Pan-London AF Primary Care Programme Launch Event. 6 th June 2016 Data pack NHS Havering CCG

Transcription

1 Pan-London AF Primary Care Programme Launch Event 6 th June 2016 Data pack NHS Havering CCG

2 A simplified view of the AF Pathway Detect (Detect) Protect Correct Perfect Risk stratification Cross correlation with other registered conditions Electrocardiograms Echocardiograms Don t wait Anti-coagulate i.e Warfarin Rate control (beta blockers (Atenolol,bisoprolol) or rate limiting CCB (Diltiazem, verapamil) Left Atrial Appendage (LAA) Surgical ablation Catheter Patient activation INR devices INR testing Case finding 1. Pre- Diagnosis Population screening 2. Diagnosis Assessment 3. Therapy Behavioural change 4. Treatment Drugs / technology 5. Living with AF Monitoring Wearable heart monitor Contact & patient invitation Pulse checks Engage Direct oral anticoagulant (DOAC s) i.e. Rivaroxaban, Dabigatran, Apixaban, Edoxaban Rhythm control DC Cardioversion, Class 1c (flecainide) or III antiarrhythmic drugs (amiodarone or sotalol) Electrical / chemical cardioversion i.e. pacemaker Telehealth remote monitoring Medication compliance Virtual clinics / Secondary care support

3 Source: Stroke association: 3

4 Source: NCVIN and QOF

5 Prevalence data for practices in the CCG 5

6 Anticoagulation rates for practices in the CCG Source: QOF AF 004 no exceptions 6

7 Anticoagulation rates for practices in the CCG Source: QOF AF 004 no exceptions QOF Actual 7

8 JABBAR 0 Total number untreated pts QOF reported (%) KINGS PARK SURGERY DR MARKS PRACTICE DR JOSEPH DR GUPTA MODERN MEDICAL CENTRE DR JAWAD UPMINSTER BRIDGE SURGERY CRANHAM HEALTH CENTRE DR RAHMAN DR HAMILTON-SMITH THE NEW MEDICAL CENTRE CHOWDHURY DR VM PATEL CHASE CROSS MEDICAL CENTRE DR B BEHESHTI & PARTNER KUCCHAI THE ROSEWOOD MEDICAL CENTRE MUNGO PARK SURGERY BERWICK SURGERY THE ROBINS SURGERY BAY TREE MEDICAL CENTRE CHOPRA FELDMAN & PARTNERS THE GREEN WOOD PRACTICE INGREBOURNE MEDICAL CENTRE MAWNEY MEDICAL CENTRE BILLET LANE MEDICAL PRACTICE DR GILLETT-WALLER WOOD LANE SURGERY KAKAD MAYLANDS HEALTH CARE UPMINSTER MEDICAL CENTRE NORTH STREET MEDICAL CARE DR ABDULLAH HORNCHURCH HEALTHCARE DR C DAHS & DR IP HUMBERSTONE WESTERN ROAD MEDICAL CENTRE DR PM PATEL CECIL AVENUE SURGERY HARLOW ROAD SURGERY DR UBEROY LYNWOOD MEDICAL CENTRE DR SJ HASKELL DR P & S POOLOGANATHAN HAIDERIAN MEDICAL CENTRE DR A PATEL PRASAD Percentage on anticoagulation Total number of patients Anticoagulation rates untreated patients Havering CCG: Anticoagulation rates in patients at high risk of stroke (CHADS2 >1) - QOF 2014/ QOF actual (- exceptions) % 8

9 Health and budget impact modelling London Benefits 5 year change in NHS and LA spend and strokes prevented Savings 15,000, ,000, ,000,000 Modelling assumptions Based on the NICE AF costing tool (2014) with the same modelling assumptions 84.21% of AF population have CHADSVASC 2 Baseline demographic data from QOF 2014/15 Current and future treatment estimates from NICE AF costing report NOACS (not edoxaban) used in equal proportion Cost of stroke 12,228 (NICE); major bleed cost 1,173 (NICE) Cost of long-term nursing care 6,880 does not include all social care costs Drug costs from MIMS 2015 Does not include other economic benefits Does not include increase in AF incidence year-onyear Does not include additional patients identified through screening Yr1 Yr2 Yr3 Yr4 Yr5-500 Costs Strokes Prevented 20,000,000 Prevent over 2000 strokes over 5 years ~ lives saved over 5 years Net savings seen at year 3, and accumulative net savings to health economy of ~ 3.5 million over 5 years. ( 5,000,000) ( 10,000,000) ( 15,000,000) Total costs Total savings Budget impact (savings - cost) Strokes prevented

10 Strokes Prevented Savings Health and budget impact modelling CCG Modelling assumptions Based on the NICE AF costing tool (2014) with the same modelling assumptions 84.21% of AF population have CHADSVASC 2 Baseline demographic data from QOF 2014/15 Current and future treatment estimates from NICE AF costing report NOACS (not edoxaban) used in equal proportion Cost of stroke 12,228 (NICE); major bleed cost 1,173 (NICE) Cost of long-term nursing care 6,880 does not include all social care costs Drug costs from MIMS 2015 Does not include other economic benefits Does not include increase in AF incidence year-onyear Does not include additional patients identified through screening Costs

11 Key contacts for the programme are either through your local Academic Health Science Network or the London Strategic Clinical Network: (Health Innovation Network AHSN, South London) (Imperial AHSN, North West London) (UCLPartners AHSN, North East and North Central London) (Strategic Clinical Network) 11