New insight into whole system approaches for cardiovascular disease prevention

A new briefing, published today, shows that strengthening cardiovascular disease (CVD) prevention is as much about improving systems working as it is about clinical practice and treatment.

CVD accounts for one in four premature deaths and affects over 7 million people in the UK. And with growing adult obesity, combined with an ageing population, an additional 2 million people could be living with CVD by 2040. The case for improving prevention couldn’t be stronger.

Drawing on the experiences of three Integrated Care Boards (ICBs) – West Yorkshire, Birmingham and Solihull, and the Black Country – the publication highlights seven enablers, supported by real-life examples of practice that others can learn from for their own systems.

The enablers highlighted in the briefing are:

• Clinical and workforce models
• Community and outreach models
• Data infrastructure
• CVDPREVENT dashboard
• Standardised treatment protocols and pathway optimisation
• Integration of the primary-secondary interface

The briefing was developed following the System Improvement Support we provided to these three ICBs between September 2025 and February 2026. We delivered the programme in partnership with the NHS Alliance and were supported by Novartis. 

During the programme, CVD leads across all areas experienced significant uncertainty regarding future funding, structures and roles. Despite the challenges faced by ICBs in this context, we were able to support them to identify clear enablers for cross-system working at different levels of the system to maximise the effectiveness of CVD prevention. 

And beyond the insight generated in the briefing, the programme had an impact for those involved, highlighting the importance of bringing people together, from across organisations and giving them a safe space and protected time.

Participants valued the diversity of people working on CVD prevention in the workshops, including public health, primary, community, secondary care, to create a shared view of what was happening across the system. 

In West Yorkshire, participants spoke about the need to continue meeting to develop system-wide approach after the programme. 

For participants from Birmingham and Solihull and Black Country ICBs, it was the first time people across both areas were brought together on CVD prevention before the ICBs cluster. This gave them the chance to build relationships and understand each other challenges and opportunities to share best practice and programmes. 

System Improvement Support is a tailored service that we provide to support organisations and systems to help them to drive large-scale, sustainable change quickly and collaboratively. Applying our cross-system improvement framework and drawing on our experience in creating the enabling conditions for systems change, we support health and care organisations to transform services and achieve sustainable improvement.