Reducing strokes and the impact they have on lives is important to the West Yorkshire & Harrogate Sustainability and Transformation Partnership (STP). Of course it is; Managing Atrial Fibrillation and hypertension prevents strokes, can be done in general practice and keeps people out of hospital. Our STP has a plan. It’s a plan built on trust. It has to be. STPs are delivery networks. They have to deliver with only the authority gifted to them by the sum of all the planners and decision makers across their footprint. Not an easy job when you are planning for a diverse population of more than 2.4m people.
WY&H have a strong track record in stroke prevention. Prior to forming as an STP the commissioners formed the Healthy Futures collaborative. Working with Yorkshire & Humber AHSN this collaborative created a commissioning plan to improve therapy for patients known to have AF. This successful strategy has seen 8,094 more patients benefit from care and is calculated to be preventing around 200 strokes a year.
So how do we go further? Yorkshire & Humber AHSN has supported the STP to move from plan to action; as a partnership of places. Our innovative approach starts with the STP setting an aspiration for the population, a challenging target to find and treat more people with heart rhythm irregularities than ever before. It capitalises on the cross sector constitution of the STP by calling on the acute trusts to offer support to primary care colleagues so that general practice can deliver the improvements necessary.
But the clever bit is how we will get the biggest impact from scare resources. The approach is to work with willing practices with the most patients to find and treat, irrespective of the practices ‘performance’ compared to their peers and irrespective of the CCG the practice is in. Some practices will get more support than others, some CCGs will see more activity than others, some will benefit more than others and some will feel the squeeze on their drugs budgets more than others. But the partnership will benefit as a whole, more strokes will be avoided and the financial benefit will be seen in the collective reorganisation of stroke services (Hyper Acute Stroke Units –HASUs).
This approach is novel in a second way. We only work with the willing. Willing practice teams with the most patients to see. Why? Because the work goes faster and achieves more. One volunteer is worth ten pressed men as the saying goes. Our quality improvement methods make it as easy as possible for practices to meet their challenges, but they have to do the work themselves. We will work hard to sing the praises of our first willing practices and use their successes and advocacy as extension agents into the next wave of practices. We are confident that willing practices exist because 32 practices are already working with us, voluntarily, to improve the care of their AF patients.
AF awareness week is a great time to reflect on the great work being done by General Practice teams across the country in reducing strokes. General practice may be stretched for resources but our diligent and caring practice teams are the pride of the nation and continue to improve the care they provide. The West Yorkshire and Harrogate STP is embracing this and in doing so, is making their plan into a partnership.