ATRIAL FIBRILLATION & STROKE INSIGHTS TOOL CAN REAL - - PowerPoint PPT Presentation

ATRIAL FIBRILLATION & STROKE INSIGHTS TOOL –

CAN REAL WORLD/PUBLICALLY AVAILABLE DATA COUPLED WITH TTR DATA HELP THE NHS STOP STROKES?

Andrzei Orlowski - Programme Development Lead for Health and Implementation (Stroke and Atrial Fibrillation) Andrzei Orlowski - Programme Development Lead for Health and Implementation (Stroke and Atrial Fibrillation)

GREATER MANCHESTER ACADEMIC HEALTH SCIENCE NETWORK

Greater Manchester AHSN is a collaborative network bringing together 30 NHS providers and commissioners across Greater Manchester, East Lancashire Trust and East Cheshire and four universities. Our ambition is to deliver a step change in health

• utcomes and to support Greater Manchester's strategy

for growth through enabling £1bn of wealth creation

• ver five years, supporting SMEs and helping to create a

healthier population.

ATRIAL FIBRILLATION & AF RELATED STROKE HEALTH AND IMPLEMENTATION PROGRAMME Our Goal is to help prevent at least 365 deaths from avoidable strokes each year AF implementation programme is encouraging

• ur members to prioritise AF and the adoption of

NICE guideline CG180 (The Management of Atrial Fibrillation).

SHARE DATA Reflect our members data back Equal and equitable access Discuss variation with a fair comparison

• Percentage
• Absolute numbers
• Per 100k population
• ONS matched
• PHE matched

PREVALENCE AND INCIDENCE

*Publically available data *Publically available data

Quality Outcomes Framework* (QOF)

• AF disease register
• Stroke register

THE NUMBER AND COST OF STROKE

*Publically available data *Publically available data

Hospital Episode Statistics* (HES)

PATHWAY OF CARE

*Publically available data *Publically available data

Hospital Episode Statistics* (HES)

• Admission route
• From where to where
• Discharge destination – to home or to a home

RISK STRATIFICATION AND TREATMENT

*Publically available data *Publically available data

Quality Outcome Framework*

DATA ON THOSE THAT HAVE A STROKE

*Publically available data *Publically available data

Sentinel Stroke National Audit Programme* (SSNAP)

APPROPRIATE TREATMENT OF THOSE AT RISK

*Available from NHS IQ *Available from NHS IQ

GRASP-AF*

• Read code data interrogation tool
• Helps to find patients that could benefit from anti-

coagulation treatment

TREATMENT

*Publically available data *Publically available data

ePACT (electronic Prescribing Analysis and CosT)*

• By drug
• By pack
• By practice
• Great for NOACs
• Useless for warfarin and aspirin

TREATMENT ePACT (electronic Prescribing Analysis and CosT) Drug By pack By practice Great for NOACs Useless for warfarin and aspirin Publically available data

TREATMENT

THE MISSING PIECE - ANTICOAGULATION CONTROL WITH VITAMIN K ANTAGONISTS Numbers of patients being treated

• HES
• Outpatients only recorded by speciality not by specific
• utpatient clinic
• Very little OPCS coding for INR testing
• QOF
• Data on those on anticoagulation only (and those have to

be registered and have had an appropriate CHADS2 score)

• ePACT
• Numbers of tablets dispensed only

QOF CHADS2 being treated – NOAC = warfarin patients?

THE MISSING PIECE - ANTICOAGULATION CONTROL WITH VITAMIN K ANTAGONISTS Patients in range

• ….

THE MISSING PIECE - ANTICOAGULATION CONTROL WITH VITAMIN K ANTAGONISTS NICE Guidance (CG180)

• 2 INR values higher than 5 or 1 INR value higher than

8 within the past 6 months?

• 2 INR values less than 1.5 within the past 6 months?
• TTR less than 65%?
• But I think I know who may have the answers…

PARTNERING ON DATA By sharing your appropriately aggregated and anonymised data you can help create a tool that may help CCGs prevent deaths by allowing them to allocate resources to the most appropriate areas

PARTNERING ON DATA

• We currently have data on >22,000 patients

from 12 4SDAWN sites in Manchester and we are looking for more

• More data helps us compare ‘apples with

apples’

• Our tool has national data and is being offered

to all AHSN and any appropriate interested NHS organisation

CAN REAL WORLD AND PUBLICALLY AVAILABLE DATA COUPLED WITH YOUR TTR DATA HELP THE NHS STOP STROKES?

BY HAVING THE COMPLETE PICTURE

*Publically available data *Publically available data

CCGs can pick the most appropriate area

• Screening
• Pathway change
• Earlier treatment
• Treatment change

Questions?

andi.orlowski@gmahsn.org AF Programme lead jane.macdonald@gmahsn.org Director of Implementation