Atrial Fibrillation

(asked on 20th October 2016) - View Source

Question to the Department of Health and Social Care:

To ask Her Majesty’s Government what proportion of clinical commissioning groups have undertaken a systematic audit across GP practices to identify people with (1) possible undiagnosed atrial fibrillation, and (2) atrial fibrillation at high risk of stroke who are not anticoagulated or maintained in therapeutic range.


This question was answered on 1st November 2016

NHS England’s Sustainable Improvement Team is taking action to promote the use of GRASP-AF (Guidance on Risk Assessment and Stroke Prevention for Atrial Fibrillation) within general practitioner (GP) practices in England. GRASP-AF is an audit tool developed by and trialled in the National Health Service which greatly simplifies the process of identifying patients with Atrial Fibrillation (AF) who are not receiving the right management to help reduce their risk of stroke.

The Sustainable Improvement Team is also working with NHS RightCare, a programme committed to improving people’s health and outcomes, to help promote the use of GRASP-AF in the programme’s 65 first wave clinical commissioning groups (CCGs). NHS RightCare’s ‘Commissioning for Value’ packs help CCGs identify priority areas such as AF, and the GRASP AF tool provides a practical method of addressing any inequalities. NHS England’s intention is that the work with NHS RightCare will increase the number of CCGs using GRASP-AF in a systematic way.

Anonymised data from GRASP-AF can be uploaded to CHART Online, a secure web enabled tool that helps practices improve performance through comparative data analysis. This allows practices and CCGs to benchmark their management of AF with other practices across England and so help identify and reduce any variation in practice.

The use of GRASP-AF is voluntary and its use therefore varies across CCGs. Currently 2,248 GP practices have uploaded data from GRASP-AF to CHART online across 151 out of the 209 CCGs. Of these, 19 CCGs have all GP practices in their area uploading data.

In addition to the NHS action outlined above, all local authorities in England are required to offer the NHS Health Check programme, with the large majority commissioning general practice to provide them on their behalf. More than 15 million people aged 40-74 are, have been or will be eligible for an NHS Health Check between 2014 and 2018. The programme’s best practice guidance recommends that a pulse check is carried out as part of the process of taking a blood pressure reading and those individuals who are found to have an irregular pulse rhythm should be referred for further investigation.

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