Thank you very much, and thank you Roger for your interesting and informative speech.
I’m sure everyone in this room agrees that anything we can do to prevent stroke is a step in the right direction.
Role of organisations
It’s difficult to overstate the importance of the contributions made to the health of this country by organisations like the Arrhythmia Alliance – raising patient awareness, providing bereavement support and linking directly to specialist and community services. You are the Big Society, and you are an example for us all.
That’s one of the reasons I’m so delighted to be here today, doing my bit to raise awareness of the ‘Know Your Pulse’ campaign.
As a Government, it’s our job to give you the tools you need to complement the expertise you have.
Many of you, I’m sure, will be aware of the recent White paper ‘Liberating the NHS’. It’s a document that involves a lot of change.
But it won’t be the sort of change that the NHS has seen so much of over recent years. It won’t be the dribble of didactic, top-down reshuffling, or the well-meant but ultimately ineffective imposition of targets and box-ticking.
Instead, we want to change the NHS for the better.
Rather than have everything directed from Westminster by people like me, power will be given to people like you:
People who know to lead and design the services relevant to communities.
And they will be rewarded not for jumping through hoops, but for actually improving outcomes for patients.
This way, we’ll be putting patients at the heart of everything we do.
There will be ‘no decision about me, without me’.
And we’ll concentrate on providing some of the finest health outcomes in the world. Not because that means an impressive pie chart, but because it means patients get better, safer, more innovative treatment.
One of the most exciting changes will be in commissioning. Not simply because it’ll be led by health professionals. But because the whole process of commissioning will be a collaborative one.
And organisations like the Arrhythmia Alliance will all be able to come together to mould the right services.
It will ensure everyone will have access to the best and most suitable treatment.
I am sure you already have close ties with local health professionals. But now is the right time to develop those ties further. You have the opportunity to help decide how cardiac services will work in your local area. I’m sure I don’t have to tell you how important that is.
But of course, we aren’t asking you to plough a lone furrow.
The coalition government sees the prevention and management of stroke as a major priority area for the NHS.
You will of course all be aware that the annual risk of having a stroke is five to six times greater in patients with AF than in people with a normal heart – and that AF affects at least 800,000 people in England.
Recognition and optimal treatment of AF is of particular importance. Strokes due to AF are particularly severe but also eminently preventable.
It is an area where we know we could do better. We need to make sure everyone has access to bespoke treatment that is not only effective, but tailored to the needs of the area.
So we’re working with NHS Improvement to improve detection and diagnosis and get the best treatment for patients with AF. NHS Improvement have been running a number of projects taking a different approach in response to the needs of the local communities. Some of them have included identifying patients with AF through pulse screening at flu and other clinics. Work done in the Bedfordshire and Hertfordshire Heart and Stroke Network has been particularly innovative in this field and has been replicated in other areas.
As well as delivering real local improvements, these projects have helped inform a national evidence template which will help improve the areas that need it most. The template has quite rightly been held up as model of how to achieve quality, innovation, productivity and prevention at a local level.
And we want these improvements to continue..
So NHS Improvement have increased the resourses they are dedicating to AF. This is testament to how much of a priority it is. Specifically, they have appointed three full time national improvement leads to help accelerate the spread of good practice – to improve the prevention, detection and treatment of stroke in AF.
They will help ensure optimal treatment is provided for everyone, everywhere – risk assessment, anticoagulation clincs, secondary care, intermediate care, new drug therapies – we’re looking into improving every element of the treatment and management of AF.
‘Know Your Pulse’ and pulse checks
That’s why I welcome and recognise the hard work that is going into the ‘Know your Pulse’ campaign. I’m sure it will help influence comisssioners in developing their local AF programmes.
To support commissioners in doing this, NHS Improvement and the National Patient Safety Agency are developing a toolkit to help them. . It will be published in January next year and will bring together the information, guidelines and examples of good practice. It will offer a practical user-friendly tool for commissioners to decide what is best for their communities.
What about the NHS Health Check programme? Currently the core test and measures don’t include a pulse check for AF.
We cannot say with certainty that adding a pulse check to the programme would be clinically or cost effective. When the time comes to review the programme, we will be considering whether to extend it to include other tests such as the pulse check for AF. In the meantime, PCTs can choose to include pulse checks in their programme because of the particular characteristics of their population. Obviously, they will need to take into account the potential costs and weigh them up with the potential benefits.
We're adamant that the programme is both accessible and effective for everyone. So PCTs can choose for themselves who they want to provide the checks. They can look across a range of providers, including the voluntary sector. That’s what the White Paper is about – extending choice for both the patients and the professionals. The NHS will become responsive to people's specific needs and circumstances."
Finally, may I just say how pleased I am that Trudie Lowban, the founder of the Arrhythmia Alliance, has agreed to be part of our Heart Disease Advisory Group. It’s chaired by Roger Boyle, our National Clinical Director, who as you know is also here for this reception. I’m sure with her talent, dedication and experience she will be a superb asset to the team. And I look forward to working with both Trudie and Roger in continuing our efforts to improve heart disease in the short, medium and long term.