Healthy Hearts and Kick It Oliver Phillips – Referral Generation And Partnership Officer (Westminster)

CVD Prevention service Our Reach & Goals CVD Prevention service BMI 30+, pre/diabetic, HBP, CKD, TIA Aims to support 550 people per year Holistic support Feedback to GP’s Smoking cessation 6 one-to-one sessions Available to any smoker Aim to support 1437 to quit per year Overview – criteria – benefits – ultimate goals – prevention – increased focus from public on prevention – people with long term health conitions 2

CVD costs NHS £8.96 billion a year 26% of all deaths caused by CVD DoH aims to reduce smoking to 12% by 2022 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/623633/NHS_Central_London__Westminster__CCG_CVD_intelligence_pack.pdf https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/648190/cardiovascular_disease_prevention_action_plan_2017_to_2018.pdf 3

We Deliver Multiple Measures Blood pressure Total cholesterol HDL cholesterol Exercise advice provided Healthy lifestyle advice provided Q risk Waist Circumference Smoking status Smoking cessation advice provided Smoking referral Alcohol intake We will highlight abnormal readings for Cholesterol, Blood Pressure, AFib and Glucose Over both services we run in a mixture of GP clinics and community settings. We deliver a range of measures that you can see here. These all are QOF points that we will update. Not only we will update these but as part of HH we will flag people with high cholesterol, blood pressure, Afib and glucose. And I am going to show how hopefully this can help CLCCG and all GP’s in Westminster

52% of patients in CLCCG not diagnosed with Hypertension Healthy Hearts can support with providing BP measurements So I looked at some figures on the primary care intelligence packs for CVD prevention. And we can see that there is potentially quite a large number of patients that hasn’t been diagnosed with high blood pressure. We can support with this.

57% of people with diabetes diagnosed within CLCCG Healthy Hearts measure glucose levels within clinics Again we can see that there could be a large proportion of patients within CL and West London CCG that haven’t been diagnosed with diabetes. Again through our non-fasting glucose measurement we will flag anyone that has a high reading. These are just 2 examples of how I hope our provision can really support patient and practice outcomes. We would really encourage and practice that has any particular focus to contact us to see how we can help them meet some of these figures. Like I said we can also measure for irregular BP and cholesterol. All patients will be flagged via a letter or tasked to their GP.

Smoking prevalence is better than similar CCG’s in the area I thought it would be good to show you where our CCG stand in Westminster. Currently doing really well when we look at demographically similar surgeries. We are actually doing really well but there is definitely pockets of the borough where we see a higher prevelance.

3,323 Hospital Admissions Per Year in Westminster Appointment times, referrals, appointment times can be longer, extra cost I thought it would be good to show the hospital admissions last year. We can see that Westminster is below the national average but last year there was still a high number. We know that if we can get more people to quit that this number can reduce. We really see there is still a need to improve this. Hospital admissions are more likely to mean more appointments. 3,323 Hospital Admissions Per Year in Westminster

Quit Dates Set Cumulative 619 1188 1454 Target Quit Dates Set 690 1322 2041 % Achieved 90 71 We are looking to improve thiese numbers across the smoking cessation service over the next few months. And I really wanted to come to you with options in how we can support this.

Pilot in Portsmouth Hospital 2011-2012 The DoH commissioned NCSCT community interest group to test a streamlined, systematic and robust referral system in one acute trust that would increase the referral of smokers to appropriate stop smoking support. Achieve this by enabling: A simple and time efficient referral system Effective and measurable VBA training A system that enables stop smoking services to respond quickly and efficiently to referred patients A whole system approach that stimulates progress towards providing a supportive environment for patients to stop smoking I wanted to show you a case study from a hospital in Portsmouth that developed a new system that had some really amazing results.

Key Outcomes Prior to the pilot 55 members of staff were reported as being trained in VBA by the local stop smoking services. Online VBA was offered to all staff and 282 staff were trained. In total there were 330 referrals made overall by all referral methods. This equates to a total increase of 602% when compared to the 47 referrals made during the same period in the previous year.

L1 Smoking Cessation Training Certified training VBA Smoking prevalence and dangers Referral familiarisation Delivered by Kick It Between 1/1 and a half hours

DoH – Towards a Smokefree Generation “Promote links to "stop smoking" services across the health and care system and full implementation of all relevant NICE guidelines by 2022.” “Provide access to training for all health professionals on how to help patients - especially patients in mental health services - to quit smoking”

Summary We can support with QOF’s Help improve patient outcomes Support with diagnosis Deliver free certified bespoke training programmes

Westminster Launching in January Currently being mobilised Integrated healthy lifestyle service (combining Kick It and Healthy Hearts) Smoking cessation remaining largely the same Delivery of ONE YOU Clubs We are currently looking for extra clinics Training Can we have GP’s from each network refer into one GP clinic 15

References https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/623633/NHS_Central_London__Westminster__CCG_CVD_intelligence_pack.pdf https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/648190/cardiovascular_disease_prevention_action_plan_2017_to_2018.pdf https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/630217/Towards_a_Smoke_free_Generation_-_A_Tobacco_Control_Plan_for_England_2017-2022__2_.pdf