Powering The Prevention Shift

New analysis shows the NHS could prevent 100,000 heart attacks, strokes and other serious conditions over five years and deliver £5 billion in benefits

Highlights

• Almost 100,000 serious cardiovascular events (including heart attacks, strokes, heart failure and end-stage kidney disease) could be avoided in England over 5 years (99,158 modelled) by ensuring more people receive established, affordable NICE-recommended medicines.

• The analysis is underpinned by CVDACTION—a smart data tool that searches GP records, prioritises at-risk patients, and supports healthcare teams to optimise treatment.

• Aligns with the NHS 10 Year Plan’s shift from sickness to prevention and its mission to prevent cardiovascular disease: the cause of 1 in 4 deaths in England.

A major new national analysis — Powering the Prevention Shift — shows how the NHS could prevent 100,000 serious cardiovascular events in five years by adopting CVDACTION, a smart data and implementation programme that helps primary care teams identify and optimise treatment for patients at risk of cardiovascular disease (CVD).

CVD remains one of the greatest health challenges facing the UK. It accounts for a quarter of all deaths, is a leading driver of health inequalities, and creates significant pressures on the NHS and the wider economy. Yet much of this burden is preventable — not only through lifestyle changes but through secondary prevention: routinely using proven, NICE-recommended medicines to treat high-risk conditions (hypertension, high cholesterol, diabetes and chronic kidney disease). Optimising these therapies helps prevent heart attacks, strokes, heart-failure admissions and kidney failure.

The independent analysis, commissioned by Into-Action.Health, was conducted by Economics by Design and Get the Data in response to the CVD prevention challenge: too many high-risk patients miss out on proven therapies, and busy primary care teams struggle to identify and optimise them amid complexity and time pressure of routine care. For example, one in three people with hypertension are not on sufficient medication to control their blood pressure. Using a robust economic model, this analysis assesses the impact of using CVDACTION to support teams to act at scale.

The report models three scenarios: Step Change, Advanced and Full Uptake. Step Change is the minimum realistic near-term improvement level — using CVDACTION to find patients on suboptimal therapy and optimise treatment within routine workflows. Advanced goes further; Full Uptake is a theoretical 100% optimisation.

Five years of Step Change would avoid 99,158 events:

• 16,556 heart attacks avoided

• 31,000 strokes avoided

• 47,918 heart-failure admissions avoided

• 3,684 cases of end-stage kidney disease avoided

The economic benefits over five years are estimated at £5 billion, after accounting for the cost of increased use of medicines, driven by fewer avoidable admissions and complications, reduced use of health and social care, less reliance on unpaid carers and improved productivity. The estimated return on investment would be more than £5 for every £1 spent.

The analysis recognises the pressure on GPs and primary care. CVDACTION proactively identifies people who are not on the right preventive treatments, helps clinicians prioritise, and provides structured support so teams can adapt ways of working to optimise treatment within capacity. Treating before complications arise avoids serious events, reduces emergency admissions, frees clinical time and helps relieve pressure across the system.

The CVDACTION dashboards also show treatment gaps in people who are at higher risk of CVD due to social deprivation, ethnicity and severe mental illness, as well as by age and sex. This makes it easier to target outreach and treatment optimisation to communities most often left behind, helping reduce unwarranted variation and narrow health inequalities in CVD outcomes.

Dr Matt Kearney OBE, GP and former National Clinical Director for Cardiovascular Disease Prevention in England, and co-founder of CVDACTION, said:“This landmark report shows we can do much better at preventing cardiovascular disease. We know from NICE guidance what to do; the decades-long challenge has been how to do it in real-world primary care with all its pressures. The solution is to change how we manage high-risk patients - making smart use of GP data to identify those on suboptimal treatment and to optimise therapy at scale.

No change is not an option. This single intervention can have a huge impact on population health in a short timeframe - prevention that delivers now, not in the distant future.”

Professor Bryan Williams, Chief Scientific and Medical Officer at the British Heart Foundation, said: “Optimising cardiovascular prevention is key to turbocharging the country’s health as well as the wider economy, as this analysis clearly shows. Smart tools like CVDACTION can help doctors identify more people at highest risk of heart attack, stroke, and, importantly, target support to patients whose background or circumstances could mean that they are more at risk or less likely to receive treatment. This is the kind of innovation that could help to drive much-needed huge improvements in the prevention of cardiovascular disease.

“We’re on the cusp of a revolution in how we detect and manage key risk factors like high blood pressure, cholesterol and diabetes, and this must be prioritised as the Government progresses the 10 Year Health Plan and develops a modern framework for cardiovascular care.”

About CVDACTION

CVDACTION is a smart data tool that identifies all patients who are at high risk of CVD because they are not on NICE recommended preventive therapy and provides structured support to primary care teams to adapt workforce and pathways and to optimise treatment at scale.

Developed at UCLPartners, national deployment and further development of CVDACTION are now led by Into-Action.Health.

About the report

The CVDACTION Impact Model is a discrete-time, cohort-based Markov economic model. It estimates clinical events avoided, costs and economic benefits to the health and social care system, the economic benefits of reduced informal care, and improved productivity arising from reduced morbidity and premature mortality. Data sources included national datasets, pilot and sample site data and peer-reviewed evidence on treatment effects, event probability and costs. The model focuses on 4 high impact treatments that are NICE recommended but substantially underused in conditions that cause CVD: high blood pressure, high cholesterol, diabetes and chronic kidney disease. The specific treatments are blood pressure lowering, cholesterol lowering, renal angiotensin antagonists and SGLT2 inhibitors.

Exclusions: The model does not include the value of improved health-related quality of life to individuals, nor fiscal impacts (tax revenues/welfare). Results therefore conservatively reflect health and social care, informal care and productivity perspectives.

The full report and ICB-level results are available here.