Approximately seven million people in the UK live with cardiovascular disease (CVD), it is one of the biggest causes of death and disability in the UK, costing health services billions of pounds each year. Despite significant successes in reducing CVD mortality, it remains a major contributor to premature death and health inequality.
“Raised total cholesterol is a major cause of disease burden in both the developed and developing world as a risk factor for ischemic heart disease and stroke. In 2008, the global prevalence of raised total cholesterol among adults was 39% (37% for males and 40% for females)” (WHO).
The Health Survery for England (2021) part 2 reported that the:
- Prevalence of raised total cholesterol was 59%
- Adults aged 16 to 44, men (53%) were more likely than women (46%) to have raised cholesterol
- 77% of women aged 45 to 64 and 67% of men aged 45 to 64 had raised cholesterol
The estimated adult population across West Yorkshire with a 10-year CVD risk > 20% is 175,000, and of those 89,250 aren’t treated with a statin.
This page provides professionals with some useful information and resources relating to cholesterol.
West Yorkshire projects focused on lipid optimisation
We have delivered some fantastic projects across West Yorkshire during 2023/24 to improve lipid optimisation including:
West Yorkshire Lipid Optimation Project Phase Two
West Yorkshire Integrated Care Board (WY ICB) in collaboration with Leeds Teaching Hospitals Trust (LTHT) are providing additional support to improve lipid optimisation across West Yorkshire. This is an extension from the WY System Transformation Fund (STF) lipid project. Full details of the first phase of the project STF Project: WY Lipid Optimisation Clinical Taskforce (April 2023-August 2024) can be found further down this page.
There is still a variation in the region, where patients in the most deprived areas had lower proportion of CVD-treated-to-lipid-target compared to those living in least deprived areas. For this reason several PCN's and their practices throughout West Yorkshire have been invited to participate in phase two of the project beginning in November 2024. As participants they will recieve enhanced support to improve lipid optimisation, including:
- direct access to specialist advice and guidance, and access to a virtual lipid multidisciplinary team (MDT),
- support to complete a practice specific action plan (attached) as part of your plan to improve lipid management,
- support to review outputs from CVD intelligence tool like CVDPrevent and develop a population health approach to tackle health inequalities in lipid optimisation.
Phase two project resources
The following documents and links are relevant to these project participants:
PCN and practice documents
Webinars
STF Project results, learning and evaluation (phase one) documents
System Transformation Fund (STF) Project (Phase one)
Between April 2023 aned August 2024 in partnership with the cardiology Innovative CaReMe Medicines Optimisation Team at Leeds Teaching Hospitals NHS Trust, West Yorkshire Integrated Care Board Medicines Optimisation Teams worked together on a Lipid Optimisation Project in:
- Setting up a Lipid Optimisation Clinical Taskforce (LOCT).
- Providing a lipid optimisation clinical Multi Disciplinary Team discussion platform for primary care workforce working with the 16 most deprived Primary Care Networks across our five places. The aim of this clinical MDT discussion platform was to engage and build confidence in primary care workforce to perform lipid optimisation.
- Electronic direct access to lipids Advice and Guidance via the NHS email. This enabled quicker access to lipids experts. The team at LTHT responded to more than 70 A&G.
LOCT met bi-monthly and offer a space for staff interested in lipids to come together and drive improvements in lipid optimisation across West Yorkshire. The team produced FAQ in lipids based on the A&G questions raised by various PCNs and handled by lipid experts.
WY Inclisiran FAQ has been developed by LOCT to support primary care with prescribing Inclisiran.
NHSE Analysis in September 2023 using CVDPrevent data showed the percentage of patients with cardiovascular disease (CVD) treated to lipid target increased from 25.9% in Sep’22 to 35.2% in December’23 (9.3% improvement) The treatment gap of patients with CVD treated to threshold has been narrowing over time between all five WY places. This demonstrates positive impact of this project working together collaboratively. A full evaluation of phase one can be downloaded using these links: WYHCP STF Results and Learning and WYHCP STF Project HaCES Evaluation Template.
The project has improved levels of prescribing for each step of the national lipid pathway, including uptake of NICE-approved new drugs like inclisiran and bempedoic in participating PCNs. In comparison to the average change across the ICB, the participating PCNs increased the number of patients optimised by 1 percentage point more than the ICB’s average in December 2023 accounting for 333 additional patients optimised.
|
Measures for patients with CVD
|
March 23 (%)
|
December 23 (%)
|
May 24 (%) |
|
% with non-optimised lipids
|
60
|
59
|
59 |
|
Proportion with no lipid lowering therapies
|
14
|
12
|
10 |
|
Inclisiran uptake per patients
|
0.02
|
0.3
|
0.49 |
|
Bempedoic acid & ezetimibe uptake per patients
|
0.02
|
0.26
|
0.41 |
Table 1: Lipid Optimisation Outcome Measures for Participating PCNs
Innovation Health Inequalities Programme (InHIP) Lipids Project: Healthier Cholesterol for Your Community
Together in collaboration with South East Leeds GP Confederation, Leeds City Council and Voluntary Community Social Enterprise sector organisations, Leeds place piloted an integrated lipid outreach Multi-Disciplinary Team. The project team consisted of 0.4WTE of an independent prescriber pharmacist, a pharmacy technician, dietitian and health and wellbeing coach, that worked in community settings, to deliver cardiovascular disease prevention (CVD) education and screening in conjunction with communities' healthy lifestyle activities, offering CVD screening, risk factor awareness raising and lipid optimisation reviews to people. The key driver of InHIP was to increase uptake of NICE approved new drugs like inclisiran and bempedoic acid in Core20PLUS5 areas.
The 12-month project (April 2023 to March 2024) targeted 2 PCNs from the most deprived areas of Leeds (Beeston and Middleton PCNs) and worked with community connectors from the Black and Asian communities as well as Gypsy, travellers and Roma communities. Evaluation report can be found here.
Additional information and resources