New service improvement project will help identify patients with an underlying heart condition

Ambulance clinicians can come across patients with conditions they are unaware of and are often different to the reason they called the ambulance.  One of these conditions is an abnormal heart rhythm called atrial fibrillation (AF).    

Having AF increases a person’s long-term risk of having a stroke, but the risk can be reduced with medication.  By communicating this to a patient’s GP, it can be followed up and appropriate medication can be started if needed. 

The project, which is funded by the British Heart Foundation and in partnership with Hull York Medical School, will monitor patients over a 12-month period. 

Starting from 30 September 2025, ambulance clinicians will complete their medical documentation as normal, but in the instance of a patient not being conveyed to hospital, information can then automatically be sent to the patient’s GP to say AF has been detected. Although this information is routinely shared, the new process will highlight the condition to allow a GP to follow-up with a patient more effectively.   

Research paramedic, Laura Blair said: “We hope that this process will improve detection of risk factors for stroke, ultimately reducing the number of people having strokes.   

“Over 139,700 of our patients are treated at home every year, without needing to be taken to hospital. By highlighting this condition with a GP earlier, it could result in a patient needing less medical treatment in future.      

“Previous work written by some of the project team and published in the British Paramedic Journal showed that as many as two people per day in the NEAS catchment appear to have AF detected by ambulance clinicians.” 

The researchers will compare information about patients before and after this new system starts, to see how this new process is affecting a patient. As well as looking at data from patients who did not have a GP letter sent, they will compare information from a previous year.  This will be 1 September 2023 to 31August 2024.  

Confidential data accessed will be NHS number, age, sex, ethnicity and past medical history of AF.  NHS number will be shared with NHS North of England Commissioning Support Unit, to find out numbers of people who went on to be diagnosed with, and treated for, AF.  These numbers will be received back to NEAS in an anonymised format.    

The patients whose information is shared in this new way will be aware of this process.  Relevant research approvals will be applied for, to access other comparator patient information.  Section 251 support has been given by the health research authority following advice from the confidentiality advisory group. 

Dr Chris Wilkinson, consultant cardiologist at James Cook University Hospital and one of the chief investigators for this project, will be working with NEAS as part of this work. 

He said “Stroke can be devastating but is often preventable through identifying and treating underlying risk factors like atrial fibrillation. This British Heart Foundation funded project will help ensure that atrial fibrillation is appropriately treated to reduce the risk of stroke.”   

Professor Bryan Williams, chief scientific and medical officer at the British Heart Foundation, said: “Atrial fibrillation is an important risk factor for stroke but, if spotted early, we have effective treatments that can reduce that risk. This interesting project could produce real improvements for patients, improving communication between the ambulance service and doctors to keep more people out of hospital. 

“At the British Heart Foundation we are excited to be supporting projects like this, which aim to harness technology to improve healthcare and prevent people experiencing heart and circulatory conditions in the future.”   

This project will respect existing national data opt outs. If you would like to specifically opt out of the atrial fibrillation notification project described here, please contact research@neas.nhs.uk.