Project Name: Optimisation of patients with CVD conditions to address health inequalities and improve outcomes for patients across Primary Care 24 Limited Social Enterprise 

Project Summary:

The CWP is structured such that a multi-disciplinary health professional team will provide tailored care for patients, aligned with the social enterprise group, and the locally defined cardiovascular plans.

The main objective of the CWP is to improve the quality of care for patients and to support:

  • The early identification, review, and medical optimisation of patients with atherosclerotic cardiovascular disease (“ASCVD”) who are at high risk of cardiovascular events and who are not achieving lipid levels as specified in national and/or local guidance.
  • The identification of patients with heart failure with reduced ejection fraction (“HFrEF”) to optimise their current heart failure (“HF”) medications in line with ESC (European Society of Cardiology) HF guidance. 
  • A proactive and comprehensive approach to monitoring known cardiovascular disease (“CVD”) risk factors.

Expected Benefits:

Anticipated patient benefits:

  • Improved access to care leading to optimal diagnosis and management of treatments.   
  • Enhanced experience around disease with ongoing management of their condition.   
  • Improved access to appropriate medication for suitable patients to preserve health and prevent long-term events.  
  • Easier access to care closer to home in the Primary Care setting.
  • Identification and focus on patients who may have previously not attended a GP appointment or been lost to follow-up. Thus, leveling health inequalities within the social enterprise group

Anticipated organisation benefits:

  • Increased proportion of patients reviewed by primary care.   
  • Increased proportion of patients receiving expert and timely review closer to home.  
  • Reduction in patient referral rates to secondary care.  
  • Increased proportion of patients receiving guideline-directed pharmacotherapy.  
  • Insight into benefits of primary care nurse led management clinics in primary care with MDT collaboration.   
  • Support aligned to NHS Long Term Plan, CVDPREVENT, is aligned with the social enterprise group, and the locally defined cardiovascular plans.

Anticipated Novartis Benefit

  • Insight on the use of licensed medicines in line with NICE guidelines, including Novartis’s medicine, where appropriate
  • Enhanced reputation and supporting Novartis’ vision that no patient should have to wait for an extraordinary life, by supporting high quality Collaborative Working with healthcare organisations which addresses the problem of health inequalities.  
  • Ethical, professional, and transparent relationship between Novartis and the Healthcare Organisation.

Start Date & Duration: February 2025 for 15 months

FA-11385678 | March 2025