Question to the Department of Health and Social Care:

To ask Her Majesty’s Government what action NHS Improving Quality is taking to increase the number of general practitioner practices using the GRASP-AF tool.

This question was answered on 11th February 2016

NHS England’s Sustainable Improvement Team, which has taken over the work of NHS Improving Quality, 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 AF who are not receiving the right management to help reduce their risk of stroke. The Sustainable Improvement Team is currently collaborating with partner organisations, including charities, to support the nationwide roll-out of GRASP-AF.

To support this work, an analysis of the costs and benefits of using the anticoagulant drug warfarin to help prevent stroke in people with AF was recently published. A copy of this analysis is attached.

The National Institute for Health and Care Excellence also published a Quality Standard on AF in July 2015, which sets out what a high quality AF service should look like and will help drive improvement locally. A copy of this Quality Standard is attached.

There is also a wealth of information available on the detection and management of people who have AF. The NHS Atlas of Variation includes such data and similarly Public Health England (working with stakeholders) has produced information for clinical commissioning groups (CCGs) to enable them to identify and encourage poorly performing areas to improve their detection and management of people with AF. The Atlas is an online tool and therefore it is not possible to attach a copy.

These resources are available to Strategic Clinical Networks to help them with their work to improve the prevention and diagnosis of AF locally.

AF related stroke prevention has been a significant area of focus for the East Midlands Cardiovascular Strategic Clinical Network in recent years. Actions include:

- providing individual advice to CCGs in the area, supporting CCGs to implement AF training for GPs;

- supporting CCGs to implement GRASP-AF;

- developing a non-valvular AF anticoagulation algorithm which has informed updates to local AF guidelines;

- developing an electronic clinical template for the diagnosis and management of AF; and

- promoting the use of the warfarin patient safety audit tool.

AF is also covered as in the National Cardiovascular Intelligence Network’s masterclass programme aimed at all NHS health professionals within CCGs, local authorities and clinical services with an interest in cardiovascular disease data tools and information.