Volume 9, Number 9, October 2002

Implementation of the National Service Framework for Coronary Heart Disease in primary care
Caroline Levie, Stewart Findlay

The innovation of specialist nurses in coronary heart disease prevention across 12 practices in a rural County Durham Primary Care Trust (PCT) with a high rate of premature death from heart disease helped the Trust achieve the National Service Frame-work (NSF) for Coronary Heart Disease (CHD) targets and milestones. The introduction of nurse-led CHD clinics at each practice provided a structured follow-up for all patients with CHD to locally agreed guidelines. Audit data collected showed that after 12 months, the service showed an improved management of secondary prevention: more patients had had their cholesterol measured, more had received lipid-lowering medication and more had achieved target cholesterol levels of < 5.0 mmol/L than at baseline. Aspirin prescribing also increased. The PCT has also recently introduced a specialist heart failure nurse to carry out a similar programme and, in addition, has addressed cardiac rehabilitation to provide a home-based service for some patients.

Br J Cardiol 2002;9:554-559.

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