Atrial Fibrillation (AF) Detection Pilot in Primary Care (2025)

Leicester, Leicestershire and Rutland Integrated Care Board (LLR ICB)

Project summary

CVD causes a quarter of all deaths in the UK and is the largest cause of premature mortality in deprived areas. LLR ICB provides care for some of the most deprived populations in England and interventions related to improving CVD outcomes presents an opportunity to reduce health inequalities. Identifying patients with AF and using best value DOACs was one of the NHSE Medicines Optimisation Priorities chosen by LLR in 2024-25. To align to this, the opportunistic AF Detection Pilot was initiated following analysis of PHE and 20/21 QOF, that estimated approximately 6000 patients across LLR have undiagnosed AF. The largest prevalence gaps appeared in PCNs in areas of high deprivation.

A task and finish group was established which included Medicines Optimisation pharmacists, Clinical Leads from the Long-Term Conditions Group, diagnostics managers, finance and communications experts. The group met monthly and established 3 objectives: increase awareness of AF, increase AF detection in hard-to-reach populations using a simple digital diagnostic tool, provide ECG and AF diagnosis training.

To meet these objectives a strategy was developed with the communications team to address how to reach diverse populations across LLR. The diagnostic tool MyDiagnostick was selected after a device appraisal based on its simplicity, accuracy and portability. A SOP was written to support use of the device, along with development of a reporting template. Educational sessions, related to ECGS and diagnosis of AF, were delivered virtually. Moreover, the pilot proposal was presented at several ICB forums to ensure governance requirements were satisfied. Funding for the pilot was secured through a grant from the pharmaceutical company Daiichi Sankyo. 

Expressions of interest were sought following the launch of the pilot at a LLR wide webinar, with particular focus on encouraging participation from areas of lower AF prevalence. 42 practices out of 126 across LLR ICB, registered an interest to take part. Practices were then invited to an introductory session and asked to sign a memorandum of understanding to confirm involvement.

Monthly outcomes are being measured via SystmOne and EMIS templates: number of patients screened, number cases of AF detected, and number of confirmed diagnoses of AF following 12 lead ECG. We hope to see improvement in longer term outcomes in AF prevalence data captured by QOF and CVD Prevent in the future. The pilot is currently ongoing.