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 aims to improve the management of cholesterol, increase the detection of those with Familial Hypercholesterolaemia and optimise the use of all medicines for patients on the cholesterol management pathway.

AHSNs will work with NHS trusts and primary care services across England to improve the offer to people with known or previously unknown high risk of cardiovascular disease, to ensure their blood cholesterol levels are understood and that the patient receives the appropriate treatment along the pathway.

 

Medical professional reviewing cholesterol lipid panel results

There are 3 focus areas

  1. Familial Hypercholesterolaemia (FH) detection and lipid management optimisation to reduce death and disability due to premature CVD. This includes expanded access to genetic testing for FH via screening of electronic records.
  2. Working in partnership with the Accelerated Access Collaborative (AAC) Rapid Uptake Products (RUP) lipid management programme to accelerate patient access to appropriate medicines to enable lipid treatment using the NICE-recommended clinical pathway, with a focus on secondary prevention and including novel therapies.
  3. In partnership with HEARTUK, The AHSN Network are delivering the Tackling Cholesterol Together education programme and the Cholesterol Now campaign. The Education Programme aims to provide clinicians and managers with the opportunity to learn about different elements of the lipids pathway, from internationally regarded experts in the field and supports the broader objectives of our lipids national programme.

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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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