Atrial Fibrillation Toolkit: Tackling avoidable strokes to save lives and strain on the NHS

Image of a heart in the body with the mechanics of the circulatory system to show Atrial Fibrillation Toolkit: Tackling avoidable strokes to save lives and strain on the NHS

The AHSN Network of 15 Academic Health Science Networks in England has launched the national ‘Atrial Fibrillation Toolkit’ (www.aftoolkit.co.uk) to address barriers to stroke prevention in atrial fibrillation (AF) with a unique AF Data Tool to highlight improvement opportunities across the AF pathway.

Across England, atrial fibrillation is sub-optimally detected and managed resulting in avoidable strokes which can lead to death or significant disability. Early detection of AF to enable the initiation of protective anticoagulant therapy is vital to save lives and strain on the NHS.

Impact of atrial fibrillation:

  • Public Health England modelling suggests there are around 300,000 people in England with undiagnosed AF¹,².
  • Each year, about 15,000 people in England, Wales and Northern Ireland are admitted to hospital for an AF-related stroke³.
  • The average cost of an AF-related stroke to both health and social care is £46,039 over the first five years¹.

The Atrial Fibrillation Toolkit provides methodologies, resources and support for commissioners and clinicians working to reduce AF-related strokes, saving lives and NHS resources nationally. Following the AF Improvement Cycle of Detect, Protect, Perfect, the Atrial Fibrillation Toolkit brings together the core elements that make up the foundations of an AF improvement project.

With service change high on the NHS agenda due to the coronavirus pandemic, the AF Toolkit gives commissioners and clinicians all the tools they need to address atrial fibrillation in their region. It offers examples of pathway redesign, skilling front line staff, spread and adoption of innovation and aligning system incentives.

Unique to the Atrial Fibrillation Toolkit is the interactive AF Data Tool which supports clinical commissioning groups (CCGs) to develop their local AF service to meet the needs of the population. Utilising data from the Quality and Outcomes Framework Data² (QOF), Sentinel Stroke National Audit Programme³ (SSNAP) and the National Cardiovascular Intelligence Network1 (NCVIN), the AF Data Tool can be used to highlight improvement opportunities nationally across the AF pathway, including:

  • A comparison of actual local AF prevalence to the NCVIN expected prevalence.The number of people in a CCG with AF and at risk of stroke, who are not receiving anticoagulation therapy.
  • The number of people with an AF diagnosis who experienced an AF-related stroke, and how many were receiving anticoagulation therapy at the time of their stroke.
  • Comparisons of local data with the NHS England Cardiovascular ambitions for Atrial Fibrillation4 (2019-2029).

Commissioners and clinicians can use the data for service design or improvement. Data is presented in an informative infographic which can be filtered by CCG and year for comparative analysis. Infographics can be downloaded for use in presentations and business case development.

Dr Matt Kearney, GP and Programme Director, UCLPartners AHSN said: “This Atrial Fibrillation Toolkit is an excellent resource. It will help us to do things differently providing methodologies, resources and support for commissioners and clinicians to reduce AF-related strokes in their local communities.”

The Atrial Fibrillation Toolkit can be found at www.aftoolkit.co.uk and also includes comprehensive resources, clinical guidance, myth busters, and additional reading to support commissioners and clinicians working to reduce AF-related strokes.

References

¹NCVIN https://www.gov.uk/government/publications/atrial-fibrillation-prevalence-estimates-for-local-populations
²QOF https://digital.nhs.uk/data-and-information/publications/statistical/quality-and-outcomes-framework-achievement-prevalence-and-exceptions-data/2018-19-pas
³SSNAP https://www.strokeaudit.org/results
4 Health matters: preventing cardiovascular disease https://www.gov.uk/government/publications/health-matters-preventing-cardiovascular-disease/health-matters-preventing-cardiovascular-disease