GPs need more support from ICBs for CVD prevention, report warns

GPs need more practical support from ICBs to boost cardiovascular disease prevention in those at high risk of heart attacks and strokes, a report from The King’s Fund has concluded.

CVD prevention is not taking place at the scale that is needed with persistent and wide inequalities in deaths, the think tank said.

With CVD responsible for a quarter of all premature deaths in England, there are significant opportunities to improve health and ‘deliver economic benefits’ at the same time, the report concluded.

‘A concerted national drive’ on CVD prevention could have a dramatic impact and ease pressures on the NHS.

But there is a lack of capacity in ICBs to support GP practices doing CVD prevention ‘at scale’, it found.

The report also said there are ‘difficulties at the ICB level protecting funding for prevention’ amidst operational pressures.

Support from ICBs should include focusing resources on high-risk communities, including Black and Asian communities and areas of high deprivation.

Practices should also be provided with risk stratification tools and data to help identify who would most benefit from targeted CVD prevention.

Clinical leadership at the ICB level is vital for driving this forward but could be at risk as they undergo ‘significant changes’ over the coming months, it said.

Responsibility for CVD prevention should also be shared by the wider primary care workforce including nurses, pharmacists, and social prescribers with training provided for practices at PCNs, the King’s Fund found.

The focus on CVD as part of ‘prevention accelerators’ announced in the 10 Year Health Plan, is welcome but ‘falls short’ of the universal adoption of proactive approaches in general practice that is needed, the report concluded.

It cited research which found that if 80% of people with diagnosed hypertension had their blood pressure reduced to target levels using antihypertensives, the NHS could prevent 7,000 heart attacks, 10,400 strokes and 5,600 deaths in England over three years.

Figures from the Office for Health Improvement and Disparities show that over half a million middle-aged adults invited to an NHS Health Check in Jan-Mar 2025 did not take up the offer.

Pulse reported in April that practices in more than one area had been told to limit the number of NHS Health Checks they provide.

Longer term figures show that only around four in ten people have a health check when invited. They are offered every five years to 40-74-year-olds with no pre-existing health conditions.

Chris Naylor, senior fellow at The King’s Fund and report author, said it was great to see the government putting CVD at the centre of its ambitions around prevention.

‘For those ambitions to be met, existing efforts need to be ramped up significantly.

‘That means supporting GP practices across England to be more consistent at identifying, monitoring and treating people at risk of CVD, strengthening links between the NHS and public health teams in local authorities, and taking bolder national action to reduce risk factors such as obesity and smoking.

He added: ‘The prevention accelerators announced in the government’s 10 Year Health Plan will help, but we need to see change at scale across the country, not limited to a few pilot sites.’

Beccy Baird, also senior fellow at The King’s Fund, said: ‘If this work is to be successfully spread across ICBs, GPs will need the tools and the time to do it. Recent cuts in ICBs which have affected clinical leadership to primary care could make this harder, and it will be important that ICBs remain able to provide the support GPs will need to ensure this work.’

John Maingay, director of policy and influencing at the British Heart Foundation, said the majority of cardiovascular disease cases are preventable.

‘Integrated Care Systems (ICSs) have a major role in the shift that is needed from sickness to prevention, and much good work is already happening.

‘However, this report identifies some common systemic barriers to prevention at scale across the population, such as inconsistent and vulnerable funding for prevention, difficulty maintaining adequate staffing in ICSs, and varying levels of clinical engagement in primary care.’

Plans for neighbourhood health services have ‘great potential’ he added, but must be designed with these current barriers in mind and not just reproduce them in a new structure.