Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what steps his Department plans to take to (a) identify and (b) support young people at risk of cardiac problems.

There are a number of inherited cardiac conditions. These include familial hypercholesterolaemia (FH) (which leads to premature cardiac disease and reduction in life expectancy), and conditions which increase the risk of sudden cardiac death.

The responsibility for commissioning FH services lies with local clinical commissioning groups (CCGs). Provision of services will take into account the needs of the population overall.

NICE has published a guideline on the identification and management of FH which includes recommendations that children at risk because they have a parent with FH should have diagnostic tests before the age of 10. The national clinical director (NCD) for heart disease at NHS England is working to promote cascade testing for the relatives of people who have hypercholesterolaemia. NHS England’s NCD has also worked closely with the British Heart Foundation in their appointment of FH Nurses to undertake genetic testing, and with the other major charity in this field - HEART-UK.

NHS England is working closely with Public Health England (PHE) to identify the barriers to FH testing (and cholesterol management in general) with the support of the British Heart Foundation and a great deal is now being done to raise the profile of this condition, break down the barriers to genetic testing and provide better management of the condition.

With regards to those conditions which may raise the risk of sudden cardiac death, the National Screening Committee concluded that a national screening programme was not appropriate. However, children who are taken on by football clubs for formal youth training do undergo cardiac screening as do a number of professional sports participants.

A recent review concluded that childhood obesity not only increases cardiovascular risk in adulthood, but it is also associated with cardiovascular damage during childhood.

To identify and support children classified as obese and therefore at risk of cardiovascular disease, PHE oversees delivery of England’s National Child Measurement programme (NCMP). NCMP provides robust local and national data on child weight status to inform health service planning and engage families through the provision of feedback of results to parents. Local authorities are provided with guidance to support the delivery of the NCMP programme and encouraged to sign post parents to local weight management services where possible.

The programme covers children in Reception (ages 4-5 years) and Year 6 (ages 10-11 years), and is now a mandated public health function of local authorities.

There is also strong evidence for a positive association between physical activity and cardio-metabolic health among school aged children, with higher levels of physical activity associated with higher levels of cardiovascular and metabolic health.

PHE is working to support children to adhere to healthy eating guidelines and meet the Chief Medical Officer’s physical activity guidelines through a number of approaches including through its flagship Change4Life programme and the development and implementation of the framework, ‘Everybody Active, Everyday’ at national and local level. This framework sets out a long term, evidence-based approach to embed physical activity into daily life.