Resources for referring to the CVD Prevention Programme - NHS Birmingham and Solihull

Welcome!  This is a long webpage!  However, it contains in one place the resources HCPs may need to identify and invite/refer eligible patients to the Cardiovascular Disease Prevention Programme (CPP).  It is designed to be self-sufficient but you can also attend an education session or regular lunchtime drop-in if you have any questions or to find out more.

Referrals must be completed by June 21st 2023.

All relevant documents are available here for easy access.  Searches and Referral templates are already available on many Practice systems.

If you have any questions or feedback please contact kathryn.brown50@nhs.net 

Alternatively, we host weekly MS Teams drop-ins at 1230 on Thursdays – just copy this link into your diary.

Thank you very much and we look forward to your referrals.

If you are not from Birmingham and Solihull or are looking for a different service please see alternative pages here.



 Momenta’s targeted multi-component CVD Prevention programme supports eligible patients with hypertension or early-stage coronary artery disease to reduce their blood pressure and risk of progression to more serious conditions by making sustainable improvements to their diet, activity, weight and medication adherence.  Co-developed with the NHS, with input from BHF, early weight loss, cholesterol, HbA1c, mental health and fitness outcomes are promising.  

The programme comprises 18 one-hour group sessions delivered by trained Coaches over 9 months – either in-person on online.  You can read more about the programme  and patient journey in this document. 

Participant feedback

Participants have shared reams of positive feedback – we have included a small subset here.  You might find they help you explain the programme to your patients or just get a better feel for it:

"Great explanation of why blood pressure goes up"
"I’m finding the course very helpful and I’m delighted it seems to be working for me and has changed my mindset on what I eat and on encouraging me to be more active"
"I'm getting a lot of encouragement and good ideas from both our coach and the other participants"
"I’m very pleased my blood pressure has stabilised at a lower level"
"Nobody is judgemental, Its good to know you are not doing this alone .The coach is kind and helpful"
"It’s positive. It will help with lifetime changes for healthier living"
"It’s positive. It will help with lifetime changes for healthier living"


See below for quick reference for primary care inclusion and exclusion criteria.* 

This information is repeated at the top of the Referral form (see below and on your Practice systems).

*Note: Chest Pain Clinic eligibility criteria vary 

Eligibility Table


We know that both primary and secondary care are under significant pressure. Therefore, with ICB colleagues we have outlined three ways you can support your patients to access the service – with resources / instructions below:

  1. Register search and invitation: The most efficient approach to reach large numbers this involves running a register search to identify eligible patients and inviting them to find out more about the programme and register if interested. Invitations can be sent by bulk text (AccuRx) or letter with a leaflet – latter is more expensive and takes longer but is typically twice as effective. We suggest you perform a manual screen for non-searchable eligibility criteria (e.g. pregnancy, ability to benefit from a group programme etc.) before inviting patients.
  2. Ad hoc: The most personal approach. If appropriate (e.g. at diagnosis, after a NHS Health Check, at a LTC review etc.) HCPs can offer to refer their patients to the programme directly using a Referral form.
  3. Signposting: We have sent A4 posters and trifold leaflets to display in waiting / consultation rooms – these signpost patients to find out more and register if interested. You can also use the Heart Health Check to support signposting – see below. Finally, if you would like to promote the service using social media channels we can provide a toolkit.

 

Relevant documents are in the sections below – and may be available on your systems.

You can download this Microsoft Word version of the Referral form for ease of viewing – or to complete manually and send to us by NHS.net email if you prefer.



These documents may already be available on your practice system – see the downloadable ‘CPP EMIS Guide…’ below for instructions of how to search for them. If they are not on your system please email Kathryn Brown at kathryn.brown50@nhs.net and she will ask your CSS to upload them for you.

  1. Searches: There are two searches – one returns patients with a BMI >=30 (higher risk) and the second returns additional patients with BMIs of 25-29.9
  2. Invitation letter: Relevant details auto-populate.  We recommend sending a leaflet with letters.  You can use the ones we sent your practice, request more or print your own (see below).  See below for AccuRx text template.
  3. Referral form: Relevant details mostly auto-populate.  Eligibility criteria and the destination email are repeated on the form.

 



These documents are available on your practice system – see the downloadable ‘CPP TPP Guide How to locate…’ guide below.

  1. Searches: There are two searches – one returns patients with a BMI >=30 (higher risk) and the second returns additional patients with BMIs of 25-29.9
  2. Invitation letter: Relevant details auto-populate. We recommend sending a leaflet with letters. You can use one we sent your practice, request more or print your own (see below). See below for AccuRx text template.
  3. Referral form: Relevant details mostly auto-populate. Eligibility criteria and the destination email are repeated on the form.


We have also added MS Word documents of the invitation letter / text and Referral form fyi.



As noted above, the most time-efficient way to raise awareness amongst your patient population is to do a search, followed by an AccuRx message (like many practices do for the NHS Diabetes Prevention Programme, Healthier You) 

Summary steps include:

– Run Register search to generate ‘longlist’

– Conduct manual screen against non-searchable eligibility criteria

– Send a bulk text message using AccuRx templates

– This will signpost them to https://momentanewcastle.com/cpp-bsol where they can find out more about the programme and sign up securely if interested.

  

Suggested wording for AccuRx text invitation – please amend as you like:

Screening by the practice has identified that you MAY be eligible for the FREE new Cardiovascular Disease Prevention Programme.  This helps you reduce your risk of heart disease, lose weight and improve your blood pressure. For details see https://momentanewcastle.com/cpp-bsol 

If you are interested, please sign up quickly as places are limited.

Notes to practice: 

– We recommend you add the name of an individual e.g. well-known doctor or other HCP to the text as this will improve the response rate over a generic practice sign-off

– AccuRx automatically starts the message with, Dear (patient name)

– You can replace the url with this bitly link if preferred

http://bit.ly/3YRKQyY  

Patient readiness

This kind of programme might not be acceptable or helpful to all eligible patients. If you are speaking to a patient who expresses interest it’s important for them to think carefully about whether this is the right type of support and the right time for them to take part. 

For example, you could suggest they consider questions like:

How important their heart health is to them at this point in their life?  Whether a group format appeals? Are they in a position to commit to attending 18 sessions over 9 months?  If they are unsure it might not be the right approach or time to refer them.



We have sent your practice 4 A4 posters and 15 trifold leaflets for waiting/consultation room display.  If you would like more please email us – see below for details.  

You can also download A4 PDF versions of the Patient Information Leaflet and Patient Information Poster to print locally or send electronically (e.g. using AccuRx).

Finally, in addition to the landing page referenced above, we have developed a public-facing website and self-registration page.  These are referenced on the patient information leaflet but you can signpost patients here too:

Website: https://momenta.health/cpp

Link to secure self-registration link 



The presentations and recordings will be available here in due course.

The MS Teams information for the session is here:

COMING SOON

Files Coming Soon



Referrals

momenta.bsol-cpp@nhs.net

Momenta Newcastle

Kathryn Brown – Engagement Officer

 kathryn.brown50@nhs.net

Alternatively, we host weekly MS Teams drop-ins at 1230 on Thursdays. 

0121 289 2505

NHS Birmingham & Solihull

Corrie Gardiner – Long Term Condition Project Manager; CVD & Stroke



The CVD Prevention Programme (CPP) in Birmingham and Solihull is funded by the NHS, through SBRI and the Accelerated Access Collaborative.  

The CPP is delivered by Momenta, working in partnership with NHS Birmingham and Solihull, the West Midlands Academic Health Science Network, Birmingham City Council, the British Society of Lifestyle Medicine and other partners.  

The CPP was co-developed by Momenta with the South Eastern Health and Social Care Trust in Northern Ireland and input from the British Heart Foundation. 



Files Coming Soon

Referring to the NHS Low Calorie Diet or from a different area?

Momenta also provides the NHS Low Calorie Diet programme in Birmingham and Solihull and other areas, each with their own referral forms, local contacts and minor differences. Please follow the links below for LCD Referrer information:

Birmingham and Solihull

Newcastle

North East & North Cumbria

Somerset



Complaints should be addressed to the Provider (Momenta Newcastle):  complaints@momentanewcastle.com 

Complains Procedure

Answer yes if:
  • You have been told by a health care professional that you have high total cholesterol, or high LDL (bad) cholesterol.
  • You are taking medication to lower your cholesterol e.g. statins.

Note: If you’ve taken your own cholesterol using an at home kit and had a high reading this is not a clinical diagnosis and you should answer “Don’t know” to this question.

Your Heart Health Report will give you more information about this risk factor and how you can get it measured.

Answer yes if you:
  • Include vegetables or fruit at every meal
  • Choose fruit for dessert or as a snack
  • Almost always eat wholegrain cereal products like wholegrain bread, wholewheat pasta and brown rice over “white” alternatives
  • Eat fish, beans, lentils, white meat or some dairy foods as your main sources of protein in most meals
  • Eat red or processed meat only occasionally, if at all
  • Reserve sweet treats and sugary drinks for special occasions rather than having them every day
  • Limit foods that are high in salt and don’t add salt to meals
What counts as physically active?

All activity is good activity but some has greater health benefits. This question is asking for how much “moderate” intensity activity you do.

If you’re working at “moderate” intensity , typically:

  • your heart rate increases
  • you feel warmer and may start to sweat
  • you breathe a little faster or harder but are not out of breath
  • you can carry on a conversation, taking a few extra breaths between sentences, but not be able to sing

 

Simply walking more quickly than normal or cycling can achieve this. Other activities like housework, gardening, dancing, exercise and sport can also have the same effect.

Note: If you can’t sing or have to take a breath between words, this can be described as “vigorous” activity. To answer this question, count every 1 minute of vigorous activity as 2 minutes of moderate activity.

Answer yes if: you drink more than 14 units a week

If you’re not sure how much alcohol you drink in a typical week, use our “Alcohol Units” diagram to find out. Think about the type and how many drinks you have over the course of a typical week and use the diagram to calculate your average number of units per week.

If you’re still not sure answer “Don’t Know”

Answer yes if:
  • You’re of white family origin and your BMI is 25 or above.
  • You’re of Black African, African Caribbean, South Asian, Chinese, Middle Eastern and mixed family origin, and your BMI is 23 or above (you have a higher risk of developing some long-term conditions like Type 2 diabetes and cardiovascular disease at a lower BMI ).
Calculate Your BMI

This link will open a new browser window, so you can use the NHS BMI calculator to work out your BMI.

This link will open a new browser window, so you can use the British Heart Foundation BMI calculator to work out your BMI.

This browser window will stay open, so you can come back and carry on with your Heart Health Check straight away.

If you’re still not sure what your BMI is, answer “Don’t know”

Answer yes if:
  • You have been told by a health care professional that you have diabetes (Type 1 or Type 2) or pre-diabetes
  • You are taking medication for diabetes e.g. metformin

Note: If you’ve taken your own blood glucose (sugar) using an at home kit and had a high reading this is not a clinical diagnosis of pre-diabetes or diabetes and you should answer “Don’t know” to this question.

Your Heart Health Report will give you more information about this risk factor and how you can get it measured.

Answer yes if:
  • You have been told by a health care professional that you have high total cholesterol, or high LDL (bad) cholesterol.
  • You are taking medication to lower your cholesterol e.g. statins.

Note: If you’ve taken your own cholesterol using an at home kit and had a high reading this is not a clinical diagnosis and you should answer “Don’t know” to this question.

Your Heart Health Report will give you more information about this risk factor and how you can get it measured.

Answer yes if:
  • You’ve been told by a health care professional that you have high blood pressure (hypertension)
  • You take medication for high blood pressure (hypertension)

Note: If you’ve taken your own blood pressure at home without support from your GP surgery and had a high reading this is not a diagnosis of high blood pressure, which can only be done by a health care professional. You should answer “Don’t know” to this question.

Your Heart Health Report will give you more information about this risk factor and how you can get it measured.