Integrated Lipid Management
Transforming primary care pathways to optimise treatment for familial hypercholesterolemia and cholesterol. This programme is now closed
Project
overview
- A new and innovative Lipid Service in Somerset is improving patient access to lipid lowering treatment by expanding its capacity to manage and treat patients.
- Increased knowledge and confidence in lipid management in primary care through provision of clear clinical guidance, resources and education.
- Achieved an increase in the number of monthly lipid clinics and a reduction in waiting times from referral to treatment.
- Health Innovation South West secured funding through the Collaborative Lipids Fund (CLF) to deliver a project focused on improving and building a service model in Somerset, implementing best practice and developing cross-organisational working in both Somerset and Devon.
Partners involved
- Health Innovation South West secured funding through the Collaborative Lipids Fund (CLF) to deliver a project focused on improving and building a service model in Somerset, implementing best practice and developing cross-organisational working in both Somerset and Devon.
- The project team consisted of the South West Genomic Medicine Service Alliance (SWGMSA), Somerset Training Hub, Yeovil District Hospital (YDH), Public Health Somerset and lipid service colleagues from University Hospitals Bristol (UHB).
Project
detail
In Somerset 23,000 people are living with coronary heart disease, and there are around 14,000 stroke survivors in the Somerset area (Somerset Intelligence, 2021) (BHF, 2023).
Heart and circulatory diseases kill more the 1 in 4 people in the Somerset Area (BHF 2023). Somerset detection and treatment of hyperlipidaemias, including familial hypercholesterolemia (FH), in primary care is low, putting a significant proportion of the population at increased risk of cardiovascular disease (CVD).
In 2021, there was a limited provision of lipid clinics and specialists within the region, with one consultant-led clinic a month in secondary care. There was a growing waiting list and lengthy waiting times from referral to appointment for patients (waiting time above 79 weeks for some patients and a 92nd percentile waiting time of 77 weeks for those referred in 2021) due to limited service provision and capacity.
To address these challenges, the Partnership developed a phased approach to design, deliver, deploy and evaluate an innovative lipid service in Somerset and Devon, with the ambition to spread more widely across the peninsula. During the period September 2021 to March 2024, our work focused on:
- Building and solidifying the foundations for a sustainable service, including recruitment into key roles
- Delivering primary care education in lipid management to improve detection and treatment of hyperlipidaemia
- Building evaluation and ongoing learning into the programme to support its sustainability, and conducting an early evaluation of the programme
- Helping to develop a primary/secondary care integrated and regional lipid pathway
- Developing pharmacist and GP led lipid clinics
- Creating a service re-design toolkit to share with a wider audience to support NHS organisations to plan, set up, run and evaluate a lipid service re-design.
Impact from this work
Patient impact
- An increase from one to four lipid clinics being delivered per month.
- 323 patients have had a consultation, with a significant number receiving treatment for their CVD condition, and patient feedback is positive.
- Reduction in the average and median waiting time from referral to treatment has also been seen between 2021 and 2023.
Clinical impact
- 608 attendees have participated in 20 education sessions in lipid management.
- 45% of GP practices in Somerset have access to the resources developed during the redesign of the service.
- More than 67 healthcare organisations across the region have benefited from these sessions and the resources.
- The newly redesigned Somerset service scored 76 out of 100 on the NHS Sustainability Model, which predicts how sustainable an improvement project is likely to be. The higher the score, the more likely it is that the initiative will become an established way of working, replacing older structures and processes, and potentially allowing for continued improvement over time.
