Are your patients aware of their risk?

Did you know that:

  • Over 1 million people in the UK have atrial fibrillation (AF)
  • The risk of stroke is five times greater for people with AF
  • AF contributes to 1 in 5 strokes in the UK
  • The incidence of AF increases with age
  • AF-related strokes are often more severe with higher mortality and greater disability
  • AF often goes undiagnosed

It is estimated there could be another half a million people in the UK with undiagnosed AF. That is why we have piloted including AF checks in our Know Your Blood Pressure events and are planning to roll this out during 2019/2010 so that we can increase public awareness of AF and signpost anyone with possible AF to their GP.

To help your patients understand more about AF, we have a number of resources available which include AF: reducing your risk of stroke and an atrial fibrillation factsheet. See below for more useful resources.

Treatment and managing atrial fibrillation (AF)

Aspirin monotherapy is no longer recommended by NICE as a treatment for AF. All patients with AF should be appropriately anticoagulated to reduce the risk of AF-related stroke. However anticoagulants continue to be under-prescribed. In the UK, around a quarter of eligible patients with AF do not receive anticoagulation.

Why is it important to review the needs of your patients with AF?

It's estimated that if AF was adequately treated, around 7,000 strokes would be prevented and over 2,000 lives saved every year in England alone.

However, currently less than half of UK patients with known AF are on anticoagulant medication when they go to hospital with a stroke. Anticoagulation may be with either apixaban,dabigatran, rivaroxaban or a vitamin K antagonist such as warfarin, as recommended by NICE.

It's important to consider all available treatment options and a decision should be made between the patient and doctor based on individual needs and preferences.

Figures taken from the Stroke Association: State of the Nation 2017.

Treating AF to reduce the risk of stroke - a professional perspective

AF: How can we do better?

You can find out the state of AF care in England, and in each individual CCG, through our 'AF: How can we do better?' resources.

These are available in an England summary, and via the links below.

These resources have been developed in partnership with Public Health England, Royal College of Physicians, Royal College of General Practitioners and British Heart Foundation.

The data included is compiled from the Quality and Outcomes Framework (QOF), Public Health England (PHE), Sentinel Stroke National Audit Programme (SSNAP) and NHSIQ.

AF reports by CCG - A-H

NHS Airedale, Wharfedale and Craven CCG

NHS Ashford CCG

NHS Aylesbury Vale CCG

NHS Barking and Dagenham CCG

NHS Barnet CCG

NHS Barnsley CCG

NHS Basildon and Brentwood CCG

NHS Bassetlaw CCG

NHS Bath and North East Somerset CCG

NHS Bedfordshire CCG

NHS Bexley CCG

NHS Birmingham Crosscity CCG

NHS Birmingham South and Central CCG

NHS Blackburn with Darwen CCG

NHS Blackpool CCG

NHS Bolton CCG

NHS Bracknell and Ascot CCG

NHS Bradford City CCG

NHS Bradford Districts CCG

NHS Brent CCG

NHS Brighton and Hove CCG

NHS Bristol CCG

NHS Bromley CCG

NHS Bury CCG

NHS Calderdale CCG

NHS Cambridgeshire and Peterborough CCG

NHS Camden CCG

NHS Cannock Chase CCG

NHS Canterbury and Coastal CCG

NHS Castle Point and Rochford CCG

NHS Central London (Westminster) CCG

NHS Central Manchester CCG

NHS Chiltern CCG

NHS Chorley and South Ribble CCG

NHS City and Hackney CCG

NHS Coastal West Sussex CCG

NHS Corby CCG

NHS Coventry and Rugby CCG

NHS Crawley CCG

NHS Croydon CCG

NHS Cumbria CCG

NHS Darlington CCG

NHS Dartford, Gravesham and Swanley CCG

NHS Doncaster CCG

NHS Dorset CCG

NHS Dudley CCG

NHS Durham Dales, Easington and Sedgefield CCG

NHS Ealing CCG

NHS East and North Hertfordshire CCG

NHS Eastbourne, Hailsham and Seaford CCG

NHS Eastern Cheshire CCG

NHS East Lancashire CCG

NHS East Leicestershire and Rutland CCG

NHS East Riding of Yorkshire CCG

NHS East Staffordshire CCG

NHS East Surrey CCG

NHS Enfield CCG

England

NHS Erewash CCG

NHS Fareham and Gosport CCG

NHS Fylde and Wyre CCG

NHS Gloucestershire CCG

NHS Greater Huddersfield CCG

NHS Greater Preston CCG

NHS Great Yarmouth and Waveney CCG

NHS Greenwich CCG

NHS Guildford and Waverley CCG

NHS Halton CCG

NHS Hambleton, Richmondshire and Whitby CCG

NHS Hammersmith and Fulham CCG

NHS Hardwick CCG

NHS Haringey CCG

NHS Harrogate and Rural District CCG

NHS Harrow CCG

NHS Hartlepool and Stockton-on-Tees CCG

NHS Hastings and Rother CCG

NHS Havering CCG

NHS Herefordshire CCG

NHS Herts Valleys CCG

NHS Heywood, Middleton and Rochdale CCG

NHS High Weald Lewes Havens CCG

NHS Hillingdon CCG

NHS Horsham and Mid Sussex CCG

NHS Hounslow CCG

NHS Hull CCG

AF reports by CCG - R-Z

NHS Redbridge CCG

NHS Redditch and Bromsgrove CCG

NHS Richmond CCG

NHS Rotherham CCG

NHS Rushcliffe CCG

NHS Salford CCG

NHS Sandwell and West Birmingham CCG

NHS Scarborough and Ryedale CCG

NHS Sheffield CCG

NHS Shropshire CCG

NHS Slough CCG

NHS Solihull CCG

NHS Somerset CCG

NHS Southampton CCG

NHS South Cheshire CCG

NHS South Devon and Torbay CCG

NHS South Eastern Hampshire CCG

NHS South East Staffordshire and Seisdon Peninsula CCG

NHS Southend CCG

NHS Southern Derbyshire CCG

NHS South Gloucestershire CCG

NHS South Kent Coast CCG

NHS South Lincolnshire CCG

NHS South Manchester CCG

NHS South Norfolk CCG

NHS Southport and Formby CCG

NHS South Reading CCG

NHS South Sefton CCG

NHS South Tees CCG

NHS South Tyneside CCG 

NHS Southwark CCG

NHS South Warwickshire CCG

NHS South West Lincolnshire CCG

NHS South Worcestershire CCG

NHS Stafford and Surrounds CCG

NHS St Helens CCG

NHS Stockport CCG

NHS Stoke on Trent CCG

NHS Sunderland CCG

NHS Surrey Downs CCG

NHS Surrey Heath CCG

NHS Sutton CCG

NHS Swale CCG

NHS Swindon CCG

NHS Tameside and Glossop CCG

NHS Telford and Wrekin CCG

NHS Thanet CCG

NHS Thurrock CCG

NHS Tower Hamlets CCG

NHS Trafford CCG

NHS Vale of York CCG

NHS Vale Royal CCG

NHS Wakefield CCG

NHS Walsall CCG

NHS Waltham Forest CCG

NHS Wandsworth CCG

NHS Warrington CCG

NHS Warwickshire North CCG

NHS West Cheshire CCG

NHS West Essex CCG

NHS West Hampshire CCG

NHS West Kent CCG

NHS West Lancashire CCG

NHS West Leicestershire CCG

NHS West London CCG

NHS West Norfolk CCG

NHS West Suffolk CCG

NHS Wigan Borough CCG

NHS Wiltshire CCG

NHS Windsor, Ascot and Maidenhead CCG

NHS Wirral CCG

NHS Wokingham CCG

NHS Wolverhampton CCG

NHS Wyre Forest CCG

Patient case studies

David Derrett talks about his experience of AF and stroke:

Watch more videos on managing atrial fibrillation on the British Heart Foundation's YouTube channel. 

AF resources for you and your patients

Hard copies of our factsheets and leaflets for patients are available to order from our online shop.

  • AF: what you need to know: A professionals facing leaflet includes an ideal AF patient pathway and useful advice for identifying, treating and managing AF.
  • AF: reducing your risk of stroke: A patient facing leaflet covering the link between atrial fibrillation and stroke, possible symptoms, treatment and other things you can do to reduce your risk of stroke. 
  • Atrial fibrillation factsheet: Offering detailed information on AF symptoms, different types of treatment and where you can find out more.

To help support practitioners in their discussion with patients on anticoagulation, the Wessex AHSN, in partnership with Royal Pharmaceutical Society and Hampshire Hospitals NHS Foundation Trust have developed an anticoagulation video and leaflet.

For statistics and key information about the prevalence of AF in the UK and the link between AF and stroke, take a look at our State of the Nation 2017 report.

AF Business Case Model: Public Health England and the AHSNs have collaborated to create an AF Care Pathway Business Case Model. The model assesses each management opportunity in AF to identify any potential deficits in current care, the cost impact on the local health economy, and the number of strokes that could be prevented and lives saved as a result of improvements in anticoagulation treatment patterns.

Your organisation could use this model to review a set of specific interventions to address local needs and evaluate the most efficient focus of investment and resources in your region. 

AF Toolkit: Detect, Protect and Perfect

There is evidence of outstanding work delivered by the NHS, charities and industry to improve AF care and outcomes for patients within London and nationally.

Download this useful toolkit which provides methodologies, resources and support for commissioners and clinicians working to reduce AF related strokes.

Best practice case studies

Our best practice professional case studies detail some examples of the great work CCGs across the UK are doing to improve AF detection and management:

If you would like to share details of some of the work in your area, please get in touch.

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