A key part of our work until 2023 will be improving the management of cholesterol. Good management of cholesterol is important in preventing heart attacks and strokes, but patients with high cholesterol are likely to be asymptomatic.

A number of organisations are also working to support CVD ambitions across the country, such as the British Heart Foundation, Heart UK, NICE, Right Care and Public Health England. We are linking with these organisations.

NHS health checks play a large role in identifying patients who will benefit from preventative interventions.

We will also be looking at improving the management of familial hypercholesterolaemia (FH), a hereditary condition of high cholesterol that is evident from birth but is rarely picked up before the individual has a CVD event. Currently, identification of people with this condition is very low.

Supporting our national ambitions to improve cholesterol management and the identification and management of familial hypercholesterolemia


System levers to achieve CVD ambitions

Public Health England has identified lipids management as a key area of improvement. Over the next three years, the AHSN programme will focus on:


detection of people with FH


improvement in the management of people with resistant high cholesterol


Key national support initiatives

CVDPrevent audit     find out more
A national audit that will identify key areas of improvement for primary care, to report in April 2021

Directed Enhanced Service (DES) scheme      find out more
A national programme to support primary care in achieving improvements 2021/2022

Accelerated Access Collaborative    find out more
A number of products have been funded through this approach, including PCSK9i

NICE-endorsed pathways for lipids and statins intolerance
Supporting clinical guidance CG181, CG 71, and technology assessments TA385, TA394



Outcomes will be measured in accordance with national metrics:

Improving the numbers of patients with high cholesterol managed in accordance with NICE guidance

Increasing the numbers of patients identified with FH

Improving the number of appropriate referrals to lipid clinics

Increasing the numbers of patients with a recorded cholesterol reading that is optimised.


Current projects

We currently have several improvement projects with primary and secondary care:

  1. Liverpool lipids improvement project
  2. Halton primary care lipids improvement project (Control Cholesterol)
  3. Knowsley community pharmacy lipids improvement project (Control Cholesterol)

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