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The benefits of this project
Benefits for Your Patients
- Healthier habits and better health
- Less medication
Benefits for Your Practice
- Lower healthcare demand
- Reduced prescription administration
- Financial savings
Benefits for The Planet
- Better patient health leads to reduced healthcare demand and so lowers carbon impact of healthcare
Opportunity for improvement
- This project is looking at whether lifestyle advice and support have been offered to patients when their cholesterol is raised (see disclaimers). Raised cholesterol is one aspect that increases a patient’s cardiovascular (CVD) risk.
- NICE guidance states that before offering statin treatment for primary prevention, discuss the benefits of lifestyle changes and optimise the management of all other modifiable CVD risk factors (such as cholesterol level).
- Recognise that people may need support to change their lifestyle. To help them do this, refer them to programmes such as exercise referral schemes or weight management services. Only if lifestyle change is ineffective or inappropriate should statins be offered.
- NB. Do not include patients who may have familial hypercholesterolaemia in the risk profiling. They need to be assessed using the Simon Broome or Dutch Lipid calculators and referred for genetic testing if suspected.
- You might like to make a SMART goal for this project, e.g. increase referrals to lifestyle programs (e.g., exercise/weight management) by 50% within 6 months for eligible patients with raised cholesterol, tracked via practice data.
How to carry out this project
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Identify patients
Run a search for all patients who had a raised cholesterol level (>5mmol) over a 3-month period more than 2yrs ago as this will give opportunities to look for a discussion at the patient’s annual review.
We hope to provide downloadable IT searches for EMIS & System 1 soon. In the meantime, you could use our EMIS and SystmOne search guides to create your own.
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Too many patients?
If you find more than 25 patients, randomly select 25 patients using an online random number generator.
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Review
Review the notes of your selected patients to record when there is any documentation of lifestyle advice given and/or referrals for support offered.
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Discuss
Arrange a meeting with the clinicians and pharmacists in your practice to discuss the NICE guidance around lifestyle advice and the national and local options available to refer patients to for support. It will be crucial to involve the nursing team as they are likely to be doing the long-term condition reviews:
https://www.nhs.uk/better-health/lose-weight/
https://www.england.nhs.uk/digital-weight-management/how-to-access-the-programme/
https://www.nhs.uk/live-well/exercise/get-running-with-couch-to-5k/
These Patient Text Messages may also give you some ideas of things to suggest.
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Recording Lifestyle Advice
To make it easier for staff, you could tailor this text to send out and link it to a SNOMED code: 313204009 (Lifestyle Education).
Resource: Cholesterol
Your cholesterol level is high which, over time, can lead to serious problems such as heart attacks and strokes. Your current risk of having serious problems is low so no medication is necessary at this time, however, it would be beneficial for you to lower your cholesterol with healthy lifestyle changes. Please see these links for more information: https://www.heartuk.org.uk/healthy-living/introduction https://www.nhs.uk/live-well
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Post-Intervention data collection
Re-run the search for the 3-month period after your meeting and review patient records to note the changes in lifestyle advice recorded and offered to patients during their annual review.
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Study
Review the results, summarise learning, share with practice team + decide if any changes are needed to improve the process.
Use the project monitoring form to keep track of this project and when to repeat cycles.
Top tip
You could involve your staff in this project by asking them to suggest local activities to help with lifestyle changes or share the same information you are sending to your patients with your staff so they can also improve their lifestyles.
Your social prescriber is likely to be a helpful source of advice.
How to scale this project up or down
| Please note - Use of this project requires NetworkPLUS membership. If you would like to share this project with others, please invite them to purchase their own membership—access must not be shared with non-members. |
Share your project with your PCN, Federation, ICB (England) or Cluster, Health Board (Scotland or Wales) or GP federation, Health Trust (Northern Ireland), so the learning can be shared and the project easily implemented by other practices too.
Have you completed this QIP?
Tell us a little about your project in order to generate a certificate showing the probable benefits. This project may help with CQC evidence submission (see disclaimers).
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