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Potential to improve efficiency

Key themes to improve efficiency emerging from national and local evidence relate to commissioning services that are evidence based, improve access and lead to effective patient outcomes while simultaneously reducing inequalities. This involves working in holistic manner to look at the wider long term conditions agenda to streamline pathways of care, putting prevention first and ensuring early discharge from hospitals with care provided closer to home. Robust lifestyle interventions -exercise, sensible drinking, stop smoking etc - play a key role in prevention and rehabilitation of CVD and would provide a key long term benefit for the patients and cost-efficiency for the health services. 

Future initiatives and projects

Future initiatives relate to 100% coverage of the NHS health checks programme for everyone between 40-74 years in NoT with primary focus on hard-to-reach communities. The strategy includes involving GP practices in the first year followed by delivering the checks in community pharmacists and by Any Willing Providers (AWPs).  

To gain an in-depth understanding of the local CVD situation a detail exploration of primary care / secondary care data is necessitated by triangulating and deriving inferences from a number of data sources like QOF, QMAS, HES, ONS etc. A minimum data set (MDS) is planned to be collated by the HDQIG (Heart Disease Quality Improvement group) which will feedback recommendations to the LTC board and finally ECT. Also, close working with NECVN (North East Cardiovascular Network) would ensure that Newcastle matches regional standards and aspires to be best regionally. 

Five key priorities and commissioning plans for future 

• To implement the NHS health checks programme across North Tyneside for all between the age group of 40-74 as part of the national programme. To target the 'highest of the high risk' groups first as part of their vascular checks. Targeted social marketing strategies needs to be implemented to ensure that key focus of the NHS health checks are the 'hard-to-reach / easy-to-overlook' groups. 
• To implement a systematic approach for case ascertainment for CVD so as to close the gap between reported and expected numbers on disease registers. 
• Further achievement on the CHD-6 WCC target whereby adequate control of BP remain a key priority. Working alongside Primary care commissioning team it would require close monitoring of primary care performance via Primary care contract monitoring, Primary care dashboards, QOF validation teams/QOF visits. 
• Adequate funding needs to be allocated to the primary/secondary prevention of cardiovascular diseases in Newcastle. 
• Commissioners need to ensure that tertiary prevention activities like cardiac rehab/heart failure rehab services form a core part of wider long-term conditions rehab services model which needs to be delivered in a cohesive/streamline manner to be effective and efficient.