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Cardiovascular Disease Prevention Opportunities Tool.

Release of the cardiovascular disease prevention opportunities tool
The cardiovascular disease (CVD) prevention opportunities is a tool that provides a snapshot view of the disease events that could be prevented and their potential cost savings if primary care treatment of cardiovascular and cardiovascular-related conditions were optimised to higher levels within CCGs. The prevention and savings are referred to as “opportunity”.


The tool looks at the current number of people treated in a clinical commissioning group (CCG) for a set of defined interventions where two criteria are filled:


The tool produces outputs at CCG level for some clinical therapy measures recorded in Quality and Outcomes Framework (QOF) for a small number of disease events. A total of four interventions in six populations are available:
1. Controlling blood pressure in adults with hypertension
2. Controlling blood pressure in adults with:
a. Diabetes
b. Stroke
3. Controlling cholesterol in adults with:
a. Diabetes
b. CHD
4. Anti-coagulation treatment in patients with atrial fibrillation

Method of defining opportunity


The difference between the current CCG treatment levels for the four measures outlined above to a comparator treatment level gives an additional number of people that could be treated. The opportunity is simply the NNTs applied to this additional number of people.


The tool is currently published using a practice comparator method, which uses practices within the CCG. The treatment level for the CCG is compared against the treatment levels of a practice which performs at the 75th percentile of the range of all practice treatment levels within the CCG. This method shows the opportunity in shifting from the average to top quartile treatment levels found within the CCG. The tool can also show opportunity at other practice comparator points within the CCG.


When looking at this information, CCGs should consider the opportunities possible for them locally to contribute toward national potential opportunities. If all CCGs in England had the same levels of blood pressure control in patients with hypertension at the level of their practices at the 75th percentile, then more than 4,200 strokes, 2,750 heart attacks and 2,200 deaths could be prevented over five years in these patients.

The practice comparator publications can be accessed here:

http://www.yhpho.org.uk/resource/view.aspx?RID=226091

We would welcome feedback on this tool, as it is a first version and may be revised or developed further at a later stage, including using different comparator methods.
Feedback should be sent to healtheconomics@phe.gov.uk.

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The team does not and cannot offer clinical advice. If you have any urgent medical enquiries we urge you to contact your GP, or NHS Direct at www.nhsdirect.nhs.uk or by calling 0845 4647. In an emergency call 999