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Pharmacist-led virtual clinics help cut stroke rate by 25%

Pharmacist-led 'virtual clinics' in Southwark and Lambeth have helped reduce the rate of stroke by 25% for patients considered at greatest risk.

The project – a collaboration between the two CCGs and King's College Hospital NHS Foundation Trust – aimed to improve rates of blood clot prevention treatment (anticoagulation) to help manage atrial fibrillation (AF) [a condition causing an irregular heart rate] in general practice.

Over a 12-month period, the programme worked to identify and treat those at the highest risk of stroke, by reviewing over 1,500 patients across 91 GP practices who had AF, but were not receiving blood clot prevention treatment.

This resulted in an additional 1,200 patients receiving the blood clot prevention treatment and, in the following three years, has seen the rate of AF-related strokes fall by 25% - compared to a 3% fall nationally.

Specialist pharmacist-led 'virtual clinics' in GP practices decided which patients would benefit most from focused treatment, discussed the different options available, and produced personalised plans for each individual patient.

A virtual clinic is an opportunity for GP practice staff to discuss how they can improve the care of individual patients with a local specialist – in this case, a pharmacist. The virtual clinic can be face-to-face in the GP practice, or delivered remotely using new technologies.

The programme has since been rolled-out to other CCGs in south London, with similar increases in the number of patients receiving anticoagulation and a reduction in AF-related strokes.

NHS Southwark CCG was 'highly commended' for its work on pharmacist-led virtual clinics at the HSJ Awards, held in November 2018.

Helen Williams, Consultant Pharmacist for cardiovascular disease at NHS Southwark CCG, said:

"It was widely recognised, both locally and nationally, that a significant number of stroke patients were not receiving anticoagulation treatment, despite being known to have atrial fibrillation.

"Working with health and care partners across Lambeth and Southwark, our pharmacist-led virtual health clinics have helped ensure that an additional 1,200 people with AF are receiving the blood thinning treatment – with a consequent reduction of 25% in the number of AF-related strokes.

"The programme is an excellent example of how colleagues from across the NHS can work collaboratively to deliver improved health outcomes for local patients, and I'm delighted that as a result of its success, the model has been rolled out to other areas – with similarly positive outcomes."

Find out more about the programme, including what went well and where improvements can be made, by reading the full case study published by Public Health England.

Photograph: Pharmacists Tara Patel (left) and Ann-Dora Kwame (right), and Dr Aparna Babu (centre), local GP and Clinical Associate for Antimicrobial Stewardship, at the HSJ Awards 2018