Change quality targets to avert CHD time bomb

GP appointments for CHD will rise by 40 per cent by 2020 unless the GMS quality framework is changed, according to a report by the charity Heart UK.

GPs could face an extra 678,000 appointments every year, it warns.

Professor Andrew Neil, chairman of Heart UK, warns that although the NHS had made fantastic improvements in preventing deaths from heart disease, the number of people developing and living with CHD is spiralling and could result in the government ‘sleepwalking into a potential health crisis’.

The report states that primary care is uniquely placed to address the crisis in CHD and recommends areas of immediate action for the government.

The report calls for full implementation of the Joint British Societies (JBS2) guideline and inclusion of a total level of cholesterol of 4mmol/l as a quality target.

The current GMS quality framework states that the total level of cholesterol should be lowered to 5mmol/l.

The report adds that: ‘Current targets are failing patients by only driving the NHS to achieve the minimum standard of care.’

But Surrey GP Dr John Pittard, member of the Primary Care Cardiovascular Society, suggested that the best way to reduce the burden of CHD might be to increase the number of people currently targeted by the quality framework.

‘The quality framework is undertreating people and should be extended to include 10–20 per cent more people,’ he said.

Evidence from cholesterol trials has shown that lower cholesterol targets are better. How- ever, JBS2 data is from trials rather than from actual patient accounts and does not consider the side-effects and reactions that can occur when lowering cholesterol levels, said Dr Pittard.

CHD action areas
What Heart UK calls for:

  • A publicly funded campaign to raise awareness of cholesterol.
  • Full implementation of JBS2 guidelines.
  • Greater access to cholesterol testing.

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