Familial Hypercholesterolaemia: implementation guide

PHE, NICE, NHS England, HEARTUK  & The  British Heart Foundation|  August 2018 | Familial Hypercholesterolaemia: implementation guide

A new implementation guide, written collaboratively by PHE, NICE, NHS England, HEARTUK and the British Heart Foundation, highlights that improving care for those with Familial Hypercholesterolaemia will need a co-ordinated effort and a whole-system approach. 

Familial Hypercholesterolaemia (FH) is a genetic predisposition which more than 85% of people with FH in the UK are unaware that they have the condition and that they are at risk of premature heart disease. Untreated, people aged 20-39 with FH have a 100-fold increased risk of death from heart disease compared to those of a similar age without FH, and so early identification and treatment are absolutely crucial.

The new guide: Familial Hypercholesterolaemia: implementation guide, t

This guide IS aimed at local commissioners and service providers. By searching GP records for those at risk and offering DNA testing to family members of people diagnosed with FH we can start to address this hidden burden.

This implementation guide aims to provide practical support to organisations, helping them to identify the gaps in the provision of FH services in their local area, and helping them address these gaps in line with the recently updated NICE guidance.


It includes:

  • a summary of recommendations from the recent update of the document
  • an outline of national and European policy documents
  • best practice case studies

(Source: PHE, NICE, NHS England, HEARTUK  & The  British Heart Foundation)

Implementation Guide: Familial Hypercholesterolaemia Implementing a systems approach to detection and management


Guidance for CCGs on prescription for conditions that over the counter items treat

NHS England  | April 2018 | Conditions for which over the counter items should not routinely be prescribed in primary care: Guidance for CCGs 

New guidance from NHS England for Clinical Commissioning Groups (CCGs ) to take the proposed conditions for which over the counter items (OTC)  should not routinely be prescribed in primary care guidance into account in formulating local polices, and for prescribers to reflect local policies in their prescribing practice. Spending on OTC items for the year up to June 2017 was  approximately £569 million on prescriptions for medicines, which could otherwise be purchased over the counter from a pharmacy and/or other outlets such as petrol stations or supermarkets.drug-icon-2316244_1280
These prescriptions include items for a condition:

  • That is considered to be self-limiting and so does not need treatment as it will heal or be cured of its own accord;
  •  Which lends itself to self-care i.e. the person suffering does not normally need to seek medical advice and can manage the condition by purchasing OTC items directly.
    These prescriptions also include other common items:
  •  That can be purchased over the counter, sometimes at a lower cost than that which would be incurred by the NHS;
  •  For which there is little evidence of clinical effectiveness.

NHS England gives the example that for every  £1 million saved on prescriptions for OTC items could fund :

39 more community nurses; or

  •  270 more hip replacements; or
  •  66 more drug treatment courses for breast cancer; or
  •  1000 more drug treatment courses for Alzheimer’s; or
  • 1040 more cataract operations

The full guidance can be read at NHS England 

The Improving Access to Psychological Therapies (IAPT) Pathway for People with Long-term Physical Health Conditions and Medically Unexplained Symptoms  

NHS England & NHS Improvement  | March 2018  | The Improving Access to Psychological Therapies (IAPT) Pathway for People with Long-term Physical Health Conditions and Medically Unexplained Symptoms

NHS England & NHS Improvement  have developed, The Improving Access to Psychological Therapies (IAPT) Pathway for People with Long-term Physical Health Conditions and Medically Unexplained Symptoms. This guidance has been produced to support Clinical Commissioning Groups CCGs in expanding Improving Access to Psychological Therapies by commissioning (IAPT) services integrated into physical healthcare pathways.  To facilitate this expansion, it sets out the treatment pathway that that underpins the access and waiting time standards, which all services should seek to measure themselves against.

Image source: england.nhs.uk

From April 2018 all CCGs are expected to expand Improving Access to Psychological Therapies by commissioning (IAPT) services integrated into physical healthcare pathways (NHS England & NHS Improvement).

The guidance can be read at NHS England 

New data protection legislation affecting all NHS organisations

The General Data Protection Regulation (GDPR) is set to replace the existing Data Protection Act on 25 May 2018. It will require all organisations, which process personal data – including CCGs, to meet higher data protection standards.

Some of the new requirements of GDPR will be appointing a data protection officer, the ability to demonstrate that you are complying with the new law and higher penalties for those not following the rules.

The Information Commissioners Office has produced a package of tools and resources to help you get ready. These resources include:

Image source: ico.org.uk/

Further information can be found on the Information Commissioner’s Office’s website.

Best start in life: cost-effective commissioning

Public Health England  |  March 2018   | Best start in life: cost-effective commissioning  

Public Health England has produced guidance for local commissioners to provide cost-effective interventions for children aged up to 5 and pregnant women.  It is designed to support local authorities and clinical commissioning groups  when making commissioning decisions.


The interventions included in the tool have been selected because they demonstrate cost-effectiveness and good economic return aimed at the target population(s).  In total, there are eleven interventions; two of these are focused on breastfeeding uptake and the other nine look at preventing or treating postnatal depression (PND).

Best start in life: cost-effectiveness and ROI of interventions,  a report which provides further details on how the tool was constructed can be read at PHE 

Best start in life: return on investment tool can be  downoaded from PHE  

Further details are available at Public Health England 


Responsibility for prescribing between Primary & Secondary/Tertiary Care

The latest guidance for Commissioners has been published by NHS England. Its purpose it to provide clarity on the responsibilities of all professionals involved in commissioning and prescribing across primary, secondary and tertiary care, and to provide support in developing shared care agreements and in the transfer of care.


The guidance can can be read here 

Commissioning primary care services

NHS England has updated the Primary medical care policy and guidance manual to reflect the changing landscape in primary care co-commissioning.   This document provides commissioners of primary care services the context, information and tools to safely commission and contract manage primary medical care contracts.

The document is split into four sections:

Part A – Excellent Commissioning and Partnership Working

Part B – General Contract Management

Part C – When things go wrong

Part D – General