In July, the Department of Health and Social Care and NHS England published the cardiovascular disease (CVD) modern service framework (MSF). Cardiomyopathy UK contributed to discussions, highlighting the importance of early diagnosis and the complex, longer-term needs of some people living with cardiomyopathy.
The new CVD MSF sets out a 10-year strategic vision to reduce ‘premature mortality’ (deaths before the age of 75) from heart disease and stroke by 25%, and a roadmap for the health and care system to deliver this ambition.
Heart disease is an umbrella term for conditions affecting the heart, including coronary heart disease, cardiomyopathies, heart failure, heart valve disease, heart rhythm disorders (arrhythmias) and congenital heart disease.
Recognising that people are sometimes diagnosed late or receive inconsistent treatment, the framework includes a welcome focus on early diagnosis and prevention, alongside ideas to try to help people access the right care.
Read more about the framework on GOV.UK
What could the CVD MSF mean for people affected by cardiomyopathy?
The new framework recognises that several conditions and risk factors – such as high blood sugar, high cholesterol and chronic kidney disease – share common causes and contribute to most heart attacks and strokes.
Because much of the framework’s detail is centred around identifying and addressing these risk factors, it’s not all directly relevant to the cardiomyopathy community. However, some parts are relevant to people affected by cardiomyopathy and offer potentially promising opportunities for how care could develop.
Heart failure treatment
The CVD MSF sets out 12 priority areas for the next three years, one of which is to increase uptake of all four recommended drugs (also called four pillar therapy) for eligible people with heart failure with reduced ejection fraction (HFrEF). Any type of cardiomyopathy can cause heart failure, and dilated cardiomyopathy (DCM) is a common cause. This ambition could therefore make a real difference for people living with the condition.
Cardiac rehabilitation
Alongside the 12 priority areas, the framework mentions the importance of incorporating personalised support for people living with heart failure as part of cardiac rehabilitation, including psychological support. This is a welcome emphasis, given the variation in care and gaps in emotional and rehabilitation support that we know people with cardiomyopathy often experience.
However, there is still a need for people with cardiomyopathy to have clear and tailored NHS guidance that explicitly includes their condition, beyond what is currently recommended for people living with heart failure. This includes access to rehabilitation and advice from staff who understand cardiomyopathy.
Testing for inherited conditions
Included under ‘priorities for the future’, the CVD MSF commits to expanding testing for inherited conditions, including hypertrophic cardiomyopathy (HCM), which is a welcome direct reference to cardiomyopathy.
12 priorities for the next three years
The CVD MSF identifies 12 priority areas where there is strong evidence for what works, but where the care and treatment people receive isn't always consistent. These priority areas are grouped under four themes:
- Finding the missing millions: Identifying people living with risk factors for cardiovascular disease such as high blood pressure, high cholesterol or diabetes, and ensuring they’re linked in to treatment pathways.
- Driving treatment to target: Making sure people receive the right treatment and ongoing management to reach evidence-based targets (for example, people with CVD should have their blood pressure and cholesterol proactively managed).
- Ensuring timely, high-quality acute care: Reducing variation and delays across the urgent care pathways for stroke and a specific type of heart attack called STEMI (where there is total blockage of the coronary artery).
- Living with CVD and expanding rehabilitation: Expanding access to cardiovascular rehabilitation and tackling inequalities so more people can benefit.
What happens next
As with any plan, the real impact is dependent on delivery – further detail is expected later this year. We'll continue to monitor how this develops and what it could mean for people affected by cardiomyopathy.