PrescQIPP

Development of an Integrated Pharmacist-Led Lipid Clinics at University Hospitals of Derby and Burton NHS Foundation Trust (UHDB) (2025)

Cardiometabolic Service at University Hospitals of Derby and Burton NHS Foundation Trust (UHDB)

Project summary

To address the growing burden of cardiovascular disease (CVD), long waiting times, and health inequalities across Derbyshire, University Hospitals of Derby and Burton NHS Foundation Trust (UHDB) developed and implemented Integrated Pharmacist-Led Lipid Clinics (IPLCs). This innovative model empowered an advanced pharmacist prescriber to deliver specialist lipid management, supported by digital infrastructure and multidisciplinary collaboration.

Traditional consultant-led clinics were unable to meet demand, with waiting times exceeding seven months. IPLCs introduced two additional teleclinics, one virtual review clinic, and one injectable clinic per week, increasing capacity by 89% for teleclinics and 200% for injectable clinics. By January 2025, waiting times had reduced to under two weeks. Between January and November 2024, 421 IPLC appointments were conducted, achieving an average LDL-C reduction of 2.43 mmol/L, which is supported by published literature to be associated with a 53.5% reduction in major vascular events after one year.

The model is underpinned by a bespoke cardiometabolic module within SystmOne, enabling seamless integration between primary and secondary care. This digital tool supports real-time access to patient records, blood results, and prescribing history, reducing administrative burden and improving continuity of care. Integration with Accurx further enhances patient engagement through personalised communication, appointment scheduling, and educational resources via SMS or email.

The IPLC model aligns with all four medicines optimisation principles: it is patient-centred, evidence-based, embedded in routine practice, and prioritises safety through timely initiation and titration of NICE-approved lipid-lowering therapies. These include statins, ezetimibe, bempedoic acid, Inclisiran, and PCSK9 inhibitors.

Patient and stakeholder feedback has been overwhelmingly positive. Of 71 anonymised patient surveys, the majority rated their experience as “good” or “excellent,” citing improved understanding, confidence in self-management, and appreciation for personalised care. Stakeholder interviews with consultants, nurses, and ICB leads highlighted improved access, outcomes, and collaboration.

Financially, IPLCs cost approximately £174,000 annually compared to £241,000 for consultant-led clinics, yielding a £67,000 annual saving. The model is scalable, cost-effective, and replicable across other services and regions. It supports NHS Long Term Plan goals and exemplifies a sustainable, digitally enabled, and patient-focused approach to preventative care. Whilst also supporting Lord Darzi’s vision for a shift towards preventative, patient-centred care.