Published on: 12,Aug 2025

Putting patients at the heart of cardiovascular reform

April Whitworth, Senior Policy Officer, British Heart Foundation

At British Heart Foundation (BHF), we exist to tackle one of the most pressing threats to our nation’s health. Cardiovascular disease (CVD) is needlessly causing early death, forcing people out of employment, and deepening health inequalities. Yet as many as 70% of cases in England are preventable.  

To meet its Health and Growth missions, Government will need to act decisively to transform cardiovascular care. 

A promising vision 

The recent 10 Year Health Plan (10YHP) for England offers a hopeful vision. Its commitment to a modern service framework for CVD, in particular, is a welcome recognition that progress on health and economic outcomes will depend on population-wide advances in cardiovascular health.  

Historically, service frameworks have delivered measurable gains. Government should build on past learnings, while embracing emerging opportunities, leveraging advancements in AI, data science and genomics. 

And to make this framework truly ‘modern’, patients must be central to its design. This will elevate it from one that solely improves clinical outcomes, to one that also upgrades patient experience. We can’t overlook the latter, with satisfaction in the NHS at an all-time low. 

What we heard from patients 

Following the publication of the 10YHP, BHF convened a series of workshops with Diabetes UK, Kidney Care UK, Kidney Research UK, and Stroke Association to hear from patients who share risk factors across these conditions. 

Patients welcomed the creation of neighbourhood health centres and felt the shift to delivering more care out of hospitals was right. 

However, concerns were raised about accessibility, particularly for those living in rural areas. There was strong support for co-designing centres with patients to mitigate these challenges. 

A desire for more holistic care 

Participants also saw neighbourhood centres as a vehicle to deliver more preventative care and long-term management. While many reported excellent urgent treatment, other types of care often fell short. 

“[It] feels like we have a national emergency service which works pretty well but following up on anything non-urgent is a disaster.”​ 

“The emergency treatment was excellent, but the ongoing question of how to live with a stroke is a bit ropey.” 

These voices illustrate a perception of the NHS as a sickness service, rather than one which promotes health. Patients called for greater public awareness and support to help spot warning signs and manage conditions independently. 

Patient empowerment cannot happen in isolation 

Improving access to preventative care isn’t just about increasing supply to meet demand. It also hinges on how individuals see themselves as candidates for care: while services define who needs care, people also decide what is worth seeking help for. This is based on how they interpret their symptoms, understand their eligibility, and how and when they choose to engage with services. If the public continue to conceive of the NHS as an emergency service, it will likely remain one. 

Of course, the system must be designed to enable patients to become active agents. With greater engagement will come increased demand, so services need the capacity to cater to this. Neighbourhood centres could facilitate better management of cardiovascular risk factors by offering convenient care, but questions remain on feasibility, infrastructure, and workforce.  

More broadly, our ability to make healthy choices is determined largely by our environment, and so service reform must be matched with action on the commercial determinants of health. The Healthy Food Standard is promising, but it now must pass through Parliament without interference from commercial interests. 

Keeping policy alive 

We encourage the long-term vision, but the 10YHP and CVD framework should also remain iterative. Embedding robust evaluation mechanisms in the delivery plan will help to ensure policy remains responsive to what is working, and what is not. This is particularly vital amid system-wide change. 

Patient feedback should be one tool by which to assess impact, though this must be meaningful. Measures such as patients dictating payments to providers risk undermining genuine improvement efforts and may lead to a host of unintended consequences.  

Turning ambition into action 

We are optimistic that the 10YHP and CVD framework can be catalysts for radical change. But patients need to be on board. 

Charities are well-placed to convene and amplify these voices. We’re ready to help Government develop an evidence-based framework that integrates patient and clinical needs, to deliver the step-change required for CVD.