Tackling cardiovascular disease inequalities in the North East and North Cumbria

21st June 2023 - By Professor Julia Newton

As reported by the Kings Fund in 2022, Cardiovascular disease (CVD) causes 1 in 4 deaths in England, and is a leading cause of morbidity, disability and health inequalities.

However, CVD is largely preventable, which is why the NHS Long Term Plan has identified the condition as the single biggest area where the NHS can save lives over the next 10 years.

Working together with partners, the Academic Health Science Network for the North East and North Cumbria (AHSN NENC) is delivering a number of projects with a shared goal of improving population health and tackling healthcare inequalities that exist in our region.  

In this blog, AHSN NENC Medical Director, Professor Julia Newton, provides an overview of these projects from across the North East and North Cumbria that aim to address local healthcare inequalities relating to CVD.

Beneficial Changes Network

During the COVID-19 pandemic, NHS England funded AHSNs to work in partnership with NIHR Applied Research Collaboratives (NIHR ARCs) to support projects that evaluated the impact of healthcare innovations developed in response to the pandemic. As part of this work, the Beneficial Changes Network (BCN) in North East North Cumbria funded researcher Dr Maggie Fu to work across the NIHR ARC NENC and the AHSN NENC. The focus of this research was to understand the impact of lipid management in deprived areas served by North East and North Cumbria Deep End practices.

This project has been extremely productive; the protocol has been published, a paper of quantitative data has been published in BMJ Open and a systematic review has been accepted  for publication in the British Medical Bulletin. The qualitative interviews that have taken place are being written up for publication and have subsequently informed a range of other projects.

This project identified that one of the challenges facing those living in disadvantaged communities with engaging with the lipid management pathway is the need to have a blood test as this can sometimes require multiple visits to the GP surgery with time and cost implications for individuals. This has influenced the new at home cholesterol testing that we are piloting in the North East and North Cumbria, which you can read about below.

 

Innovation for Healthcare Inequalities Programme (InHIP)

In 2022, the Innovation for Healthcare Inequalities Programme (InHIP) was launched, providing an opportunity for integrated Care Boards (ICBs) and AHSNs to define regional healthcare inequality priorities and co-design a project using innovation to minimise health inequalities.

In the North East and North Cumbria, we will be delivering a project in Middlesborough, an area that is recognised for high levels of deprivation and inequalities relating to CVD.  As part of this project, we are working with the NIHR ARC NENC to understand the challenges faced by the South Asian, Afro-Caribbean and other disadvantaged populations in accessing an annual CVD check.

This project builds upon our initial findings from the BCN work, with the two projects together acting as a platform for other projects being delivered in North East North Cumbria. As part of this work to gather behavioural insights into why people do and do not engage with the health system, we’ll be hosting a webinar on Thursday 29th June for anyone who is interested in behavioural insights and how understanding them can improve the care we provide.

 

System transformation fund (STF) and Small Business Research Initiative Grant (SBRI)

The System Transformation Fund (STF) launched in September 2022 and has provided an opportunity to bid for funding to deliver a project that aims to overcome some of the barriers to accessing lipid management in disadvantaged communities.

In the North East and North Cumbria, we are working with HealthTech company PocDoc to pilot their at-home cholesterol test. Using innovative technology, the test involves a finger prick blood test, a lateral flow device and an app, which gives results indicating whether a person has high cholesterol. The project will identify high risk patients in disadvantaged communities who find it challenging  to engage with a CVD health check and offer them a PocDoc test.

In parallel to this work, PocDoc also applied for a Small Business Research Initiative (SBRI) grant which will provide additional testing capability in primary care and extend testing to community pharmacy and a corporate employer.  We’re already in conversations with a large corporate in the Cleveland area and we are looking to engage with community pharmacies which are located near Deep End practices.

As a collective, these four projects represent a significant step forward in our understanding of the barriers to engagement with CVD risk assessments and in turn aim to improve public understanding of the benefits of reducing CVD risk. We are now looking to build on that experience and provide co-delivered, co-designed solutions to overcome these barriers. Collectively we believe that these projects will reduce the incidence of CVD and as a consequence reduce health inequalities within our population.