How Health Innovation Wessex helped secure £350,000 to support expansion of a secondary care, secondary prevention lipid management service

Anthony Young, University Hospitals Dorset Lead Cardiac Advanced Clinical Practitioner has delivered a nurse-led secondary prevention lipid management service from Poole Hospital for the last two years (funded by Amarin).

The current service sees patients who have had a primary cardiac event i.e. a heart attack or stroke and have had the opportunity to undertake cardiac rehabilitation. Normally at this point, patients return to the management of primary care without having had their treatment optimised to achieve the NICE-approved LDL threshold. When using the service, in just six months, 72% of patients have reached cholesterol levels below national targets, a figure that far surpasses the typical 30-40% improvement over 12 months.

To continue the service, expand current provision and include working directly with primary care (three PCNs – Mid Dorset, Purbeck and Shore Medical) Health Innovation Wessex worked with Anthony and the Dorset Inward Investment team to develop and submit a bid to the British Heart Foundation (BHF). The bid of £350,000 was awarded and included funding for an evaluation by our in-house Insight team.

"This is a considerable grant which is to my knowledge one of the first of its type to given in the UK. It has the genuine potential to transform the delivery of this novel nurse-delivered lipid lowering secondary prevention service across East Dorset. Its clinical impact is likely to be considerable. The wider implementation of this service is expected to significantly reduce secondary atherosclerotic cardiovascular events for patients with conformed significant coronary artery disease in our catchment."

Professor Christopher Boos (Consultant Cardiologist University Hospitals Dorset and Visiting Professor at Bournemouth University, Leeds Beckett University and Imperial College, London)

Collaborating with primary care will involve case finding secondary prevention patients, supporting practice teams to optimise treatment for lower priority patients and the referral of high priority ones to the new service.

The challenge

Hyperlipidaemia is a leading cause of premature cardiovascular disease (CVD). It is responsible for a quarter of all deaths in the UK. The National Institute of Clinical Excellence (NICE) Lipid Modification guidance (2023) has shown that the lipid management of people with established CVD remains suboptimal; CVD prevent data reporting that whilst 80% of patients with CVD are treated with statins, optimal dosing is achieved in only 33%.

The reasons for this include inadequate adherence and dosing of evidence/guideline-recommended lipid-lowering treatment. Contrary to recommended best practice, there has not been an integrated secondary prevention lipid service for patients with established CVD in East Dorset prior to the start of this service.

A collaborative effort

Health Innovation Wessex worked with Anthony and the University Hospitals Dorset Inward Investment team to complete the British Heart Foundation (BHF) grant application process. This collaborative effort ensured the submission was both strategically sound and aligned with the funder's expectations.

As part of the application, the Insights team at Health Innovation Wessex codesigned a comprehensive logic model and defined the evaluation methodology to support the project’s delivery and impact assessment. This provided clarity on outcomes and ensured measurable success indicators were embedded from the outset.

To drive the initiative forward, Health Innovation Wessex formed and chairs the project delivery steering group, bringing together key stakeholders to maintain momentum and strategic oversight. In addition, they are actively liaising with the three primary care networks (PCNs) involved in the project, offering expert advice and guidance to support implementation at the local level.

Beyond operational support, Health Innovation Wessex has also championed the project regionally, creating opportunities for Anthony to showcase the initiative at high-profile events, including the South West Collaborative webinar held on 11 September. This commitment to visibility and stakeholder engagement continues to strengthen the project's reach and impact.

Impact of innovation

The introduction of a nurse-led secondary prevention service led to marked improvements in lipid lowering performance in East Dorset during the first two years of this project, highlighted by the data presented in this clinical poster.

The immediate impact of the bid’s success is to enable the current service to continue operating and expand with the subsequent recruitment of two new team members (1.3 FTE). This means that more patients will benefit via the existing secondary care pathway. The expansion into primary care will make the service available to potentially 912 secondary prevention patients from the UCLP priority 3 group and staff upskilling/education has the potential to benefit in excess of 7,500 patients from groups 1, 2a and 2b.

"The nurse-led Secondary Prevention Lipid Clinic has shown that by supporting patients with education about their cholesterol levels and educating them on secondary prevention, optimising medication for lowering cholesterol and ensuring we take a vested interest in their health, we have been able to lower cholesterol in 72% of patients after six months to below the current recommended targets. This not only improves the health of our patients but reduces the cost on the NHS over 5-10 years."

Anthony Young, Lead Cardiac Advanced Clinical Practitioner,University Hospitals Dorset

Anthony is constantly receiving feedback from patients experiencing the service, which has informed its ongoing development. The initial face to face appointment (to establish LDL-C goals and provide lifestyle advice) and telephone follow-ups are focused on working in partnership with patients and tailoring treatment plans to suit their individual needs. Phase two of the project, funded by the British Heart Foundation bid, is just beginning and will run for a further two years from September 2025.