Final stage for new NICE guidance developed with help of Bradford GP

New NICE guidance, which could prevent thousands of strokes in people with a common heart rhythm disorder, is driving up standards of care across the country, thanks to the involvement of a Bradford GP.

The guidance from the National Institute for Health and Care Excellence (NICE) – which has just been given quality standard status - highlights the need to ensure people with atrial fibrillation (AF) are offered the right treatments to reduce their chance of dying from strokes.

Dr Matt Fay, a Bradford GP specialist in cardiology, is a member of NICE’s guideline development group which issued the new advice for GPs. The guidance says blood-thinning drugs like warfarin are better for patients with AF, a common heart rhythm disorder which can increase the risk of stroke, than aspirin.

NICE quality standards set out high priority areas for quality improvement in a defined care or service area. The new AF standard also recommends that patients with AF, who are prescribed anticoagulants, discuss their options with their doctor at least once a year to make sure they get the most from the treatment.

GPs in Bradford, Airedale, Wharfedale and Craven are already involved in pioneering work with patients with irregular heartbeats. The project, which is leading to fewer strokes, is being rolled out by more than 60 GP practices in NHS Bradford City, NHS Bradford Districts and NHS Airedale, Wharfedale and Craven clinical commissioning groups (CCGs).

Across the three CCGs there are more than 6,000 patients living with AF. Of those, 5,000 are deemed moderate to high risk of stroke. However, before the project only 2,300 were being prescribed anticoagulant drugs such as warfarin, as a precautionary measure.

Thanks to the project – believed to be the first of its kind in the UK – hundreds more patients are being targeted and are now being prescribed anticoagulants. Ultimately this will result in 200 fewer strokes each year in the Bradford district.

Dr Fay said the NICE standard flagged up the ineffectiveness of aspirin in treating people with AF and encouraged GPs to talk to their patients about the benefits of anticoagulants before they suffered a stroke.

“With more than 10% of over 65 year olds having AF, GPs have to deal with both its identification and management on a regular basis,” said Dr Fay. “The NICE guideline builds on the relationship between the patient with AF and their GP, outlining how each patient should have a clear management plan which takes into account their personal preferences and the clinician’s view of the evidence.

“All strokes are devastating but AF strokes are bigger and potentially lethal. The good news is that we know when prescribed anticoagulant drugs, these strokes can be avoided. Too many patients are being given aspirin when they could be given anticoagulants – so the new guidance is very welcome and will help thousands more patients receive the right treatment.”

AF is a major cause of stroke because it often leads to the formation of blood clots and increases the risk of strokes by up to five times. It is estimated that the condition causes around 12,500 strokes nationally each year.