Making Best Practice, Every Day Practice
Cardiac and stroke networks enable change and support the implementation of national strategies, such as the National Stroke Strategy which was published in 2007. There are 28 cardiac and stroke networks in the country: they play a fundamental role in bringing together commissioners, providers and patients to plan and deliver high-quality services for their populations.
Keep up the good work’ is the theme of this issue of BJPCN, with latest figures showing that the structured care we provide to our patients is helping to save lives. But we are not there yet – so we are looking at remaining challenges in managing cardiovascular disease and what more we can do to really make a difference to our patients’ lives.
Chronic kidney disease (CKD) has shot up the primary care agenda over the last few years, and is now well recognised as an independent risk factor for cardiovascular disease (CVD). At the same time, CVD is a risk factor for progression of CKD. The close links between CKD and CVD mean we have to get to grips with assessing patients’ kidney function and ensuring those with CKD receive the treatment needed to prevent progression. This special issue devoted to CKD is full of step-by-step guides and illustrated articles to help you get to grips with this important condition.
The effective management of long-term conditions such as chronic kidney disease (CKD) is probably the single greatest challenge faced by the NHS. The population is growing and people are living longer. Every week, the life expectancy for a newborn baby in the UK increases by more than 24 hours. While this is, in part, testament to the success of our health services, it also places steadily increasing demands upon them. As the population ages, the number of people living with long-term conditions is predicted to triple by 2050.
There are 28 cardiac and stroke networks in the country. They play an important part in implementation of national strategies, enabling high-quality services to be planned and delivered to patients within the framework of primary and community care. One of the most useful contributions of the networks is provision of education and training for primary care staff. The “Back to Basics” material in this supplement forms the backbone of what is presented at study days. The articles cover some of the most common cardiovascular conditions that are seen in primary care, showing clearly what causes the symptoms, how best to assess and manage patients, and how the treatments actually work. They help healthcare workers both to understand these conditions and to explain them to patients, and therefore really improve patient care.
This educational supplement is brought to you by the Cardiac and Stroke Network. What is this Network, and how can it further support your education and development?
The government’s new public health strategy, Healthy Lives, Healthy People, aims to transform public health and – perhaps for the first time – to create a ‘wellness’ service to meet today’s health challenges. We may have our reservations about the NHS reforms, but improving public health is something we can all sign up to. So this issue of BJPCN focuses on one of today’s key public health challenges – obesity.
Are you sitting comfortably? Then I’ll begin. Once upon a time… Telling stories is something that many of us do with our children. But what about with our patients, and what about encouraging patients to tell their stories? In this issue of BJPCN, we share some exciting new research showing that patients with high blood pressure can learn from each others’ stories. And we help you to fill in the gaps so you’ve got a clear story to tell during routine consultations with patients with cardiovascular disease and diabetes.
As many will know, the Secretary of State for Health, Andrew Lansley, announced last December that the government would be developing a new strategy for cardiovascular disease under the direction of Sir Bruce Keogh (NHS Medical Director). As part of this work two Interim National Clinical Directors have been seconded to the Department of Health: me (Professor Huon Gray, University Hospital of Southampton) for Cardiovascular Disease and Dr Damian Jenkinson (Royal Bournemouth Hospital) for Stroke. Both are part-time secondments and together cover the work previously overseen by Professor Sir Roger Boyle, before his retirement last summer.
It is exceedingly uncommon for a woman in the UK to die during pregnancy, with maternal mortality in the region of one death per 10,000 maternities1. Although there have been very significant improvements in antenatal care, such as a marked reduction in the number of deaths due to thromboembolic disease, other areas are trailing behind. One such area is cardiac disease – now the leading cause of maternal death in the UK. These relatively rare deaths also mask the much larger issues of maternal, fetal and perinatal morbidity. The most recent Confidential Enquiries into Maternal Death and the new European Society of Cardiology guidelines summarised in this issue of the PCCJ highlight the major clinical issues and attempt to provide consensus opinion regarding optimal care in what is a relatively evidence-sparse field.
The prevalence of many physical illnesses is increased in people with severe mental illness and accounts for around three quarters of all deaths; cardiovascular disease is the commonest cause of death. The level of screening for and management of diabetes and cardiovascular risk factors remains low but a straightforward yet systematic care pathway should go a long way towards reducing the health inequalities experienced by people with severe mental illness.
The European Primary Care Cardiovascular Society (EPCCS) exists to inform, support and interact with general practitioners (GPs) across Europe in relation to cardiovascular disease, including stroke and diabetes. The EPCCS provides an interactive and expanding website at www.epccs.eu with news, comments, information, meeting reports and slide presentations.
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