Lesley Williams Assistant Director Primary Care Strategy Londonwide LMCs and Londonwide Enterprise Ltd Tel: 020 7387 2034 ext *221 Direct Dial: 020 3818 6221 Mobile: 07768 109690 Email: [email protected]<mailto:[email protected]> Web: www.lmc.org.uk<http://www.lmc.org.uk/> Twitter: @LondonwideLMCs
Dear all Please see below in case this has not come through your usual channels. Kind regards Lesley Lesley Williams Assistant Director Primary Care Strategy Londonwide LMCs and Londonwide Enterprise Ltd Tel: 020 7387 2034 ext *221 Direct Dial: 020 3818 6221 Mobile: 07768 109690 Email: [email protected]<mailto:[email protected]> Web: www.lmc.org.uk<https://eur02.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.lmc.org.uk%2F&data=05%7C01%7CLesley.Williams%40lmc.org.uk%7Cb404c2656c604c11f4c008da7b033ded%7C5670c82635004dfd9a7fc45939b3c53f%7C0%7C0%7C637957551100765190%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=slwUo9MerxHRuIsXplSVtqXxTgbcB1pnnnj9HrZMH4Y%3D&reserved=0> Twitter: @LondonwideLMCs ---------------------------- Visit www.lmc.org.uk/coronavirus-covid-19 for the latest official resources and guidance on covid-19. 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From: EVANS, Nick (NHS NORTH WEST LONDON ICB - W2U3Z) <[email protected]<mailto:[email protected]>> Sent: 10 August 2022 12:11 To: EVANS, Nick (NHS NORTH WEST LONDON ICB - W2U3Z) <[email protected]<mailto:[email protected]>> Subject: Implementation of the NHS National Framework Agreement for the Supply of DOACs in England for Adults with Atrial Fibrillation Sent on behalf of the Medicines Management team for the attention of NW London PCN Clinical Directors - please disseminate to members The North West London Atrial Fibrillation Working Group has provided guidance for clinicians<https://eur02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.nwlondonics.nhs.uk%2Fprofessionals%2Freferral-guidelines-and-clinical-documents%2Fcardiology&data=05%7C01%7CLesley.Williams%40lmc.org.uk%7Cb404c2656c604c11f4c008da7b033ded%7C5670c82635004dfd9a7fc45939b3c53f%7C0%7C0%7C637957551100765190%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=FfsTbHzSEs4m3hHGW4A5D4DNNSVkSl984wUXy1eF3Mo%3D&reserved=0> to support them in adopting the principal commissioning recommendation from the NHS National Framework Agreement for the Supply of DOACs in England. The NHS Investment and Impact Fund 2022/23 indicator CVD-06 measures the number of patients who are currently prescribed Edoxaban, as a percentage of patients on the QOF Atrial Fibrillation register and with a CHA2DS2-VASc score of 2 or more (1 or more for patients that are not female) and who are currently prescribed a direct-acting oral anticoagulant (DOAC): https://www.england.nhs.uk/wp-content/uploads/2022/03/B1357-investment-and-impact-fund-2022-23-updated-guidance-march-2022.pdf<https://eur02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.england.nhs.uk%2Fwp-content%2Fuploads%2F2022%2F03%2FB1357-investment-and-impact-fund-2022-23-updated-guidance-march-2022.pdf&data=05%7C01%7CLesley.Williams%40lmc.org.uk%7Cb404c2656c604c11f4c008da7b033ded%7C5670c82635004dfd9a7fc45939b3c53f%7C0%7C0%7C637957551100765190%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=bCEsSAFLC7i6VLg8oPN09CuyAFBK8y3PUl0A8b2eIbM%3D&reserved=0> NHS Commissioning recommendation for patients commencing treatment for Atrial Fibrillation - subject to the criteria specified in the relevant NICE technology appraisal guidance: * Clinicians should use edoxaban where this is clinically appropriate. * If edoxaban is contraindicated or not clinically appropriate for the specific patient then, subject to the criteria specified in the relevant NICE technology appraisal guidance, clinicians should then consider rivaroxaban first, then apixaban or dabigatran. NW London Atrial Fibrillation Working Group recommendations * If edoxaban is contraindicated or not clinically appropriate for the specific patient, the contraindication or reason(s) that it is not clinically appropriate should be documented in patients' notes. * Existing DOAC patients already established on an alternative DOAC for Atrial Fibrillation should continue on their current DOAC (provided they are not experiencing adverse events of concern and provided their current DOAC is not contraindicated). Please note: This NW London document has taken its key principles for initiating new patients on edoxaban when clinically appropriate from the NHS England guidance as outlined in the document, 'Anticoagulation for non-valvular atrial fibrillation (NVAF) following NHSE DOAC commissioning recommendations'.<https://eur02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fevessio.s3.amazonaws.com%2Fcustomer%2F8603be9c-b8c3-49ef-86d2-e4ccb958c5d1%2Fevent%2F9ea04726-5981-493a-871e-91a7eba91159%2Fmedia%2FGeneral_Content%2F2b4b1529-node_FINAL_Guidance_on_prescribing_anticoagulation_in_NVAF_July_22_v2.pdf&data=05%7C01%7CLesley.Williams%40lmc.org.uk%7Cb404c2656c604c11f4c008da7b033ded%7C5670c82635004dfd9a7fc45939b3c53f%7C0%7C0%7C637957551100765190%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=P7z3m03Jt8o%2B10XRufmerIxj5gPd7zwmlgFPIXJDwi8%3D&reserved=0> For guidance on switching (e.g. from one DOAC to edoxaban), please refer to the national guidance document, 'Anticoagulation for non-valvular atrial fibrillation (NVAF) following NHSE DOAC commissioning recommendations.<https://eur02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fevessio.s3.amazonaws.com%2Fcustomer%2F8603be9c-b8c3-49ef-86d2-e4ccb958c5d1%2Fevent%2F9ea04726-5981-493a-871e-91a7eba91159%2Fmedia%2FGeneral_Content%2F2b4b1529-node_FINAL_Guidance_on_prescribing_anticoagulation_in_NVAF_July_22_v2.pdf&data=05%7C01%7CLesley.Williams%40lmc.org.uk%7Cb404c2656c604c11f4c008da7b033ded%7C5670c82635004dfd9a7fc45939b3c53f%7C0%7C0%7C637957551100765190%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=P7z3m03Jt8o%2B10XRufmerIxj5gPd7zwmlgFPIXJDwi8%3D&reserved=0> ************************************************************************************** ****************************** This message may contain confidential information. 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