Lipidology service at University Hospitals of Derby and Burton(UHDB) increased service capacity and efficiency of reviewing Derbyshire's population of dyslipidaemia patients by introducing a new approach in tackling the increased demand of high cardiovascular-risk patients including a large proportion of patients from ethnic minorities.
Derbyshire was identified as the county in East Midlands with the greatest gains to be achieved through improvements in cholesterol management. Derbyshire has a population of approx. 800,000 people. In 2021/22, 3.5% of people in Derbyshire had coronary heart disease (CHD) compared to East Midland avg. 3.2% and England avg. 3.0%. In Derby City 90 people per 100,000 died before 75 years from cardiovascular disease (CVD) (England avg. 77.8). 26.3% of Derby's population are ethnic minorities (compared to England avg.19%).
The population is relatively deprived with an Index of Multiple Deprivation score of 26.3 (England avg. 21.7) with an extensive rural geography of small, isolated communities with limited local access to secondary services in some cases.
Joined Up Care Derbyshire (JUCD) have an established CVD strategy and 'improving lipidology' is a priority in the JUCD Integrated Pharmacy Medicines Optimisation plan.
A new approach with to service delivery with pharmacy-led clinics was introduced to address growing demands, change of care standards to align with national and local guidance and emergence of novel lipid lowering therapies (LLTs). This would also help prevent the gap for accessing LLT optimisation and medications in ethnic minorities from further increasing.
We developed an Integrated Pharmacist-Led Lipid Clinic service (IPLC) as part of a new cardiometabolic service to improve patients' access to lipid optimisation, combat health inequalities and attempt to reduce our cardiovascular risks.
Service development included: Introducing a new role for specialist lipid pharmacist prescriber to assess patients, prescribe and administer LLTs via independently led clinics (after appropriate upskilling, Developing a new clinical module within SystmOne for integrated secondary and primary care for dyslipidaemia patients and to improve efficiencies with co-management of patients. Providing educational outreach in primary and secondary care to increase MDT working and improve quality of care for dyslipidaemia and CVD prevention.
Increasing identification of patients in primary care with dyslipidaemia and suboptimal management from LLT
Quantitative and qualitative data was obtained to demonstrate impact on patient care, patients' perceived experience, and new service efficiencies. Benefits showed a cost minimisation compared to consultant-led clinics and positive feedback was gained from patients and key UHDB stakeholders (HIEM, 2024).
