Issue Multiple agencies interested in improving Cardiovascular Disease (CVD) prevention were working in silos, resulting in repeated approaches to CCGs offering a variety of solutions in partnership with different organisations, causing confusion and limited outcomes.

Intervention London CCGs requested the Cardiac and Stroke Clinical Networks to develop a unified approach. The Networks engaged improvement organisations forming the London Cardiovascular Disease Prevention Partnership (CVDPP) to achieve this for Atrial Fibrillation, Hypertension and Familial Hypercholesterolaemia. Condition specific steering groups were formed to provide clinical, patient and system leadership and support delivery of improvement projects.

Strategy for improvement The CVDPP held workshops attended by numerous system partners to develop a London vision for CVD prevention, share best practice, include patients and discuss solutions to common barriers.

A RACI was used to clarify roles of organisations engaged in CVD prevention. Detailed plans for each condition are being developed with STPs using a logic model and menu of evidence-based interventions. Agreed detection and treatment targets for each condition to be achieved by 2023.

Impact

1. Increased detection and management of CVD risk factors;

2. Additional 400 lives saved each year by reducing heart attacks and strokes;

3. Empowering Londoners to take control of their circulatory health.

Lessons learnt Working collaboratively and innovatively across organisations with competing priorities brings complexities. Implementing large scale change across a complex and varied landscape requires patience, flexibility and time coupled with a clear aim.

Messages for others Working in a co-ordinated partnership minimises duplication and maximises utilisation of limited resources to achieve large scale change. Multiple and sometimes conflicting approaches to commissioners has been eliminated through partnership working.