The NHS Long Term Plan states that the biggest area where the NHS can save lives over the next 10 years is in reducing the incidence of cardiovascular disease (CVD). CVD causes a quarter of all deaths in the UK and is the largest cause of premature mortality in deprived areas.

To reduce death and disability due to premature CVD we’re focusing on a range of projects. Read more about:

Lipid Management Pathways

The NICE endorsed AAC Summary of National Guidance for Lipid Management for Primary and Secondary Prevention of CVD, updated in December 2021, includes additional medication to use alongside statins and other lipid-lowering drugs, including novel therapies such as PCSK9i’s and Inclisiran. This pathway unifies multiple NICE guidance and technology appraisals into a single document to support clinical decision making on lipid management.

Lipid optimisation pathway following an acute cardiovascular event

The Health Innovation Network has published a clinically approved pathway to support secondary care clinicians to optimise lipid management following an acute cardiovascular event. The pathway provides clear and unified guidance for clinicians on how optimal lipid management may be achieved, to reduce the risk of  further cardiovascular events.

Access the pathway for secondary care clinicians.

Collaborative Lipid Fund

We are running a project until the end of October 2024, in collaboration with BNSSG ICB and One Care CIC to support the implementation of the UCLP Proactive Care Frameworks (UCLP) in Primary Care with a focus on lipid optimisation for high-risk patients. This project has been funded as part of the Collaborative Lipid Fund (CLF) which is part of a wider national programme of work around secondary prevention lipid optimisation. The design of this project has been coproduced with wider stakeholders and input from both Primary (Dr Febin Basheer, GP and Clinical Lead for this project) and Secondary Care colleagues (Dr Paul Downie, Consultant Chemical Pathologist).

Five Primary Care Network’s (PCN’s) within BNSSG have been identified as having a large Quality and Outcome Framework (QOF) treatment gap for cholesterol management combined with being in a deprived area and will therefore receive enhanced support. They will receive a funding allocation to support case finding using the UCLP proactive care frameworks and knowledge and confidence development in optimising patients in line with the NICE lipid management pathway for secondary prevention.

The project will produce an evaluation report against agreed key performance indicators which will allow us to explore the impact the project has had on sustainable lipid optimisation within these PCN’s.

For further information on this project please contact Amy Bowden, Senior Project Manager.

Child-parent screening for FH

What is Child Parent Screening?

Familial Hypercholesterolaemia (FH) is an inherited condition passed down through families which will lead to extremely high cholesterol levels. It affects 1 in 250 people in the UK, yet over 90% of cases are still undiagnosed.

Without treatment, FH can lead to heart disease at a young age. Identifying affected individuals before the onset of disease is important because treatments can be put in place that promotes a healthy, active life and lowers blood cholesterol levels, all of which substantially reduce the risk of heart disease.

What does Child Parent Screening involve?

Child-parent screening offers a population wide, low-cost solution to the management of CVD and is currently the best model for FH detection.

With parental consent, a child is tested for FH at their routine one-year immunisation appointment using a heel prick capillary test.

Evidence shows that age one is when cholesterol measurement discriminates best between individuals with and without FH, so screening new-borns or adults is less effective. A small blood sample is taken and from this total cholesterol can be measured.

In those children with a reading of >95 percentile, further genetic testing can be undertaken. If the child receives a diagnosis of FH, at least one of the parents will also be positive, so testing is undertaken. Siblings and second-degree relatives can also be counselled and screened. Age-appropriate medication and advice can then be offered to families to reduce the risk of cardiac disease.

Benefits to Practices taking part in the Child Parent Screening service:

  • Free training and support for all staff.
  • Access to widely available point-of-care analysers and, if needed, provided consumables.
  • Financial benefit of £10 per patient screened.
  • Being part of an innovative Child parent Screening Service to detect Familial Hypercholesterolaemia which is part of the NHS long-term plan.
  • Simple, straightforward project, not burdensome.
  • Ongoing support from the Health Innovation West of England.
  • Input from Consultant Lipidologist supporting the project throughout.
  • Likely to be additional benefits in increasing knowledge base for clinicians on identification and management of lipid disorders as a whole, may benefit QoF targets.

Free e-learning: Management of Familial Hypercholesterolemia in General Practice

The Royal College of GPs has recently launched a short ‘Management of Familial Hypercholesterolemia  in General Practice’ course, designed to enable primary care health care professionals to better identify, and understand the causes of, FH in patients. This e-learning course will take approximately 45 minutes to complete.

Programme webinar and blog

Read our blog which hears from Gloucestershire GP, Dr Amy Howarth about her practice’s experiences of piloting the screening programme.

Find out more about the programme in a webinar hosted by Health Innovation North East & North Cumbria:

FH – a patient’s story

Leanne has been diagnosed with Familial Hypercholesterolaemia which has also led to several of her family members also being diagnosed with FH. Hear her story and how she manages her genetic condition in this short video from Health Innovation North East & North Cumbria: 

Get involved

If you work in a practice in the West of England and would like to get involved, please contact us at

Lipids optimisation

The Health Innovation Network’s lipids optimisation programme is part of a package of work delivered in partnership with the 21/22 Rapid Uptake Products (RUP) programme which focuses on: High Intensity Statins, Ezetimibe and PCSK9 inhibitors.

We’ve worked with Bristol, North Somerset and South Gloucestershire (BNSSG) Integrated Care Board and local GP practices to use search options within practice databases to identify patients at risk of raised cholesterol who would benefit from a detailed medication review. Using the pathway, the pilot identified 444 patients eligible for medication reviews, and of those 7 were referred to secondary care for PCSK9i therapy.  The pilot was successful in ensuring hundreds of patients across the region were taking the most effective CVD medication. Read more about our work across BNSSG to optimise lipids, and increase use of PCSK9i therapy for eligible patients.


Before now if a patient was on the maximum dosage of statins, had been prescribed Rapid Uptake Products such as ezetimibe or PCSK9i and their cholesterol levels were not decreasing, options were limited. But now inclisiran can support these patients. Inclisiran was made accessible to patients through the first NHS ‘population health agreement’.

Inclisiran injections use a biological process where molecules can shut down protein translation to help the liver remove harmful low density lipoprotein cholesterol (which are often simply referred to as ‘bad cholesterol’) from the blood. Inclisiran can be used with statins or on its own. Read NICE guidance on the use of inclisiran.

The Accelerated Access Collaborative are responsible for the implementation of the inclisiran partnership with the Health Innovation Network, working to ensure inclisiran fits seamlessly into the updated lipids care pathway.

If you’re a healthcare professional, you can read summary information on the supply and funding of inclisiran from NHS England.

Uptake of inclisiran  is above average in the West of England, and we are looking to work with more practices to drive adoption and spread.

Get involved

If your work is related to CVD and lipids optimisation in the West of England region please get in touch with us at to discuss how we can work with you and your team.

Tackling Cholesterol Together – a free education programme for primary care

Tackling Cholesterol Together is a professional education programme to support healthcare professionals in addressing under-diagnosis and under-treatment at scale and using new models to manage cholesterol – all underpinned by the updated NICE-endorsed pathway.

Tackling Cholesterol Together will be delivered through videos, podcasts, webinars, expert clinics and online modules. For more information and access to content please visit Tackling Cholesterol Together.

Using Proactive Care Frameworks

To support the case finding of primary care patients with long-term conditions, we piloted a package of tools and resources designed by UCL Partners to enable practice teams to continue to effectively manage patients during and post-COVID-19.

Frameworks focus on the management of atrial fibrillation; high blood pressure; high cholesterol; type 2 diabetes; asthma and COPD.

Read more about proactive care frameworks, and access free implementation resources.