The Government has recently published the Cardiovascular Disease Modern Service Framework (CVD MSF). Aligned with the NHS 10-Year Health Plan, the Framework sets its focus on prevention, with its delivery model designed to tackle health inequalities through a cardiovascular-kidney-metabolic (CVKM) approach.
CVD is one of the main causes of premature death, with an estimated 33,000 lives being lost from heart disease or stroke every year. The Government has reiterated their goal to reduce premature mortality from heart disease and stroke by 25% in the next 10 years.
The BCS has been involved in shaping the Framework prior to its publication, in collaboration with other organisations and health experts, through our responses to open consultations and contributions in feedback sessions.
Professor André Ng MBE sFBCS, President of the British Cardiovascular Society, said: “We welcome the publication of the CVD MSF and strongly support its ambitious vision to reduce premature cardiovascular mortality through earlier detection, prevention and more integrated cardiovascular-kidney-metabolic care. The emphasis on tackling inequalities, improving risk factor management and strengthening rehabilitation represents an important step forward for cardiovascular care in England.
“Successful implementation, however, will depend on realistic workforce and resource planning. Delivering this transformation cannot be achieved by shifting activity into community settings alone; it must be matched by sustained investment across the entire cardiovascular pathway, including specialist secondary care services, diagnostics, cardiac physiology, imaging and multidisciplinary teams – people who already have heart disease must not be left behind, in simple pursuit of prevention.
“Heart failure affects more than 1% of the UK population, and delivering appropriate care to all the affected patients will require considerable investment in heart failure services, both in primary and secondary care. It is important to remember that the typical patient with heart failure is very much older, and has many more comorbidities, than the patients included in clinical trials. Whilst the targets are laudable, enthusiasm must be tempered by the need to continue relevant and robust research to inform best practice.
“Secondary care expertise will remain fundamental to delivering effective primary and secondary prevention, supporting diagnosis, initiating complex and life-saving therapies and ensuring equitable access to specialist care. We also acknowledge the weakness in primary and secondary interfaces which need to be addressed to improve efficiency and ensure continuity of care.
“While the framework rightly recognises atrial fibrillation as a major cardiovascular risk factor, the BCS believes greater emphasis should be placed on its detection and comprehensive management. AF is one of the most preventable causes of stroke, yet opportunities remain to improve systematic case finding, anticoagulation, rhythm control, integrated long-term management and the use of digital technologies and virtual care models. Greater prominence should also be given to the role of specialist cardiovascular services in supporting these pathways.
“The BCS looks forward to working with the Department of Health and Social Care, government and partners to ensure the delivery plan is adequately resourced and that implementation reflects the essential contribution of both primary and secondary care in achieving the framework’s ambitious goals.”