Wallsend Community CVD Prevention Pilot

A Wallsend cardiovascular disease (CVD) prevention pilot was developed by the North Tyneside Community CVD Prevention project group, of which the AHSN NENC is a part. The pilot was led by North Tyneside Council and aimed to test a place-based approach to increase the detection of high blood pressure (hypertension) and Atrial Fibrillation (AF). The project delivered community CVD checks for people registered with GP practices in the Wallsend Primary Care Network (PCN), but has the potential to be rolled out in other areas.

Hypertension and AF are conditions that increase the risk of cardiovascular disease . The symptoms for both can be hard to spot and the conditions often go undiagnosed. If these conditions are diagnosed and managed early enough, the risk of heart attacks and strokes can be lowered.

To make the health checks accessible and minimise the perceived barriers that might stop residents from engaging, the checks were hosted at easy-access, community venues – such as job centres and libraries. Participants did not require an appointment and were encouraged to attend at a time that suited them.

Contact Details

Project Dates

Project Start 15/03/2023
Project End Ongoing

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Cardiovascular Disease (CVD) accounts for over a quarter of all deaths in the UK and is a major driver of health inequalities. Risk factors include high blood pressure (hypertension) and having an irregular heart rhythm (Atrial Fibrillation – AF) which often go undiagnosed yet are highly modifiable. AHSN NENC were delighted therefore to support North Tyneside Council with their project to test different approaches to identifying hypertension and AF in community settings. In addition to gaining a valuable insight into the benefits and potential challenges to undertaking testing in the community, the project has also raised awareness of CVD with the public and promoted healthy lifestyle behaviours. This learning will be used to inform future activities regarding case finding in the community both within the region and across the country.
Karen Verrill, Programme Manager, AHSN NENC
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Hypertension and AF are conditions that increase the risk of CVD and the likelihood of heart attacks and strokes. CVD is the leading cause of morbidity, mortality and health inequalities in England. It disproportionately affects those living in deprived communities, with the 10% most deprived almost twice as likely to die from CVD compared to the 10% least deprived in the population.[1]

In North Tyneside, it is estimated that 28.2% of the population have hypertension[2], and 2.7% have AF[3]. However, out of these percentages, it is that 23,000 people have undiagnosed hypertension and a further 1,200 undiagnosed AF.

Several barriers were identified, that may have prevented people from receiving an NHS health check in the past. This included a poor relationship between patients and their GP, a lack of understanding of CVD risks and the purpose of an NHS health check and inconvenient times and locations for checks.

[1] NHS England. Cardiovascular Disease (CVD). Available from: https://www.england.nhs.uk/ourwork/clinical-policy/cvd/

[2] Public Health England (2020). Hypertension prevalence estimates for local populations. Available online

[3] Public Health England (2020). Atrial fibrillation prevalence estimates for local populations. Available online.

 

 

The Wallsend CVD Prevention Pilot aimed to test place-based approaches to increase the detection of hypertension and atrial fibrillation, as well as raise awareness of CVD and the associated risks, within hard-to-reach communities. The pilot provided accessible health checks at community locations, targeting those living in lower-income areas, who are disproportionately affected by CVD and its risks.

Prior to the pilot, the AHSN NENC provided training in AF detection to staff from multiple organisations who would be carrying out health checks. TyneHealth also provided training in hypertension testing.

The pilot was carried out for 12 weeks, between the 15 March 2023 and the 7 June 2023. During this time:

  • Nine health check sessions were delivered by Active North Tyneside (ANT) and 128 individuals were approached to have a check
  • Tyne and Wear Fire and Rescue Service (TWFRS) delivered three sessions at vaccine pop-up clinics and 103 people received an AF check, while 75 received a blood pressure check
  • Newcastle United Foundation (NUF) conducted two workplace health checks, at which 29 mini-MOTs were completed, which included AF and BP checks

During the pilot, feedback was collected from staff and participants which informed the evaluation. A full evaluation of the pilot has been completed by Dr Rachel Pearse, Public Health Specialty Registrar. Any relevant learning has the potential to be scaled up and rolled out to other PCN areas.

The pilot was received successfully, with 100% of participants who had a health check, stating that they would be happy to receive a community CVD check in the future. Key feedback from the pilot was that staff provided good, simple explanations of the procedure and results. Participants found that the check was less intimidating than visiting a GP and that the experience was quick and easy.

During the pilot, at least 49 people were advised to seek further follow-up from their GP, after receiving abnormal results. Although not everyone advised to follow up with their GP will be diagnosed with AF or hypertension, it is hoped that this will raise awareness of CVD and the importance of diagnosis and prevention. Those that attend an appointment with their GP due to the results of their check, will receive general health improvement advice, which is hoped to encourage positive lifestyle changes.

Early diagnosis and management of AF and hypertension has been found to significantly improve a patient’s health, by preventing cardiovascular diseases. The benefit to this is an increased quality of life for the patient and potentially less time spent in hospital, which eases the burden on NHS resources. By targeting harder-to-reach groups, the pilot has the additional benefits of minimising health inequalities and bolstering a positive relationship between North Tyneside Council and the community.

The pilot has benefitted the AHSN NENC by providing insight and understanding of the potential barriers that would deter patients from getting tested for conditions like AF or hypertension. This information is vital and will be used to inform future projects and roll-out.

 

The pilot was funded via a grant from the AHSN NENC. The grant was used to procure test equipment, which can be used again if the pilot is rolled out to other PCN areas. The grant was also used to arrange training for NUF and TWFRS staff to support community CVD prevention sessions in North Tyneside.

The AHSN also provided input into the Community CVD Prevention project group and delivered free training on the use of AliveCor devices, which were used to test for AF.

North Tyneside Council will fund the roll-out of the pilot to the next PCN area in North Shields. Following this, the pilot be extended to the rest of the Borough using funding from the Public Health Grant.

At North Tyneside Council, the health and wellbeing of our residents is a top priority. We are really excited to lead on this work to help our residents check on their wellbeing in a quick, easy and accessible way without the need for an appointment or a visit to their doctor. High blood pressure and Atrial Fibrillation (AF) can increase the risk of strokes and heart attacks, but many people don’t know they have these conditions as they don’t always cause obvious symptoms.
Louise Gray, Consultant in Public Health, North Tyneside Council