Survey into the diagnosis, management and treatment of patients with Atrial Fibrillation

Transcription

1 CHRIS RUANE MP, PRIMARY CARE CARDIOVASCULAR SOCIETY and ATRIAL FIBRILLATION ASSOCIATION FREEDOM OF INFORMATION REQUEST Survey into the diagnosis, management and treatment of patients with Atrial Fibrillation May-June 2011 Please note that the deadline for responses is 17 June 2011 Name: Alan Tenanty Position: Head of Corporate Governance PCT: NHS Rotherham Contact Number: Please return the completed survey to: Jan Maly Insight PA 52 Grosvenor Gardens London SW1W 0AU Tel:

2 Strategy 1. Does the PCT have a strategy on Atrial Fibrillation? Yes X No 2. Please attach the strategy. Follows Nice Guidance 3. Does AF feature in the PCT s top 10 priorities? 4. If YES, what number is it? 2 5. If NO, what plans does the PCT have to include it as a priority? 6. Does the PCT have in place a multi-disciplinary Atrial Fibrillation/stroke committee/team responsible for the management of patients with Atrial Fibrillation? 7. If NO, please indicate why: 8. How is the NHS Improvement guidance on Risk Assessment and Stroke Prevention for Atrial Fibrillation (GRASP AF) being implemented in the PCT? AF and GRASP discussed as a topic in the May 2011 Protected learning time event for GPs in Rotherham. NHSR also has a Wafarin LES for GPs. A Warfarin Monitoring national enhanced service is available to all GP Practices in Rotherham. Implementation of Guidelines and Guidance 9. NICE Clinical Guideline 36, on the management of Atrial Fibrillation (AF) cites an electrocardiogram (ECG) should be performed in all patients, whether systematic or not, in whom atrial fibrillation (AF) is suspected because an irregular pulse has been detected

3 How is the PCT implementing the guideline? Part of the Quality and outcomes framework. We have provided all the GP practices with ECG machines in the past and provided free training on using and interpreting ECGs. 10. Has there been an evaluation or audit of the PCT s implementation of NICE Clinical Guideline 36? Yes X No 11. What is the percentage per year of suspected AF patients who receive an ECG in line with the guidelines? Unknown. We carry out drug audits equity profiles, but have not included ECG to date. 12. What is the percentage per year of patient records with a new diagnosis of AF made following an ECG made on the basis of detection of an irregular pulse? We do not hold this information. 13. The National Stroke Strategy advises PCTs that treatment of risk factors, including AF, in line with clinical guidelines is one of ten priorities nationwide. What is the PCT doing to implement this advice? NHS Rotherham implemented NHS healthcare checks, Pulse and lifestyle advice forms part of the health check. 14. Has the PCT put in place steps to implement NICE Technology Appraisal Guidance 197 on Dronedarone? If YES please explain what steps have been taken. Discussed at Area Prescribing Committee and traffic light status-amber- shared care initiated by consultant of treatment continued in primary care. In March 2011 following a safety notice from the manufacture s decision that all prescribing to be undertaken by specialists in secondary care because of stringent monitoring requirements need following two cases of liver failure requiring transplantation. Any reclassified at Area Prescribing Committee go Red with agreement of cardiologists. (APC Newsletter no.36 March 2011) 15. How many patients in the PCT had an ablation last year. 9 Assuming Percutaeneous. 16. What guidance does the PCT adhere to when deciding whether an ablation procedure should be carried out on a patient? Cardiologist advice

4 NHS Health Checks / National Patient Safety Agency 17. Does the PCT include pulse checks within the NHS Health Checks? 18. If YES, how do you ensure that these checks are routinely carried out? Specifies so in the agreement. 19. If NO, please indicate why: 20. Is the PCT involved in the National Patient Safety Agency s initiative to reduce levels of harm in 10 high risk patient safety areas, including atrial fibrillation? X Yes No 21. If YES, what work has been undertaken? A root cause analysis has recently been carried out regarding Warfarin prescribing across primary and secondary care. 22. If NO, please indicate why not: 23. What work has been undertaken in the PCT with regards to AF in Practice Based Commissioning and GP Pathfinder Commissioning Consortia? One PBC group carried out work on AF and prescribing. A GPWSI runs a cardiac clinic, which included patients with AF. AF Data 24. The QOF rewards GP practices to maintain a register of AF patients. How many patients are currently on GP practices registers across the PCT? 3,863 as at 11/04/ What percentage of these patients were diagnosed by ECG or a specialist? % 26. What percentage of these patients were treated with anti-coagulants or anti-platelet therapy? - 4 -

5 91.53 % THANK YOU Data will be analysed and included in a report for publication in July A copy of the report will be shared with you at that time. This research project has been made possible by an unrestricted grant from sanofi-aventis, although PCCS and AFA retain full editorial control over the report