Services for the prevention of cardiovascular disease
This is an extract from the commissioning guide. The complete commissioning guide is available at www.nice.org.uk/guidance/cmg45
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This guide supports commissioners of services that contribute to population-wide, community-level and individual approaches to cardiovascular disease prevention.
Commissioners and other stakeholders should adopt an integrated approach to commissioning for the prevention of cardiovascular disease. When planning services across a locality, commissioners should liaise with health and wellbeing boards to ensure that services are commissioned in line with priorities identified in the local Joint Strategic Needs Assessment and Health and Wellbeing Strategy. This is because effective commissioning for the prevention of cardiovascular disease may contribute to behaviour change and outcomes that also help to reduce the incidence of other non-communicable diseases such as diabetes, chronic kidney disease, chronic obstructive pulmonary disease and some cancers.
In this guide commissioners are asked to consider the invest-to-save potential of commissioning a range of interventions to prevent modifiable risk factors associated with the prevention of cardiovascular disease and design their services accordingly. Commissioners are encouraged to ring-fence and pool budgets to implement an integrated local strategy to prevent cardiovascular disease.
The guide for commissioners describes the following service components required to deliver a high-quality service:
population-wide and community-level approaches (section 4.1)
assessing an individual's risk of cardiovascular disease, including commissioning the NHS Health Check programme and Making Every Contact Counts (section 4.2)
behaviour change and lifestyle interventions (section 4.3)
medical interventions (section 4.4).
Each section offers service models, including Commissioning for Quality and Innovation (CQUIN) examples for driving improvements to cardiovascular disease prevention services and models for meeting Quality, Innovation, Productivity and Prevention (QIPP) requirements.
Section 3 contains further information to help commissioners to assess levels of cardiovascular disease and modifiable cardiovascular disease risk factors in their population.
Section 5 provides an outline service specification to assist commissioners when tendering for or contract-managing cardiovascular disease prevention services.
The guide contains a commissioning and benchmarking tool that can be used to model the costs and savings associated with integrated commissioning of cardiovascular disease prevention services. The tool demonstrates how the risk of cardiovascular disease events can be reduced by successful uptake of lifestyle changes using evidence-based interventions at population-wide, community-wide and individual levels.