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The Department of Health and Social care and NHS England’s Cardiovascular disease modern service framework, published on 7 July, aims to reduce premature deaths from heart disease and stroke in England by 25% within 10 years.

The framework sets out 12 priorities for earlier prevention, diagnosis and treatment of cardiovascular, kidney and metabolic risk factors, with a focus on reducing health inequalities and shifting care closer to home.

Central to the framework is a “holistic cardiovascular-kidney-metabolic (CVKM) approach with a strong focus on reducing inequalities”. The framework document explains that several conditions and risk factors share common causes, cluster within the same individuals and contribute to most heart attacks and strokes. These include:

• High blood pressure
• High cholesterol
• High blood sugar
• Obesity
• Chronic kidney disease
• Atrial fibrillation
• Smoking

The focus for the next 3 years is to drive “dramatic improvements” in 12 priorities “where the evidence of impact on reducing premature mortality is strongest and performance is currently inconsistent,” it says.

The document does not mention any potential role for pharmacy but does say that in order to drive delivery “priorities and their metrics are immediately aligned with 2026 to 2027 financial year incentive schemes and frameworks”, including the Community Pharmacy Contractual Framework.

However, priorities Pharmacy Magazine has identified that community pharmacies could potentially help deliver, some in collaboration with GP practices, include: 

• Proactively and systematically identify people who smoke and offer evidence-based smoking cessation and tobacco dependency services
• Improve uptake of sodium-glucose cotransporter 2 inhibitors (SGLT2i) for eligible people with heart failure, chronic kidney disease and type 2 diabetes.
• Ensure people with hypertension are treated to evidence-based targets
• Optimise lipid management for people at risk of CVD
• Deliver all nine diabetes care processes (blood glucose, cholesterol and kidney function, blood pressure, urine ACR, feet examination, weight and eyes, smoking cessation)
• Ensure people living with CVD have their cholesterol and blood pressure optimally managed to evidence-based targets. Use proactive monitoring and escalation where control is not achieved
• Rapidly increase uptake of 4 pillar therapy for eligible people with heart failure with reduced ejection fraction (HFrEF) with early initiation and timely optimisation.

Malcolm Harrison, chief executive of the Company Chemists’ Association (CCA) commented: “The Cardiovascular disease modern service framework (CVD MSF) sets out a bold approach to reducing premature mortality from heart disease and stroke.

“Community pharmacy's accessibility, location and presence within local communities make it ideally placed to play a greater role in CVD prevention, diagnosis and management. Additionally, a greater role for the sector can ensure targeted action in more deprived areas, where more pharmacies operate and the CVD burden is highest.”

“As a first step, we urge policymakers to expand the Community Pharmacy Blood Pressure Check Service. Further, independent prescribing should be harnessed by allowing pharmacists to initiate the supply of medicines to treat hypertension.”

The document advises that further information to support local systems to implement the framework will be published later in the year “with detail to prioritise existing resource” to deliver the activities.