Atrial Fibrillation

The 15 Academic Health Science Networks (AHSNs) in England are working together to support improvements in AF practice.

Atrial Fibrillation (AF) is an irregular heartbeat and is the most common form of cardiac arrhythmia. NICE Guidance CG180 seeks to improve the detection and management of AF, however, Public Health England (2017) states that:

• There are 1.4 million people with AF but 1 in 4 are undiagnosed.
• People with AF have a five-times higher risk of stroke
• AF accounts for approximately 20% of all strokes and 62% these people were not prescribed oral anticoagulation prior to their stroke.
• 66% of AF related strokes can be averted with treatment.
• AF related stroke is more devastating than other forms of stroke

[Reference – Public Health England: Five key interventions 2017]

Across the SW AHSN footprint it is estimated there are 13,900 people with undiagnosed AF. [Reference – Quality Outcomes Framework 2017/18] 

We have been rolling out mobile AF detection devices to primary care since March 2018 and these devices have been used 3800 times and have picked up 216 people with possible AF. We will be contacting the remaining practices who have expressed an interested in using AF detection devices soon.

The 15 Academic Health Science Networks (AHSNs) are working together to support improvements in AF practice using the ‘Detect, Protect, Perfect’ framework. Through this, we aim to prevent AF-related stroke and associated mortality through better identification, treatment and on-going management of people with AF.

This can be achieved through:

• DETECT – Increasing the detection and diagnosis of AF in the population (case finding).
• PROTECT – Increasing risk assessment and anticoagulation of people diagnosed with AF.
• PERFECT – Improving the quality of anticoagulation and supporting people to self-manage aspects of their AF.

Resources

Below are a range of tools and services to support partners to deliver best practice for people with AF. Please click on the link for more information or if you would like to discuss further, please contact suzy.taylor@swahsn.com.

Download the information flyer.

• NHS England funded mobile ECG devices – available at no cost, via AHSNs. Expressions of interest NOW CLOSED. 
• NICE guidance CG180 – (DETECT, PROTECT, PERFECT) – Overarching guidance from The National Institute for Health and Care Excellence (NICE) for the management of AF.
• Budget Impact model 2016/17 – (DETECT, PROTECT, PERFECT) – Coming Soon!
• Primary and Secondary Care Atrial Fibrillation Pathways – (DETECT, PROTECT, PERFECT) – Examples of AF pathways for primary and secondary care, developed by Kent, Surrey, Sussex AHSN and South East Clinical Networks.
• Atrial Fibrillation: A guide for GPs – (DETECT, PROTECT, PERFECT) – A video by the South West Clinical Network on improving the detection and management of atrial fibrillation in Primary Care.

• Starting Anticoagulation with Jack – (PROTECT and PERFECT) – A video by Wessex AHSN with advice and information for patients and carers about anticoagulant medicines, how they work and their potential side effects.

• Pan London Tool Kit – This toolkit provides methodologies, resources and support for commissioners and clinicians working to reduce AF-related strokes  - wherever they are in the country. It was developed by Imperial College Health Partners AHSN, UCL Partners AHSN, Health Innovation Network AHSN and London Clinical Networks.
• The British Heart Foundation Alliance – A free membership scheme which provides learning and development opportunities for healthcare professionals who work with people affected by, or at risk of, cardiovascular disease. With a philosophy of shared expertise and lifelong learning, members can benefit from annual development grants and take advantage of free resources such as training workshops, conferences and events, as well as the latest best practice information.
• Five Key Interventions Five key interventions to facilitate patients to better self-care, improve their health and wellbeing and reduce demand on general practice if implemented systematically across primary care – On page 18 of this Public Health England document you can find information about the atrial fibrillation challenge and interventions to reduce variation of care.