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Collaborative helps GP practices to find hundreds more people with AF

Over 500 patients have been identified with atrial fibrillation (AF) in the last six months thanks to an improvement programme involving 24 GP practices.

 AF is an irregular pulse which can lead to a life-threatening stroke but, if detected, it can be easily treated with anticoagulation treatment. It is particularly prevalent in the North West Coast, where there are high numbers of AF-related strokes.

 Around 20 per cent of people experiencing AF-strokes were not known AF patients and it is estimated there are approximately 10,000 ‘missing’ people in the region with AF.

 In addition, over 45 per cent of strokes happening to people with known AF were not receiving anticoagulant treatment which can reduce strokes by two thirds.

 As part of its programme to reduce strokes in the region, the Innovation Agency, the Academic Health Science Network for the North West Coast, launched an AF Collaborative Quality Improvement initiative to improve the detection and management of AF in GP surgeries.

Launched in 2017, the Innovation Agency’s AF team has distributed over 500 Kardia Alivecor mobile ECG devices to GP surgeries and provided training and support on how to test pulses, as well as reviewing patients on the AF register and ensuring they receive anticoagulation therapy.

Following the success of the first AF Collaborative, the Innovation Agency partnered with BMS/Pfizer Alliance to fund and develop a second AF Collaborative which began in September 2018.

During the second phase of the Collaborative, practices in St Helens, Liverpool, Warrington and Morecambe Bay identified over 500 patients with AF and referred them for treatment aimed at preventing them having a devastating stroke.

Since the beginning of the project, the Innovation Agency has supported over 100 GP practices and a total of 2,000 people have been identified with AF in the North West Coast.

This has also led to improvements in Quality and Outcome Framework indicators for all practices (published in October 2019).

Dr Julia Reynolds, Associate Director and Head of Programmes at the Innovation Agency, said: “We are delighted with the progress of the AF Collaboratives so far and we’re seeing a real impact in terms of a reduction in strokes.

“We’re also pleased at the positive feedback we’ve received from the GP surgeries which have worked very hard to deliver outstanding results and improvements in patient care.

“The long-term aim of the project and collaborative is to embed these improvement actions into normal everyday working practices and share good practice with the networks and neighbouring surgeries regarding the identification and management of AF patients.”

Dr Alan Brennan at Oak Vale Medical Centre said: “We are very happy with the project. The support we received has produced change and an entire culture shift in monitoring and reviewing of AF patients in our practice which has made the management of AF patients much easier.”

Work has now commenced on the third AF Collaborative. If you would like to find out more contact Julia on 07852 562 791 or email

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