ATRIAL FIBRILLATION & STROKE INSIGHTS TOOL CAN REAL WORLD/PUBLICALLY AVAILABLE DATA COUPLED WITH TTR DATA HELP THE NHS STOP STROKES? Andrzei Orlowski -Programme Development Lead for Health and Implementation (Stroke and Atrial Fibrillation)
GREATER MANCHESTER ACADEMIC HEALTH SCIENCE NETWORK Greater Manchester AHSN is a collaborative network bringing together 30 NHS providers and commissioners across Greater Manchester, East Lancashire Trust and East Cheshire and four universities. Our ambition is to deliver a step change in health outcomes and to support Greater Manchester's strategy for growth through enabling 1bn of wealth creation over five years, supporting SMEs and helping to create a healthier population.
ATRIAL FIBRILLATION & AF RELATED STROKE HEALTH AND IMPLEMENTATION PROGRAMME Our Goal is to help prevent at least 365 deaths from avoidable strokes each year AF implementation programme is encouraging our members to prioritise AF and the adoption of NICE guideline CG180 (The Management of Atrial Fibrillation).
SHARE DATA Reflect our members data back Equal and equitable access Discuss variation with a fair comparison Percentage Absolute numbers Per 100k population ONS matched PHE matched
PREVALENCE AND INCIDENCE Quality Outcomes Framework* (QOF) AF disease register Stroke register *Publically available data
THE NUMBER AND COST OF STROKE Hospital Episode Statistics* (HES) *Publically available data
PATHWAY OF CARE Hospital Episode Statistics* (HES) Admission route From where to where Discharge destination to home or to a home *Publically available data
RISK STRATIFICATION AND TREATMENT Quality Outcome Framework* *Publically available data
DATA ON THOSE THAT HAVE A STROKE Sentinel Stroke National Audit Programme* (SSNAP) *Publically available data
APPROPRIATE TREATMENT OF THOSE AT RISK GRASP-AF* Read code data interrogation tool Helps to find patients that could benefit from anticoagulation treatment *Available from NHS IQ
TREATMENT epact(electronic Prescribing Analysis and CosT)* By drug By pack By practice Great for NOACs Useless for warfarin and aspirin *Publically available data
TREATMENT epact(electronic Prescribing Analysis and CosT) Drug By pack By practice Great for NOACs Useless for warfarin and aspirin Publically available data
TREATMENT
THE MISSING PIECE -ANTICOAGULATION CONTROL WITH VITAMIN K ANTAGONISTS Numbers of patients being treated HES Outpatients only recorded by speciality not by specific outpatient clinic Very little OPCS coding for INR testing QOF Data on those on anticoagulation only (and those have to be registered and have had an appropriate CHADS 2 score) epact Numbers of tablets dispensed only QOF CHADS 2 being treated NOAC = warfarin patients?
THE MISSING PIECE -ANTICOAGULATION CONTROL WITH VITAMIN K ANTAGONISTS Patients in range.
THE MISSING PIECE -ANTICOAGULATION CONTROL WITH VITAMIN K ANTAGONISTS NICE Guidance (CG180) 2INR values higher than 5 or 1INR value higher than 8 within the past 6months? 2INR values less than 1.5 within the past 6months? TTR less than 65%? But I think I know who may have the answers
PARTNERING ON DATA By sharing your appropriately aggregated and anonymised data you can help create a tool that may help CCGs prevent deaths by allowing them to allocate resources to the most appropriate areas
PARTNERING ON DATA We currently have data on >22,000 patients from 12 4SDAWN sites in Manchester and we are looking for more More data helps us compare apples with apples Our tool has national data and is being offered to all AHSN and any appropriate interested NHS organisation
CAN REAL WORLD AND PUBLICALLY AVAILABLE DATA COUPLED WITH YOUR TTR DATA HELP THE NHS STOP STROKES?
BY HAVING THE COMPLETE PICTURE CCGs can pick the most appropriate area Screening Pathway change Earlier treatment Treatment change *Publically available data
Questions? andi.orlowski@gmahsn.org AF Programme lead jane.macdonald@gmahsn.org Director of Implementation