Julie Bowen, from Wirral Community Health and Care NHS Foundation Trust, reflects on her participation in the CLEAR Living Well project and how it is helping to develop new initiatives for better CVD preventative care

Cardiovascular Disease (CVD) causes one in four deaths in England and is a leading cause of disability and health inequalities.

This is a startling statistic – but it can often be prevented. After 20 years of working in cardiology, I feel prevention is critical to improving people’s quality of life and reducing their chances of having heart attacks, strokes, and angina.

It has become even more important to me now – I am seeing more people in my clinic, who are my age or younger, with chest pain, diabetes, and who have suffered heart attacks and strokes. An increase in obesity, high cholesterol, smoking, high blood pressure, and diabetes can all contribute to cardiovascular disease and, importantly, are all areas that can be changed, managed, or improved – sometimes even prevented altogether.

Every risk factor we can remove or modify reduces our risk of having a heart attack or stroke in the future – and small changes can make a big difference.

But, despite all we know about the dangers of these risks, people continue to smoke or find it difficult to motivate themselves to lose weight, increase activity levels and change their eating habits.

With this in mind, I was invited to join the CLEAR Living Well project to explore ways to improve pathways for the prevention of CVD. With around seven million people in the UK with the disease, I was very happy to be involved – because I felt I could make a difference to those statistics.

The CLEAR programme enables NHS staff on the frontline to improve services by seeking the views of clinicians and others actively involved in care delivery – this really interested me, as it seldom happens – and combining their feedback with data analysis around patients’ needs and risk factors to design new models of care with support from the national CLEAR team.

We kicked off the project with the clinical engagement phase to gather qualitative data from colleagues. Although I was initially apprehensive because I know how busy people are, I was pleasantly surprised at the positive response I received.

The people I spoke to were as passionate about preventing CVD as I am and had been trying for many years to change and address it. This phase of the project was hugely rewarding but I wasn’t prepared for the amount of data it would generate that then had to be inputted and coded. After initially feeling overwhelmed, it soon fell into place and challenges, alongside early ideas for change, became apparent.

We then moved into the data interrogation phase. It was very easy to get carried away with the analysis and I had a tricky time narrowing the data for the particular cohort we wanted to focus on. I had never worked with this level or depth of data before – and found the guidance and support from the CLEAR team invaluable.

Once we triangulated the clinical insights with the data, we moved on to the innovation phase where we used the analysis to inform and design new models of care and ways of working to improve CVD preventative care. As clinicians working on the ground, we were very mindful that this had to be achievable, add real value to patient care, and not increase everyone’s workload, which is already at capacity.

The next and final phase of the project will see us presenting our recommendations for improving CVD preventative care to colleagues. I feel a big sense of achievement in getting this far – each stage of the project has felt like change is coming, which is exciting.

Once you have a heart attack or stroke it’s harder and more costly to manage, and the quality of a person’s life can be greatly affected. Empowering people to take responsibility for their own health and lifestyle is urgently needed. Although many people may have other struggles and priorities in their lives, we can help them decide what they can do to help themselves to reduce their risks of cardiovascular disease, heart attack, and stroke in the future.

Keeping ourselves well for as long as possible may also help reduce the burden on the NHS, so it is there for us in the future when we really do need it.

I hope CLEAR Living Well will help to develop new pathways to enable people to do this, so that there is a marked reduction in the prevalence of CVD in South Wirral and the terrible life changing effects that it can bring.