Pharmacy Atrial Fibrillation Pilot Project Delivery Specification for GP practices and Community Pharmacy - Version 7.11.19 - Delivery specification

Aug 31, 2026

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Pharmacy Atrial Fibrillation Pilot Project Delivery Specification defines how GP practices and Community Pharmacy work together to improve identification, anticoagulation and ongoing monitoring of atrial fibrillation (AF). It frames AF prevalence, under-diagnosis and the stroke burden in Halton and Knowsley, linking improved diagnosis and management to reduced inequalities and potential savings. The specification sets pilot aims, objectives, stakeholder roles, inclusion and exclusion criteria, consent and referral pathways, and establishes reporting, performance monitoring, quality standards and a payment schedule.

LanguageEnglish

CategoryPresentations

FormatDOCX

Pages23

Reading Time8 min

AccessFree to download

Introduction and background

Cost implications of improving diagnosis and management of AF

Pilot project aims and objectives

Project stakeholders and mobile technology

Project outline

Pharmacy project key outcomes

Performance monitoring and data

Payment schedule and invoicing details

Appendix

Pharmacy-Atrial Fibrillation Pilot Project Delivery Specification for GP practices and Community Pharmacy November 2019 Vanguard House, Sci-Tech Daresbury, Halton, WA4 4AB Offices also in Liverpool and Preston 01772 520 263 | 0151 702 9492 info@innovationagencynwc.nhs.uk Contents Introduction & background Cost implications of improving diagnosis and management of AF Pilot Project aims and objectives 3.1: Project aim 3.2: Project objectives Pilot project stakeholders Mobile technology 5.1: MyDiagnostick 5.2: Kardia Mobile Project outline 6.1: Inclusion and exclusion criteria 6.2: Community Pharmacy AF Pathway 6.3: Identifying new potential AF 6.4: Consent 6.5: Referral for ongoing review Pharmacy project key outcomes 7.1: Data collection for key outcomes 7.2: Project risk table Possible project target outcomes Performance monitoring and data Performance quality standards Payment schedule 11.1: Community Pharmacy 11.2: GP site Invoicing details References Appendix 1: CHA2DS2VASc Appendix 2: Participant consent form Appendix 3: Patient Information Appendix 4: How to take a MYDIAGNOSTICK reading Appendix 5: How to take an AliveCor Kardia Mobile ECG 1: Introduction and background The NHS Long Term Plan has indicated a strong emphasis on modifiable mortality, highlighting Cardiovascular Disease and specifically Atrial Fibrillation (AF) where substantial savings can be made alongside gains in population health. Atrial fibrillation (AF) is the commonest sustained atrial arrhythmia. It is characterised by a rapid, irregular heartbeat. In England, approximately 985,000 people have been diagnosed with AF with a diagnosed prevalence rate of 1.7%. However, this is likely to be an underestimate with an actual prevalence around 2.5% (PHE, 2017); more men are expected to be living with AF at 825,000 compared to women at 580,000 (PHE, 2017). This suggests that there are nearly half a million people living with undiagnosed AF across England. AF significantly affects a patient’s quality of life; it increases morbidity and mortality. Patients with AF need to be appropriately anticoagulated to reduce their risk of stroke. Their ventricular rate must be controlled to reduce both symptoms, and the risk of tachycardia-induced cardiomyopathy. One third of patients who have AF are asymptomatic, often leading to a delay in diagnosis. Too often, AF is only detected when the patient presents with a serious complication, such as a stroke (NICE, 2014). Data has shown that there is a need to improve identification of AF and anticoagulation rates in the North West Coast. Data for 2017/2018 has shown that there are approximately 5,891 AF patients (QoF 2016/17) (2,793 and 3098) with 902 patients with AF who are currently unknown. This equates to approximately £2 million per year on NHS and social care costs of AF stroke amounting to approximately 2,340 bed days. In addition to this, data shows that approximately half of patients who have a diagnosis and receive treatment go on to have strokes. This indicates that more support is required in the monitoring and management of patients with AF and on treatment with an oral anti-coagulant including understanding behavioural factors which might influence adherence to treatment (NICE, 2014). The NHS Long term Plan is committed to looking at new roles in the NHS to support GPs and primary care and mitigate workforce pressures. In order to find the missing AF patients there is a need to work differently and involve healthcare professionals outside primary and secondary care. Community Pharmacists have been identified as being able to take a more active role in identifying and supporting a range of Cardiovascular conditions (NHS Long Term Plan, 2019). Halton and Knowsley are in the 20% most deprived areas of the country. In more deprived areas people with CVD are twice as more likely to die prematurely as people living in the most affluent boroughs. In Halton and Knowsley resident males die approximately 9 years younge

FAQs

What is the purpose of the AF pilot project for GP practices and Community Pharmacy?

To test how Community Pharmacists support primary care in detecting and monitoring patients with atrial fibrillation, improving outcomes using technology and innovative services.

Why does the document emphasize improving AF detection, correction and ongoing monitoring?

Because AF is often under-diagnosed and inadequately managed, leading to preventable strokes, deaths, and health inequalities in Halton and Knowsley.

What key elements does the specification include beyond the project aims?

It covers stakeholder roles, mobile technology options, inclusion/exclusion criteria, consent and referral for review, key outcome data collection, risk and performance standards, and a payment schedule.

Aug 31, 2026

Upload by Oliver