Blog:The heart of the matter

Dr Julia Reynolds and Charlotte Oakley test people for AF in St Helens using the MyDiagnostick ECG device

As February is the month of love, Dr Julia Reynolds at the Innovation Agency gets to the heart of the matter of atrial fibrillation – an irregular heartbeat which can lead to stroke

The month of February is traditionally associated with hearts, and people will be showing their support and raising awareness of heart health across the country.

Cardiovascular Disease (CVD) is one of the major factors which leads to people dying younger in our region.

Plus, a recent Commonwealth report stated it is also a major contributor to poorer health outcomes in our country, compared to a number of other first world countries.

This is something we hold very close to our hearts at the Innovation Agency. As the Academic Health Science Network for the North West Coast, we are helping to improve outcomes for people with conditions which can lead to stroke. A recent evaluation exercise demonstrates our work has already had a tangible impact on outcomes – more of that later.

We are focusing on Atrial Fibrillation (AF), an irregular heart rhythm which can lead to stroke, and we’re supporting our healthcare professionals to improve management of the condition.

Stroke is a massive priority in the North West Coast. As well as causing disability, distress and devastation to patients and their families, each stroke costs the NHS and social care £24,000 in the first year alone.

Twenty per cent of strokes are caused by AF but they could be easily prevented if patients were diagnosed earlier and received anticoagulation treatment.

We know that there are around 15,429 undiagnosed people with AF in the North West Coast, and 13,120 people who have been diagnosed with AF who are not being treated with anticoagulants.

Consequently, we have some of the highest AF-related strokes in the country – many of which could be avoided.

We are on a mission to prevent these strokes by helping to detect as many people as possible with AF.

The challenge is that people with AF don’t always feel any symptoms and so many people are walking around with no idea they have the condition.

We are addressing this by introducing a number of initiatives which have proved to be highly successful in helping to detect AF, as well as saving money for the NHS.

We’ve set up an AF Collaborative of 68 GP practices in the region who have been provided with mobile ECG devices to test patients’ pulses for irregular heart rhythms, as well as support, training and guidance on treatment and best practice in AF.

Our recent evaluation report revealed that our AF Collaborative is helping to prevent strokes by increasing AF detection rates by more than 800 people in GP practices. That means an additional 800 patients have received the correct treatment while saving valuable health service funds and resources

The Collaborative has proved to be both successful and cost-effective, preventing 32 strokes per year and saving the health system £416,000 in year one alone.

In addition, we are raising awareness of AF by training volunteers to test family, friends and colleagues’ pulses in their communities using mobile ECG devices. We now have around 40 AF Ambassadors doing their bit to reduce strokes. Since October 2017, they have tested around 2,500 pulses finding around 100 possible AFs.

And we are working in partnership with other public sector organisations, such as Cheshire Fire and Rescue Service, whose firefighters and prevention staff are testing residents’ pulses during their Safe and Well Visits to people’s homes. So far, more than 5,043 pulse checks have been carried out and 224 possible AFs have been found.

Overall, we’ve enabled over 20,000 pulse tests which equates to around 90 patients being identified with AF and around 500 potential strokes avoided.

Our plan is to build on this work, recruit more volunteers, expand our AF Collaborative, make new partnerships, embrace the new technology which makes detecting AF easier and improves the AF pathway for patients.

Together we can take heart from the fact we’re reducing strokes and saving lives as a result.

If you are interested in finding out more about AF and preventing strokes in the North West Coast, there is a free event on 2 April at the Mercure Haydock Hotel from 9.30am to 3.30pm. Find out more here.

For more information on our AF programme visit www.innovationagencynwc.nhs.uk or if you’d like to become an AF Ambassador email julia.reynolds@innovationagencynwc.nhs.uk

Julia Reynolds, Head of Programmes, Innovation Agency