Health: Atrial Fibrillation and Stroke

Lord Colwyn Excerpts

Tuesday 12th December 2017 Lords Chamber

[Lord O'Shaughnessy]

Yes, I shall certainly write to NHS England to find that out, and I will write to the noble Baroness with that information.

[Lord Colwyn (Con)]

My Lords, it is quite clear that many people do not receive the anti-coagulants that they need, and my noble friend has reminded us of the figures relating to those suffering from this problem. Since 2012, four novel oral anti-coagulants—NOACs—have been recommended by NICE as both clinically and cost effective for the prevention of stroke in patients with AF. Their use is increasing but is lower than expected. Can my noble friend explain why access to the full range of anti-coagulation therapies is not acceptable to many GPs, who appear to lack confidence in their use of NOACs, and why some patients are still being given aspirin to prevent AF-related stroke? I should declare my interest as an officer of both the Arrhythmia Alliance and the Atrial Fibrillation Association.

[Lord O'Shaughnessy]

My noble friend is quite right to highlight the benefits that come from new treatments. We clearly have a long way to go, as half the people presenting with strokes have not had those anti-coagulants, but there has been an increase in the number of pre-stroke patients receiving anti-coagulants, up from 38% to 53%, so it is an improving picture. The NICE guideline recommends the use of anti-coagulants and, critically, encourages patient choice for the new breed of NOACs and DOACs. There is very clear guidance within the system. It is getting better, but there is some way to go.