Greater Manchester, National

Familial Hypercholesterolaemia and lipid management

Supporting with the prevention and management of cardiovascular disease

The NHS Long Term Plan states that the biggest area where the NHS can save lives over the next 10 years is in reducing the incidence of Cardiovascular Disease (CVD). CVD causes a quarter of all deaths in the UK and is the largest cause of premature mortality in deprived areas.

Hypercholesterolaemia (high blood cholesterol) is a significant risk factor for CVD, and evidence suggests that improving the detection of those with hypercholesterolaemia and ensuring they received effective treatment will have significant benefits.

Health Innovation Manchester is working on a wide programme of work to improve detection of Familial Hypercholesterolaemia, genetic condition which can lead to extremely high cholesterol levels, and lipid management optimisation to improve patient care and outcomes and reduce death or disability due to premature cardiovascular disease.

The programme includes:

Familial Hypercholesterolemia Cascade Testing Service

HInM is supporting the development and delivery of a Proof of Concept for establishing a new FH service.

The new system aims to improve access to testing for FH and cascade testing to close relatives who may also have FH.

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Manchester People

Supporting the national AHSN Network FH and Lipid Management work

The AHSN Network programme focuses on Familial Hypercholesterolaemia (FH) detection and lipid management optimisation as part of a joint AHSN-Accelerated Access Collaborative programme of work. Specifically, it will accelerate the identification of those with FH and facilitate optimised management of individuals with high lipid levels through a novel, NICE-approved clinical pathway, focusing on secondary prevention as part of the AAC Rapid Uptake Product programme. This includes using innovative approaches to supplement current clinical assessment processes, underpinned by changes in pathways, workforce and data collection.

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Medical professional reviewing cholesterol lipid panel results

Pioneering study to test the implementation in primary care of inclisiran

Greater Manchester is partnering with industry on pioneering study as the NHS brings a new cholesterol-lowering injection into use. Greater Manchester-based organisations are collaborating as part of a new study involving 900 patients testing the implementation in primary care of inclisiran, a new drug to reduce LDL cholesterol.

The ground-breaking project, titled Study in Primary care evaluating Inclisiran delivery implementation + enhanced support (VICTORION-SPIRIT) is a collaboration between pharma company Novartis, NHS England and Improvement, NorthWest EHealth, Health Innovation Manchester, and the National Institute for Health Research Applied Research Collaboration Greeter Manchester (NIHR ARC-GM).

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Box and syringe of inclisiran drug

The objectives across the familial hypercholesterolaemia and lipid management programme are:

  • To reduce the risk for heart attacks and strokes occurring across Greater Manchester
  • To reduce the risk of admissions and re-admissions associated with cardiovascular disease
  • To reduce health inequalities by ensuring a consistent, local approach to lipid management, using a NICE approved clinical pathway;
  • To provide a pathway to optimise the identification of those with the genetic condition familial hypercholesterolaemia (FH) by completing the FH Cascade service Proof of value and commencing roll out
  • To provide more treatment options to high-risk patients who remain at risk despite maximum tolerated statin therapy via new novel technologies and existing unused treatment options

HInM will take a whole pathway approach to the programme, including:

  • Systematic and opportunistic population-wide health checks
  • Supporting primary care to identify potential FH through systematic database searches
  • Supporting primary care with increasing lipids expertise and education resources
  • Engaging and awareness raising about FH and lipid management
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