Atrial Fibrillation

The Atrial Fibrillation (AF) Programme was a 2-year national programme mandated by NHS England which concluded in March 2020. However, this work is continuing at the AHSN NENC as part of the Cardiovascular Disease (CVD) Prevention Programme.

The aim is to reduce AF related stroke and associated mortality and morbidity by:

  1. Detecting those with undiagnosed AF
  2. Optimising treatment of those with AF.

Achievements in the National AF Programme

Targets were set by NHS England and the performance for North East and North Cumbria is listed below.

Prevalence Target: 85%

  • Prevalence has increased from 2018/19 at 2.25% to 2.34% in 2019/20. There appears to be an extra 3,105 patients with AF (2018/19 69,296 people and 2019/20 73,127 people).

Protection Target: 90% of CCGs achieving 84% of high risk patients receiving anticoagulation & all above 80%.

  • 100% CCGs are above 84%, with the NENC average at 88.2%

Past successes & resources include:

The AF Programme has prevented 57 strokes and potentially avoided costs of £2.1M (health and social care over 5 years), (Xiang, M.X. et al, European Stroke Journal, 2018; 3(1):82-91)

  1. Publication of an AF Card Deck: a resource aimed at primary care for Anticoagulant Treatment in Atrial Fibrillation For Thromboprophylaxis. Every GP in the NENC area received a hard copy. An electronic version of the card deck is now available to download and can be placed upon CCG intranets. Note: this will be updated after the new NICE AF Guidelines are released in February 2021.
  2. Detection of irregular pulses during a diabetes foot check. Diabetes is a common condition affecting 3.4M people across England. Patients with diabetes have their pulse checked as part of their annual foot check review. All patients aged 12 and over should be offered a foot check. It is important to detect the presence or absence of a foot pulse to prevent diabetes complications. The pilot work examining pulses in patients’ feet started in County Durham and Darlington NHS Foundation and is now being spread across the NENC area as well as more widely across England. This work is supported by The College of Podiatry and won an AFA Healthcare Pioneers Award in 2018 for showcasing best practice in AF. It has also been short-listed for the Advancing Healthcare Awards 2020 in the Faculty of Public Health and Public Health England award for contributions to public health.
  3. Shared decision-making videos and resources to support HCPs discussing treatment options with patients
Shared Decision Making Videos

 

Anticoagulation with Jack

Delivery in the North East and North Cumbria

Work continues to support detection of AF and optimising treatment for patients with AF by supporting the legacy work from the national AF programme. These include:

Detection

Supporting a Train The Trainer for AliveCor programme to enable CCGs to support local clinicians using the mobile ECG device, AliveCor.

Detection

Continue spreading the learning from the ‘detection of irregular pulses during a diabetes foot check’ to all parts of the NENC area by working with the Northern Diabetes Footcare Clinical Network and beyond. The aim is that this will become standard practice across the country.

Protection

Reduce AF related strokes across the Southern Collaborative area through partnership working. See projects section below.

Protection

Support three CCGs who participated in NHS England’s AF Virtual Clinics work to enable sustainability.

Many resources in relation to AF can be found in the  National AF Toolkit

For more information about the AHSN NENC AF Programme contact Kate Mackay