Wolverhampton place consistently underperforms in cardiovascular disease (CVD) performance indicators. Although the reasons for this are multifactorial, there are three major contributory factors that explain this trend, namely; relatively high levels of deprivation, relatively high levels of ethnic diversity and relatively low levels of treatment to secondary prevention target lipid levels. In March 2020, The Department of Cardiology at New Cross Hospital were recipients of an NHS England/Accelerated Access Collaborative pathway transformation funding award which was granted to help facilitate local improvements for the purposes of lipid optimisation and address barriers to the uptake of PSCK9 inhibitors. Review of data from post-ACS discharge blood test results and interrogation of GP clinical systems showed that intervention was required in both primary and secondary care to address the problem. Project implementation in secondary care involved identifying patients that required optimisation of lipid lowering therapy due to not being treated to target at 3-months post-ACS. Project implementation in primary care involved incorporation of an indicator into the prescribing incentive scheme to promote treatment to target non-HDL cholesterol level. By the end of the intervention, 37% (2144) of patients who were common to both baseline and post-intervention data sets achieved a reduction in non-HDL cholesterol with an average reduction of 0.66mmol/L equating to approximately 15% relative risk reduction in CVD events and 71 fewer CVD events over 5 years. Moreover, an additional 565 patients were treated to target Non-HDL levels with an average non-HDL reduction of 1.06mmol/L from baseline.
