The Government’s National Service Framework (NSF) for Coronary Heart Disease (CHD) identified CHD as the most common cause of premature death in the UK.

The NSF set out various standards, milestones and audit criteria for NHS organisations to achieve to demonstrate that high quality care is being provided to patients.

There are four areas within the NSF relating to primary care: secondary prevention of CHD, primary prevention of CHD, angina, and heart failure.

The National Primary Care Collaborative (NPCC) Phases l and ll focused on helping GP practices to achieve improvements for patients with established cardiovascular disease - secondary prevention.  

Phase l of the collaborative included four waves, each of which were run directly from the Improvement Foundation’s offices in Manchester.  

Phase ll of the collaborative involved the programme being rolled out nationally through the establishment of 10 regional centres (now area teams).

The Improvement Foundation’s current work on improving services for CHD patients can be found in the cardio-vascular disease section.

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Who is involved

Primary care groups/trusts were invited to participate and the table below outlines the involvement. Each organisation established an improvement team consisting of up to 15 people, including GPs, practice nurses, practice managers, a project manager, PCT senior managers and secondary care colleagues.

What we are doing

The work on CHD focused on the improvements that can be made within general practice for those patients who have established CHD. The aim was to ensure that these patients receive optimum care through the application of a systematic, sustainable approach. Equally importantly, the approach helped practice teams learn a crucial set of skills in improvement and in systems thinking that they can apply in other areas of work, particularly long-term conditions.  

Practices were asked to focus efforts around change principles and associated change ideas for the secondary prevention of CHD that the experience of others had shown to deliver maximum effect. These were:

• Know all your patients who have CHD
• Be systematic and proactive in managing care
• Ensure timely and high quality support from secondary care
• Involve patients in delivering and developing care
• Develop effective links with other key local partners.

Sharing experience and best practice, monthly measurement and feedback, and rapid change using the improvement model was central to the practices’ work.

Key results