Puttingpreventionfirst
Vascular Checks:risk assessment andmanagement
 
DH INFORMATION READER BOXPolicy
EstatesHR/Workorce CommissioningManagement IM&TPlanning FinanceClinical Social Care/Partnership Working
Document purpose
Consultation/Discussion
Gateway Reference
9679
Title
Putting Prevention First. Vascular checks: risk assessment and management
Author 
Vascular programme
Publication date
01 Apr 2008
Target audience
PCT CEs, SHA CEs, Care Trust CEs, Medical Directors, Directors o Nursing,Local Authority CEs, GPs
Circulation list
Directors o PH, Directors o Adult SSs, PCT PEC Chairs, Directors o HR,Directors o Finance
Description
An announcement outlining proposals or a system o vascular checks to becarried out in primary care. This document includes initial results o modellingwork around a ‘predict and prevent’ approach to identiy vulnerability tovascular diseases – heart disease, stroke, diabetes and kidney disease.
Cross ref 
Vascular programme briefng pack (April 2007)
Superseded docs
N/A
Action required
N/A
Timing
N/A
Contact Details
Vascular ProgrammeDepartment o HealthWellington House133–155 Waterloo RoadLondonSE1 6QFwww.dh.gov.uk/publications
For recipient’s use
 
Secretary of State foreword
The Prime Minister set out his vision or the NHS earlier this year: amore personal service supporting people to stay well and maintaingood health. It placed individuals centre-stage, engaged and takinggreater control over their own health.Moving rom an NHS ocussing predominantly on treatment andcure to one that looks frst to prevention is a challenge – but it isone that we are determined to address in this 60th anniversary year o the NHS.Over the past decade, we have made signifcant improvements to the treatmento vascular disease through the National Service Frameworks on coronary heartdisease, renal services and diabetes. We have seen a 40% reduction in deaths romcardiovascular disease in people under 75 since 1996, but it remains a major cause odisability and poor health.We now need to ocus more eort on how we can prevent vascular diseases –coronary heart disease, stroke, diabetes, and kidney disease – earlier in lie, so thatpeople can make inormed choices about how taking control can improve their healthand help them live longer and healthier lives. Today we are publishing the resultso detailed clinical modelling. These will orm the basis o our proposals to create auniversal risk assessment and management programme. For all o us who care aboutpreventing illness and saving lives, these results are very promising and confrm thatsuch a programme, or those aged between 40 and 74, will be both clinically andcost eective. They confrm that through this approach we can save and improvethousands o lives each year.This document explains in more detail what vascular disease is, why vascular riskassessments are important and how they will work in England. It also calls or our stakeholders to work with us to help develop our approach to implementation anddelivery over the next ew months. There are huge gains to be made i we get thisright – improving the quality and duration o lie or thousands o people. Only byworking together with our key partners can we develop a system that delivers all othe real and lasting benefts to the public that this programme oers.Alan JohnsonSecretary o State or Health
 
Introduction
Scope of the problem
Anne Mackie, Director of the UK National Screening Committee
The UK National Screening Committee welcomes the priority that the governmenthas placed on implementing its recommendations in England. We will now workwith stakeholders and the public to develop robust implementation plans. We willparticularly ocus on how we can make this accessible to the whole population andreduce inequalities in vascular health. We have already made a start by drawingtogether the current state o knowledge about vascular risk assessment, risk reductionand risk management in our recently published handbook
1
.Vascular disease includes coronary heart disease, stroke, diabetes and kidney disease.It currently aects the lives o over 4 million people in England. It causes 36% o deaths(170,000 a year in England) and is responsible or a ith o all hospital admissions. It isthe largest single cause o long-term ill health and disability, impairing the quality o lieor many people. The burden o these conditions alls disproportionately on people livingin deprived circumstances and on particular ethnic groups, such as South Asians. Vascular disease accounts or the largest part o the health inequalities in our society.The National Service Frameworks have already contributed to a signiicant improvement– a 40% reduction in cardiovascular deaths in people under 75 since 1996. And we arebeginning to see similar progress on diabetes and kidney disease, and have recentlylaunched a strategy to improve the quality o stroke services. Now we need to build onthis excellent start, by moving the emphasis onto prevention. Indeed, the National ServiceFramework or coronary heart disease indicated that we would need to shit the emphasisto primary prevention over time.
1 National Screening Committee, 2008,
The Handbook for vascular risk assessment, risk reduction and risk management 
, NSC, University o Leicester.
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