Atrial fibrillation (AF) is a type of irregular heartbeat condition which significantly increases your risk of stroke, but it is a manageable condition - the main treatment to reduce your stroke risk is blood thinning medication (anticoagulants). However, the condition is often not diagnosed and guidelines of how it should be managed are not always followed. By comparing local data on atrial fibrillation care, this work draws attention to regional variation in treatment and can support local areas to prevent more strokes.

Why was this work needed?

If the millions of people with AF in England were identified and then adequately treated with a medicine to prevent blood clots, around 7,000 strokes could be prevented and over 2,000 lives could be saved every year. However, many people with AF don’t know they have it and, even for those who do know, guidance on how to manage the condition is not always followed.

What happened?

‘AF: How can we do better?’ is a document produced by the Stroke Association in partnership with Public Health England, Royal College of Physicians, Royal College of General Practitioners and British Heart Foundation, which draws on publicly available data to compare AF care across different local areas. It was originally compared across what was known as Clinical Commissioning Groups (CCGs), but these are now known as Integrated Care Systems (ICSs) – the bodies responsible for planning and commissioning health care services in their local area.

What were the benefits?

By using local data to find where ICSs could be doing more to diagnose AF and prevent stroke, this document allows the Stroke Association and partners to make a clear case to improve care. With this information the Stroke Association and partners were able to draw attention to this issue, helping ensure people with AF are identified and given access to treatments, ultimately preventing strokes and saving lives.

For example, consultant cardiologist at Chelsea and Westminster NHS Foundation Trust, Dr Sadia Khan, explained:

“(When) I received the ‘AF: How can we do better’ data... we were building a case for improving AF detection and treatment in order to reduce the rates of preventable strokes in people with AF. I was able to use the data to evidence the case for change in Hounslow and to engage partners in the work. I am now working in collaboration with other professionals to run a pilot project to improve the detection of people with AF in Hounslow.”

What type of data was involved?

The data was drawn from Quality and Outcomes Framework (QOF), Public Health England (PHE) (now UKHSA), Sentinel Stroke National Audit Programme (SSNAP) and NHSIQ (now called the Improvement Capability Building and Delivery team).

This data is publically available and anonymous.

Who funded and collaborated on this work?

This work was carried out by the Stroke Association in partnership with Public Health England (now UKHSA), Royal College of Physicians, Royal College of General Practitioners and British Heart Foundation.

Where can I go for more information?


Example version of the 'AF: How can we do better' document for a GP service

Supporting healthcare professionals to raise standards, My Data, My Care, p.13