Table of contents

Recommendations for Commissioning

Adults :: CVD :: Recommendations for Commissioning

• Raise public awareness about CVD within Medway to address inequity, with particular focus on communication to men and those in the most deprived areas, ensuring that this is aligned with already existing programmes which focus on healthy lifestyles.
• Intensive behavior change can reduce type 2 diabetes risk substantially. Targeting programmes for these individuals will therefore reduce their risk of CVD.
• Prioritise smoking cessation and continue to target young people and pregnant women.
• Improve joint health and social care commissioning arrangements to effectively target high risk groups, applying evidenced based social marketing techniques and evaluation.
• Work with primary care to ensure that patients with hypertension are given lifestyle advice in order to reduce the risk of CVD.
• Cardiac MRI, cardiac CT and stress imaging should be provided locally as this is currently being referred to London hospital trusts.
• Conduct an audit of all CVD deaths considered preventable in Medway to investigate the possible causes for mortality rates being significantly higher in Medway than in England.
• Conduct an audit of NHS Health Checks programme delivery in order to identify groups or GP practices where low levels of uptake exist, and conduct targeted promotion accordingly.
• Detection and management of hypertension: through implementation of local leadership and action planning for system change, to tackle particular areas of local variation; health professional support (communication, tools and incentives) to bring professional practice nearer to treatment guidelines where this falls short; and support adherence to drug therapy and lifestyle change, particularly through self-monitoring of blood pressure and pharmacy medicine support.[1]
• Detection and management of type 2 diabetes: encouraging people to have a risk assessment for type 2 diabetes and identifying those at risk, local action to prevent type 2 diabetes, including strategy, policy and commissioning. Population and community interventions developed by local public health services working with other local authority departments: develop a local plan; convey healthy lifestyle messages to the local community; promoting a healthy diet; tailor interventions and target communities at high risk of type 2 diabetes; ensure local planners use existing mechanisms to promote physical activity, address service gaps in service provision and encourage employers to develop physical activity policies.
• Ensure GPs are aware of the correct anticoagulant therapy for the treatment of atrial fibrillation in line with 2014 NICE guidelines; takes into account the introduction of non-vitamin K oral anticoagulants, and associated technology appraisal guidance for recommending them as therapy options.[2]


[1]   Public Health England. NHS Medway CCG: Hypertension Profile 2016;
[2]   AF Association. In Pursuit of Excellence in the Prevention of AF-Related Stroke 2016;