Cara Afzal: Our Cardiovascular programme

Digital Heart

Health Innovation Manchester continues to play a leading role in the delivery of numerous projects within the Cardiovascular domain.

Through this portfolio, the Greater Manchester health and care sector has improved the care and treatment of long-term conditions, accelerated the delivery of innovations into the NHS and improved outcomes for thousands of patients across the city-region.

Cara Afzal, Senior Programme Development Lead at Health Innovation Manchester, has written about her experiences in working alongside colleagues across Greater Manchester on the programmes within this domain. These include work with Smart Hearts, Troponin Only Manchester Acute Coronary Syndromes (T-MACS), the Heart Failure Care Plan and others.

Having written about mental health sometime during last year, one of the other areas which have been a focus area for me over the past few years has been cardiovascular disease.

The sad fact that my father died at a young age, from a sudden heart attack, drives me on each day towards the betterment of the care of our population in the area of Cardiovascular disease. I recall seeing the words “myocardial infarction” on his death certificate and thinking at that time, what does that mean? It is such stark life experiences that etch on our minds a permanent marker – which gives us energy and passion for improvements in healthcare – knowing that if we take action, others suffering will be less, is a powerful motivator.

Our Cardiovascular domain, which is led by Prof Bernard Keavney, is applying discovery and translational science to generate the evidence base towards application into practice. For me, sitting alongside clinical academics on this domain has given me an insight across the translational research pathway on how we get evidence from bench to bedside.

Our Cardiovascular portfolio is extensive, consisting of several projects, some of which are listed below and include the names of the lead clinicians that we work with. They really are to be commended, striving for the improvement of care, even though their loads are greater than they have ever been during these unprecedented times.

  • Smart Hearts – Innovating heart failure pathways in Greater Manchester. We have carried out a project, using insights from implanted medical devices to identify patients with worsening symptoms and taking clinical action. The lead for this programme is Dr Fozia Ahmed, Consultant Cardiologist at Manchester University NHS Foundation Trust (MFT). This programme is funded by HDRUK.
  • Digitisation of the paper-based Heart Failure Care Plan – Building on our strong record in heart failure digital transformation through the HDRUK smart heart sprint. The delivery of a structured heart failure care plan is a key focus for Greater Manchester. This is enabling the development and implementation of digital care plans within the GM Care Record. The lead for this programme is Dr Colin Cunnington, Consultant Cardiologist at Manchester University NHS Foundation Trust (MFT). This programme in funded by NHSX.

  • Troponin Only Manchester Acute Coronary Syndromes (T-MACS)– The Troponin only Manchester Acute Coronary Syndromes (T-MACS) is a decision aid, computerised clinical prediction model which calculates individual patient’s probability of acute coronary syndrome following a single blood test at the time of arrival in the Emergency Department. This programme is lead by Prof. Rick Body, Director of Research & Innovation at Manchester University NHS Foundation Trust (MFT).
  • Familial Hypercholesterolemia (FH) –Development of a proof of value for the establishment of a coordinated cascade system for Familial Hypercholesterolemia (FH) across the Greater Manchester health economy, designed to ensure that the local population has fair and equitable access to information, diagnosis and treatment. This programme is led by Dr Handrean Soran, Consultant Physician and Endocrinologist at Manchester Royal Infirmary.

It is a privilege to lead this portfolio of work. These programmes have been developed, driven and executed by a team of committed staff, each playing their part in ensuring that not only does the project remain on track, but we ensure that if we can achieve greater value and impact, we work to do this.

The staff working on this portfolio are; Carol Bayliss, Louise Bond, Joy Stonebanks, Nancy McNeilance, Lorraine Burey, Collette Warner, Adam Reekie and Maxine Horne. Their commitment and support for the cardiovascular portfolio is key to progress. Indeed, during these difficult times, their enthusiasm and dedication have not faltered. When we are working at pace, and working as a team, we know that we can achieve greater things in less time, and when the impact data for patient benefit begins to flow, this helps increase drive and enthusiasm to strive for greater success.

“If everyone is moving forward together, then success takes care of itself” – a quote from Henry Ford always comes to mind when I am working with our teams, as it is so true, we need a committed team to achieve project goals and the drive, whatever it may be for each team member so that we keep going and achieve the end goal.

The portfolio continues to expand, because the need is so great. We are now working through how we will increase our efforts for improving lipid pathways, with a new National AHSN Lipid Programme, where we are not only progressing work on new exciting novel technologies, which are designed to positively impact on patients, we have been asked to look at Lipid Management pathways.

The pace is fast, and we know the benefits to be realised are great, so we continue our work in this area and I keep in mind those that need improved care.

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