded from acute trust for complex ablation for treatment of arrhythmias; however, final year end position is not yet available for 11/12. This information will be available in the next few weeks.

4 16. What guidance does the PCT adhere to when deciding whether an ablation procedure should be carried out on a patient? The PCT does not intervene in clinical decisions about access to ablation therapy- this is currently undertaken as clinically indicated, by locally tertiary centres. In terms of local guidance, local trusts and PCTs are developing agreed treatment pathways via rth Mersey CVD QIPP, including AF and palpitations. All treatments are underpinned by NICE guidance and best practice. NHS Health Checks / National Patient Safety Agency 17. Does the PCT include pulse checks within the NHS Health Checks? 18. If YES, how do you ensure that these checks are routinely carried out? Performance monitoring via contract review meetings and audits on patient data 19. If NO, please indicate why: N/A 20. Is the PCT involved in the National Patient Safety Agency s initiative to reduce levels of harm in 10 high risk patient safety areas, including atrial fibrillation?

5 21. If YES, what work has been undertaken? n/a 22. If NO, please indicate why not: unknown 23. What work has been undertaken in the PCT with regards to AF in Practice Based Commissioning and GP Pathfinder Commissioning Consortia? Public Health has presented a briefing paper on AF to the three PBC consortia in Knowsley highlighting current local prevalence, expected local prevalence, and an outline proposal relating to the implementation of GRASP-AF. All three PBC s requested that a GRASP-AF pilot should be undertaken and the results presented back including impacts on commissioned services (e.g. ECG, phlebotomy, etc), costs (savings and impacts) and numbers of strokes prevented. The results from the audit are expected to be presented during August AF Data 24. The QOF rewards GP practices to maintain a register of AF patients. How many patients are currently on GP practices registers across the PCT? 1.34% with 2129 on practice 2009/10 QOF return - latest position 25. What percentage of these patients were diagnosed by ECG or a specialist? n/a % not known 26. What percentage of these patients were treated with anti-coagulants or anti-platelet therapy? n/a % data not routinely available