Cardiovascular Update Event – 20th June 2019

Barnet Primary Care Training Hub (previously Barnet CEPN) is delighted to share with you some of the feedback and highlights from the second Barnet multi-professional educational event. The event had huge interest with 120 delegates in the room consisting of Practice Nurses, Nurse Practitioners, Health Care Support Workers, Pharmacists, GP Trainees and GPs. Jacqui Hodgson, CPD Lead for the training hub said “It is always a challenge to provide education for such a wide range of clinicians, however, the evaluations show there was something on the day for everyone”.  With an audience consisting of a number of professions, a delegate added it was great that “all members of the Multi-Disciplinary Team are on same page and well informed”

Speaker representation included Cardiology Consultants, CCG GP Leads, Community Specialist Nurses for Heart Failure and Diabetes, the Anti-coagulation Nurse Consultant, Public Health and our local GLL Better Leisure Manager.

The full agenda and mix of speakers ensured the event was packed with information, although some delegates suggested that there could have been more group work, which we will take on board for future events. The slides are available on the website www.barnetcepn.org.uk for people who weren’t able to join us on the day.

Cardiologists Dr Simon Kennon and Dr Sundeep Kalra provided the audience with some practical clear guidance with case studies of complex cardiology presentations in primary care including dizziness, syncope and breathlessness presentations.  It is anticipated that this will support appropriate referrals, with more primary care investigations carried out prior to referral.  ECG interpretation by Dr Kennon was a good refresher for the GPs and also contained useful guidance for others.

Did you know that Barnet Community Heart Function Improvement Service based at Edgware Hospital has four nurses who see patients in their clinic and at home? Jana Roberts gave a presentation about their service.  Please see their presentation for referral details.

It is always helpful to have case studies as reminders about the array of medication options for Diabetes, which the talk from Suraiya Kholil, Diabetes Nurse from CLCH, provided.  She would also like to remind anyone with a special interest in diabetes about the Merit Diabetes training days taking place over the summer. See flyer for more details.

It is always wonderful to work collaboratively with Barnet Public Health Team who had some interesting information about the new smoking cessation advisor and the healthy weight management programmes for both adults and children.  Since the meeting, Nicky Coote has asked us to relay the following information about some of the smoking cessation services and its evidence base in response to a question posed on the day. For further details contact Specialist Smoking Cessation Practitioner nicky.coote@barnet.gov.uk.

In response to a question from the audience, there is evidence that shows that giving NRT or another pharmacotherapy alone with just very brief advice (VBA) does often trigger a quit attempt, and it makes the person more likely by 1.5 times to successfully stop smoking.

Smoking cessation advice:

Myth Busting for HCPS and Patients

The benefits of VBA

Very Brief Advice: https://elearning.ncsct.co.uk/vba-launch

The London portal for those who don’t have a service near them

Cost effectiveness & Efficacy:

Cost-effectiveness of pharmacotherapy for smoking cessations

The effectiveness of NHS smoking cessation services: a systematic review

Following this session, Billy Philips from GLL got us all on our feet to remind us about the importance of exercise and prevention of Cardiovascular Disease. There are an increasing number of gyms across the borough offering very low cost memberships and exercise programmes.  See slides for referral details.  We would encourage all practice staff to be aware of these to strive to get Barnet fitter and healthier.

The event concluded with Dr Nicholas Mistry and Dr Amit Patel presenting the compelling evidence that lifestyle, exercise, weight management and avoidance of smoking and excessive alcohol can prevent cardiovascular disease in the first place.  It was a very useful session, especially the motivational interviewing techniques “top tips” which hopefully many of those present will utilise in their consultations.

Key Take Home Messages for all

It is clear from the evaluations of the day that clinicians are more aware of how to initiate NOAC and what are the essential considerations in the monitoring of these medications. Please see the useful slide presentations from Dr Nick Dattani and Dr Amit Shah of the AF pathways for Barnet and also Bunis Packham’s slides for more detail pharmacological information. Please remember NOT to put Dabigatran in dosette boxes as it degrades.  Most importantly don’t forget to measure pulses manually and use the Kardia/ Alivcor device, which most practices now have to detect AF early. If you still do not have one of these very helpful devices in your surgery email Amit Shah and he will organise one for you:   Amitshah4@nhs.net

For all those who attended we would like to thank you for your support and please share your learning with a colleague.

With thanks to Evelyn Diamond (Essentially Medical) for the administrative support and for providing the sponsor contacts who helped to fund the day.

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