Note and action points Meeting Blood Pressure System Leadership Board Date 8 December 2015 Time 14:00 16:00 Attendees Jamie Waterall, PHE, NHS Health Check National Lead (Chair) Jenny Hargrave, British Heart Foundation (BHF), Head of Healthcare and Innovation Professor Huon Gray, NHS England, National Clinical Director for Heart Disease Dr Heather Grimbaldeston, Cheshire East Council, Director of Public Health Hannah Rees, PHE, Blood Pressure Delivery Manager Cynthia Folarin, PHE, Blood Pressure Programme Manager Dr Matt Kearney, PHE, National Clinical Adviser (NHS Health Check and Blood Pressure) Jennifer Ankrah, PHE, Operational Support Administrator Rob Darracott, Pharmacy Voice, CEO Gul Root, PHE, Lead Pharmacist, Health and Wellbeing Directorate Andrew Hughes, PHE, NCVIN Principal Public Health Analyst Melanie Sirotkin, PHE, Centre Director Nick Collins, NHS England, Improvement Manager, Sustainable Improvement Sylvia Richards, NHS Sustainable Improvement Heather White, Department of Health, Domain 1, NHS Clinical Services Professor Matthew Cripps, NHS England, National Director, NHS RightCare Naomi Ramage, PHE, Communications Officer Alexis Wieroniey, Stroke Association, Deputy Director of Policy and Influencing Ceri Jones, BHF, Head of Prevention & Behaviour Change Julie Ward, BHF, Project Manager Prevention & Behaviour Change Sarah Malone, BHF, Project Officer Prevention & Behaviour Change Richard Healicon, NHS England, Programme Delivery Lead, Sustainable Improvement Nigel Tait, Department of Health, NHS Clinical Services Team Apologies Dr Justin Varney, PHE, National Lead for Adult Health and Wellbeing Kevin Fenton, PHE, Executive Director for Health and Wellbeing Cllr Jonathan McShane, Hackney Council, Cabinet Member for Health Rachel Johns, PHE North, Deputy Director Service Delivery Prof Simon Capewell, Faculty of Public Health, Expert Member Dr George Kassianos, Royal College of General Practitioners, Fellow Dr Jim O'Brien, PHE, National Programme Director, Diabetes Prevention Programme Dr Shahed Ahmad, Enfield Council, Director of Public Health Professor Anthony Heagerty, British Hypertension Society, Past President Paul Ogden, Local Government Association, Senior Adviser (Public Health) Helen Donovan, Royal College of Nursing, Professional Lead for Public Health Nursing Matthew Fagg, NHS England, Deputy Director, Reducing Premature Mortality Dr Raymond Jankowski, PHE, Head of Healthcare Public Health Professor Graham MacGregor, Blood Pressure UK, Chair Ian Williams, PHE, Head of Marketing, Healthy Ageing 1
Item 1 Introductions, welcome and context JW welcomed and thanked all present for attending. JW particularly welcomed colleagues from the British Heart Foundation (BHF), noting the new joint PHE/BHF collaborative team. He also welcomed Cynthia Folarin, who has taken over from Ben Lumley as Blood Pressure National Programme Manager It was agreed that the membership of the Blood Pressure System Leadership Board will be reviewed at the March meeting due to the increased interest from stakeholders to engage with the Board. The invite to Alison Tedstone National Lead for Diet and Obesity will once again be postponed to a future Board meeting, once the data for the latest Sodium survey results is released. Action 1: CF to include Review of membership of the Blood Pressure System Programme Board on agenda for March meeting Item 2 Progress Tracker - measuring the impact of the blood pressure programme CF gave a presentation on the output measures Local Action, National Action and communications. The board was reminded that it has been a year since the launch of Tackling high blood pressure - From evidence into action where a number of actions were agreed between partners, to drive action for system improvements. To aid planning for the work ahead CF has sent out a template requesting for an update on progress made to date. JW summarized that it was timely to take a proper stock take on the actions and possibly put out another publication in the new year. AH gave an update on the three national measures for prevention, detection and management, noting that nothing has changed in the measures as it is annual data. He commented that the next Health Survey results will be published later this month, which will provide indication of the latest trends. With regards to Detection, they have commissioned a piece of work to re-do the QOF measure. The Management measure is now a retired QOF measure. A query was raised by a board member with regards to the proposed measure for inclusion in the CCG Assurance Framework 16/17. At the time of the meeting it had not yet been decided which submissions had been accepted. Paper 1 Paper 1 - Progress Tracker v2.docx Item 3 Action on Hypertension in Cheshire & Merseyside HG gave a presentation on the work that they are driving forward in Cheshire and Merseyside to tackle high blood pressure, through the CHAMPS collaborative which has been in place for 12 years. Current work streams are as follows: Primary care insight work to understand the barriers to implementing best practice C&M BP Pathway development will commence in 2016 (CVD SCN) Development of community pharmacy role in identifying and managing BP Working with C & m Fire and Rescue Services to include BP in safe and Well Checks from April 2016. 2
HG also informed the board of their bid to become an NHS England innovation test bed, with the aim of implementing innovative technologies to enable a systems approach to identifying and managing high BP. This includes looking at Dynamic Purchasing to allow quick market entry and exit. HG highlighted the need to focus on empowering people and using Hypertension as a go to indicator for wellbeing. JW, together with the Board,thanked HG and commented on the excellent work taking place in the area to tackle high blood pressure. He emphasised the importance of collaborative working and cited the BP learning action event held in Cheshire and Merseyside in March 2015. This is very much in line with what the Board set out in the Blood Pressure Action Plan, published just over a year ago, and should be supported and replicated across the country. HGray proposed that the Board gives full support to the bid. It was agreed that a formal expression of support for the bid should be sent to NHS England from the Blood Pressure System Leadership Board. 3. nationalhypertensionb Action 2: JW to write to NHS England on behalf of the Board in support of Cheshire and Merseyside s application to become an NHS Innovation test bed. Item 4 NCVIN Hypertension Profiles AH gave a brief update on NCVIN Hypertension Profiles which were presented to the Board earlier on in the year when they were in the initial stages of development. He noted that they are designed for the educated reader, rather than the lay person. The Hypertension Profiles are due to be launched on 19 January 2016. Paper 2 Paper 2 4. Draft_hypertension PHypertensionProfiles A Item 5 Sprint Study Matt Kearney provided a summary of the key findings of the SPRINT (Systolic blood pressure intervention trial) study; The study was conducted in the USA, involved over 9,000 participants over the age of 50 with CVD risk, but excluded individuals with stroke and diabetes. The trial aimed to lower BP, reduce the risk if heart and kidney diseases, stroke or age related declines in memory and thinking. The trial stopped early at 3.5 years due to significant reduction in CV events, CV mortality and all-cause mortality in the group receiving intensive treatment, compared to the group receiving standard treatment. However, the rates of some serious adverse effects were also higher in intensive group. MK noted that there had been little discussion of the impact of the study in England. During the discussion that followed a few key issues and questions were raised: 3
There are reservations from the medical community regarding the over-medicalisation and over treating of patients, however considering the impact that every drop in 1mmHg has we should remain ambitious How will this study fit within NICE guidelines revisions? Adherence to drugs in intensive group an issue, considering the increased number of medications? Mentioned that in the US they have a different perspective to medical drugs compared to England. 5. SPRINT trial Matt Kearney.pptx Item 6 Partner updates NHS Sustainable Improvement (formerly NHS IQ) - CCG performance - SR tabled a paper on CCG performance for BP management in England including questions for CCGs to consider. The QOF data highlights the top performance CCGs in BP management and it is important to understand what success measures and strategies were applied to attain this and share best practice in order to improve performance across England in blood pressure management. Action 3: Board to review CCG performance paper and feedback to Sylvia Richards Paper 4 Paper 4 - CCG BP Performance.docx - Twitter chat in January - A Twitter chat on Blood Pressure has been scheduled for 20 January 2016 at 8pm; the Board was encouraged to be a part of this conversation. Action 4: SR to circulate details of Twitter chat on 20 January; Board encouraged to get involved in Twitter chat Post meeting note: The link to the chat is now live http://www.wecommunities.org/tweet-chats/chat-details/2626 #WeMDT - Wednesday 20th January 2016 8pm; Blood Pressure - Prevention, Detection and Management BHF/PHE collaborative BP team progress JH updated the board on the PHE/BHF collaborative BP team work programme; a programme manager and project officer have been recruited to work on the collaborative programme. The joint work plan for the next 5 months has been developed. Stroke Association AW, Deputy Director of Policy and Influencing at Stroke Association thanked the Board for inviting the Stroke Association to sit around the table. She informed the board about their Know your Blood Pressure campaign, including a current strategy review to make the campaign bigger and better, as well as volunteer and staff training. AW confirmed that they have already linked in to the OneYou campaign. Action 5: HR to invite colleagues from PHE Marketing and Strategy team to the next Board meeting 4
Pharmacy Voice GR gave an update on behalf of Rob Darracott, including NHS England s recent commitment of 31million for its pharmacists in general practice pilot scheme. JW suggested that the Board invite the NHS Chief Pharmaceutical Officer to the next Board meeting. Action 6: HR to work with GR to invite the NHS Chief Pharmaceutical Officer to the next Board meeting PHE Update - CVD partnership proposal JW updated the Board on the proposal being developed to bring together the various strands of CVD work currently ongoing across PHE under one umbrella, with the aim of rationalising relevant activities, clearly articulating PHE s contribution to CVD prevention, and ultimately, aim to contribute to NHS England s Cardiovascular Outcomes Strategy, which intends to reduce premature death, disability and health inequities related to CVD. - Prevention/POD bid JW gave an overview of the proposals that have been made as part of the prevention savings work, particularly the proposed development of a case finding tool (GRASP BP) to detect and effectively manage high blood pressure and pilots to expand the role of Pharmacy. JW invited JH to elaborate further on this, and she also took the opportunity to PHE Communications Update NR updated the Board on recent communications activity, including an article due to go into the LGA Chronicle early in the new year, an piece on the PHE blog highlighting one year on since the publication of the Blood Pressure action plan, as well as communications highlighting the PHE/BHF partnership. CVD leadership forum MK spoke to the Board about both the forum s involvement with the intelligence packs, which are taking the same model as the previously published AF packs, and also presented the CVD Pathway for Secondary prevention developed. Paper 3 CVD pathway - secondary Item 7 Right Care: The power of variation MC joined the Board to present on the Rightcare approach and methodology to identifying unwarranted variation locally, and the opportunity that this presents to drive improvement. The NHS Right-care is being further rolled out with 10 RightCare Delivery Partners supporting all CCGs to adopt and embed the RightCare approach andd plans for further Commissioning for value packs to be published in 2016. A discussion followed, with great interest from Board members in the approach, including the potential to develop a CVD prevention pathway. 5
Item 8 Summary of key actions, next steps and AOB There were no AOBs raised from members. JW summarised the actions agreed from the meeting and thanked all attendees, particularly the presenters who joined for the meeting. The next meeting will be held on Monday 14 March 2016 14:00-16:00pm Action Point Action to be taken forward Owner Status 1. CF to include Membership review of Blood Pressure System Programme Board on agenda for March meeting CF 2. JW to write to NHS England on behalf of the Board in support of Cheshire and Merseyside s application to become an NHS Innovation test bed. 3. Board to study CCG performance paper and feedback to Sylvia 4. SR to circulate details of Twitter chat on 20 January; Board encouraged to get involved in Twitter chat 5. HR to invite colleagues from PHE Marketing and Strategy team to the next Board meeting 6. HR to work with GR to invite the NHS Chief Pharmaceutical Officer to the next Board meeting JW All SR All HR HR/GR Actioned Actioned 6