Addressing Cardiovascular Diseases in the UK

introduction

Cardiovascular diseases contribute to a significant proportion of deaths in UK with other long term health complications manifested. Considering that CVD is a chronic condition, a healthcare policy framework would effectively manage the condition.

The NHS long term 10-year plan proposes policy measures aimed at achieving core aims in healthcare. These aims include boosting out of hospital care, enhancing digital health care for primary and outpatient care, providing personalised care and reducing pressure on emergency hospital services (NHS England 2019). This will enhance primary and community care, allow for a coordinated approach in providing primary care and enhancing proactive approach in the services provided through healthcare. Furthermore, NHS projects that the long term plan will enhance a differentiated approach to managing the conditions of the patients with respect to their diversities (NHS England 2019) and other policies like NHS England (2016) blending into the plan. Unlike the NHS long term plan that is focused on England, The WHO (2013) health 2020 policy covers the people of the WHO European region and can inform policy actions of the NHS long term plan.

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Baggott (2015) defines a health policy as decisions, plans, and actions undertaken to achieve specific health care goals. The NHS long term plan is thus a policy since its action plans seek to achieve specific health goals in healthcare, unlike a law which is a set of rules and regulations concerned with public well-being and accompanied by potential punitive measures for non-compliance (Porche 2019). NHS long term plan is a national plan aimed at reducing and managing CVD in the public and appeals to health professionals who will play a central role in healthcare with the funding dedicated to primary care making the plan cost-effective (NHS England 2019).

Developing the policy involved patient’s groups, and frontline NHS leaders through over 200 events, 2500 separate responses and through members of the public and organizations representing over 3.5 million people and having achieved 70 years anniversary, the plan is ideal since it seeks to shape healthcare for the coming 10 years. The NHS long term plan, however, faces realities of key challenges in healthcare. Timmins (2015) provides that often time funding dedicated to healthcare is diverted to other projects despite the increasing costs on healthcare. Additionally, Kings Fund publication (2018) identifies that people are living with complex medical conditions. This necessitates the long term plan that seeks to mitigate these challenges.

NHS England is implementing the right care intervention in healthcare. On the other hand, Wales’ approach is based on the NHS health plan with Scotland relying on the national clinical strategy which proposes how clinical services should change (The Scottish government 2016). Northern Ireland’s health policy provides guidelines to delivery of care in the country (Department of Health 2014)

NHS long term plan was developed following a guided development process. Porche (2019) explains that the policy development process provides a detailed step by step guidance on developing health policies. According to Baggott (2015) policy development entails setting the environment for the health policy, methodical development through need and resource assessment and health policy analysis. The endorsement of NHS long term plan originated from the NHS organizational structure with the board approving need for development of the policy. Data was collected from various sources and the draft policy developed. The board then approved the policy draft to effect the implementation of the long term plan. The participants in the policy development are member bodies that make up the NHS England and they include care quality commission, health education England, public health England, health and wellbeing boards and NHS England and commissioning groups (Powell 2017). These groups can be mobilised through creating a sense of shared commitment to healthcare that leads to coordinated action in health policy development (National Quality board 2018)

The NHS long term plan links with other publications focus on primary care for better management of cardiovascular diseases. The world health organization (2016) classifies cardiovascular disease under the diseases affecting the circulatory system. According to Public health England (2019), CVD is the leading cause of death worldwide accounting 17.9 million deaths annually and 31% of the global deaths. This compares to NHS long term plan projection that cardiovascular disease accounts for a quarter of all deaths. Additionally, the world health organization (2007) proposes that a total risk approach should be adopted in preventing CVD. This includes targeting high-risk people and undertaking clinical assessments.

Healthcare policy development often relies on historical data to draft the policy (Horton and Brown 2018). Statistics relied upon are based on documented cases through the entire policy development process which according to Horton and Brown (2018) involve identification of the national or global problem, policy formulation, MAVS (mapping, analysis, visualising and sharing), and evidence which leads to policy draft. However, according to Sheard (2017), use of history in policy development comes with challenges such as time. Sheard (2017) argues that much of history considered as relevant or useful form part of contemporary history and may not be useful in policy development to meet the anticipated future challenges. However, policy development presents an opportunity for networking with other policymakers and synchronizing the policymaking schedules (Sheard 2017). The policy issue is crucial for guiding the efforts in enhancing primary care and thus the NHS England boards are concerned with the long term plan, so is the government (Sheard 2017). The long term plan is thus crucial in care for cardiovascular disease. According to NHS England (2019), cardiovascular prevention leads to longer lives and healthy living and £4.5 billion are committed to be channelled into improving healthcare.

The funding that will be invested in the NHS long term plan for healthcare will be sourced from the national government, with local clinical commissioning groups poised to further supplement the funding (NHS England 2019). However, managing long term medical conditions among the aging population can be costly since the majority of people aged 75 and above have 3 or more medical conditions (Department of health and social care 2015). Short term measures for managing cardiovascular conditions involves working with local authorities to improve the current provision of care while in the long term, measures like training and recruiting more general practicing nurses would be effective (NHS England, 2019) since there is a general decline in the number of General practitioner nurses in UK (Quaile 2018). King Fund (2018) proposes that an integrated approach should be adopted to manage cardiovascular diseases which are the 2nd largest cause of death in UK.

Measuring the progress of the policy is crucial in enhancing the quality and effectiveness of care. According to Cyril et al (2015), the community engagement model is the most successful approach in providing care to ethnic and racial minority populations as enhanced partnerships, collaboration and empowerments increase access to quality care. To meet the demands of NHS long term plans, there is need for increased recruitment of general practitioner nurses as well as utilizing the digital healthcare system for outpatient patients. To measure the progress of the interventions in managing cardiovascular diseases, the reports on mortality rates can be useful since the trends in the statistics will point to an improving or worsening situation (NHS outcomes Framework 2019). In what appears to be anticipation of contingencies, the NHS Long term plan provides for effective emergency services that revolve around early warning systems and quick response to emergency situations and with the plan opening for continuous monitoring makes it flexible enough to accommodate new developments in healthcare.

NHS long-term plan is a viable guideline that would help England to revamp its healthcare system over the next 10 years. It is heavily reliant on the promise that it would experience a considerable rise in funding to about 3.4% annually (Oliver, 2018). Such occurrences compromise the quality of care. Related policies and publications such as Public Health England (2017) emphasize the need to effectively develop services for provision of primary and community care to manage cardiovascular diseases through approaches such as adequate funding, employing more skilled Nurses, utilizing digital nursing and effective risk assessment for early detection and prevention of cardiovascular disease conditions.

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References

Baggott R (2015), Understanding Health Policy, 2nd Edition. Bristol: Policy Press. https://doi.org/10.1017/S0047279416000726

Cyril S, Smith B, Possamai-Inesedy A, and Renzaho A (2015): Exploring the role of community engagement in improving the health of disadvantaged populations: a systematic review,

Department of health (2014): Making life better; a whole system strategic framework for public

Horton P and Brown G (2018): Integrating evidence, politics, and society: a methodology for the science-policy interface. Palgrave Communications, 4(42).

Kingsfund 2018: innovative models of general practice; ideas that change healthcare.

National quality board 2018: a shared commitment to quality; five years forward view, NHS England.

NHS England (2019): The NHS long term plan.

NHS England (2016): Leading Change, Adding Value: A framework for nursing, midwifery and care staff; A learning tool to support all nursing, midwifery and care staff to identify and address unwarranted variation in practice.

NHS outcomes Framework (2019): NHS Outcomes Framework Indicators - February 2019 Release; National statistics, Open data, Experimental statistic.

Oliver, D. (2018). David Oliver: Can the extra funds for the NHS really transform care? BMJ: British Medical Journal (Online), 362. Accessed from

PHE (2019): health matters: preventing cardiovascular disease.

Porche D (2019): Health policy; application for nurses and other healthcare professionals. 2nd Edition. Burlington, Jones and Bartlett learning

Sheard S (2018): History Matters: The Critical Contribution of Historical Analysis to Contemporary Health Policy and Health Care. Healthcare analysis, 26(2).

Timmins N 2018: “The world’s biggest quango”; the first five years of NHS England. The Kingsfund. Institute for the government.

WHO (2013): Health 2020; a European policy framework and strategy for the 21st century.

WHO 2016: international classification of diseases, 10th revision.

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