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Reminder: Feedback opportunity re process to review CVD Guidelines closes this fridayon 5 March
Reminder for College members, if you have any comments to make, please follow the link below to submit directly by Friday.
22 February 2013
Kia ora kotou
RE: Ongoing review and discussion of clinical practice for CVD Risk Assessment
This letter outlines a proposed approach for agreeing a shared clinical practice for effective and consistent CVD risk assessment.
Discussions between the Ministry, Cardiac Network, Heart Foundation, clinicians, DHBs and PHOs last year highlighted a need to review the current CVDRA guidelines. In light of different approaches to risk assessment, the learning from doing CVDRA in a general practice environment and to keep pace with emerging evidence and research within a New Zealand context.
We are working towards a target of seeing 90 percent of the eligible population having had a cardiovascular risk assessment within the last five years, by July 2014. To achieve this target and the associated patient outcomes we are working towards we need a consistent approach to cardiovascular care that can be effectively applied across the health sector. Succeeding in this relies heavily on the expertise and leadership of our primary care practitioners.
Outlined below is a proposed process that emphasises primary care leadership and expertise, with the Ministry primarily acting as a facilitator to the process. We would appreciate any feedback on the proposed process for completing this review, which is outlined below.
1. To assemble a small working group (5 – 7 people) to undertake the review together.
2. The working group would be composed primarily of various leaders and specialists with primary care experience and expertise in clinical practice, general practice management and cardiology.
3. The working group would meet face to face to work through the related issues and develop an agreed recommended practice approach with each of the key issues in mind.
4. These recommendations would then be circulated for further feedback and input from the cardiology sector, before being finalised.
5. The finalised recommendations are expected to be completed by the end of May 2013.
The key issues that need to be addressed by the working group are likely to include:
· Whether practice needs to be oriented towards assessment, screening, or both.
· Ways to simplify and streamline data recording systems and process.
· Relevance of current CVDRA guidelines – any areas that need updating.
· Best approaches to risk identification given the New Zealand context and emerging research.
· Identifying ways to updating current practice to most effectively improve patient outcomes.
· Ensuring what is recommended will work practically within the context of a general practice environment.
New Zealand patients rely greatly on their health practitioners. We need to collectively ensure we maximise every opportunity we have to reduce the instance of cardiovascular disease, especially where the development of these and other long-term conditions may be preventable.
To successfully achieve this, we need to work collectively and consistently together – sharing the best of our resources, practice and knowledge across the sector.
I look forward to any additional feedback or suggestions you might have regarding the proposed process outlined in this letter and I particularly look forward to the outcome of the working group and the recommendations they will produce.
Please address your feedback to CVDfeedback@moh.govt.nz, and submit it by the close of day, Friday 8th March 2013.
Once the feedback has been received and considered, and assuming there is sufficient endorsement for the proposed approach, we will focus quickly on the composition of the panel in order to get the review process in operation as swiftly as possible.
Dr Andrew HamerChairCardiac Network
Karen Evison Acting Target Champion More Heath & Diabetes ChecksMinistry of Health
Prof Norman SharpeMedical DirectorNZ Heart Foundation