Project Name: Connected Cholesterol Care: Digital Pathways for Lipid Optimisation taking a population health approach 

Project Summary: 

This Collaborative Working Project (CWP) aims to improve the quality, consistency, and equity of care for patients with atherosclerotic cardiovascular disease (“ASCVD”) who are at high risk of future cardiovascular events and who are not achieving lipid targets in line with national and/or local clinical guidance.

Our CW Partner is currently experiencing variation in lipid optimisation following myocardial infarction (MI), particularly for patients managed virtually by secondary care services. While post‑MI virtual clinics provide specialist oversight, access to timely blood testing is frequently limited due to patient geography, reduced hospital attendance, and variable primary care accessibility. These challenges can delay treatment optimisation and reduce adherence to secondary prevention pathways

The key objectives of this CWP are to: 

  • Improve lipid management and secondary prevention outcomes for post‑MI patients.
  • Increase access to timely blood testing and follow‑up closer to patients’ homes.
  • Reduce barriers to care associated with geography and healthcare system accessibility.
  • Strengthen integration between hospital, community pharmacy, and digital services.

This CWP will pilot a new community‑based service to complement existing secondary‑prevention pathways for post‑MI patients (incident population) who would typically remain under hospital follow‑up via a virtual post‑MI clinic. Eligible patients will be referred from the hospital pathway into participating community pharmacies, where Point of Care Testing (POCT) and structured follow‑up will support lipid optimisation and ongoing secondary prevention. This approach is designed to improve continuity of care while maintaining specialist oversight and clinical governance from our CW Partner who retains full clinical responsibility and decision making authority.

The scope of this CWP contributes to a wider pilot programme across NEL. Data generated through this CWP, alongside complementary activity delivered by the CW Partner, will inform and provide the evidence base for the development of a future business case for continuation of this service. 

Expected Benefits: 

Anticipated benefits for patients: 

  • Improved access to lipid management care leading to optimal management and management of CVD treatments closer to home. 
  • Enhanced experience around CVD with ongoing management of the condition.  
  • Improved access to appropriate medication for suitable patients to preserve health and prevent long-term events 
  • Easier and improved access to lipid management care closer to home in the primary care setting 
  • Reaching patients that are underserved and thus reducing health inequalities 
  • Increased education and support closer to home

Anticipated benefits for the organisation: 

  • Increased proportion of CVD patients managed by primary care in community pharmacy 
  • Increased proportion of CVD patients receiving timely review closer to home with support from the tertiary cardiac centre - joined up approach to support lipid optimisation   
  • Increased proportion of patients receiving guideline-directed pharmacotherapy 
  • Developing clinical services in community pharmacies enables access to primary care as well as supports the neighbourhood health service model, treating people closer to home.  
  • Improved lipid targets for the system – NEL ICB - set out by NICE guidelines

Anticipated benefits for Novartis: 

  • Insight on development of innovative pathways to improve access to licensed medicines in line with NICE guidelines for CVD, including Novartis’s medicine 
  • Enhanced reputation, and supporting Novartis’ vision that no patient should have to wait for an extraordinary life, by supporting high quality collaborative Working with healthcare organisations which addresses the problem of health inequalities  
  • Ethical, professional, and transparent relationship between Novartis and the Healthcare Organisation
  • Novartis is likely to see positive outcomes as a result of the CWP. As more patients are reviewed there is a potential for greater utilisation of Novartis’s licensed medicines, in line with national and local guidelines, where appropriate, leading to improved patient care

Start Date & Expected Duraton: July 2026 for approximately 23 months

FA-11737910 | July 2026