Cardiovascular disease kills more people in the UK than any other condition. It was a contributing factor in 39,000 premature deaths in England in 2022 alone — the highest annual figure since 2008, according to the British Heart Foundation. Behind that number are hundreds of thousands of people living with conditions that went undetected for too long, were misdiagnosed, or never received the treatment that could have changed their outcome.
For all the progress made in cardiovascular medicine over recent decades, the system doesn’t always spot patients early in the pathway. Heart failure, atrial fibrillation, and valve disease remain predominantly picked up at crisis point. For some of these conditions, up to 80% of patients are first identified when they present acutely but around half of them had already been to their GP with relevant symptoms beforehand.
The NHS is fully aware of these issues, and now there is both the political commitment and the strategic framework to do something about it.
The NHS 10-year health plan places cardiovascular disease at the centre of its ambitions. It is identified as the single condition where the NHS has the greatest opportunity to save lives over the coming decade. NHS England's cardiovascular programme sets a concrete ambition: to prevent over 150,000 heart attacks and strokes. The British Heart Foundation has described the plan's focus on earlier detection and prevention as a meaningful step forward, though one that will require sustained effort and investment to realise.
The plan's shift towards neighbourhood health has direct implications for cardiovascular disease. Managing complex, long-term conditions closer to home, through proactive primary and community care rather than reactive acute intervention, means:
These ambitions translate into specific asks of primary care, Integrated Care Boards (ICBs), pharmaceutical and medtech partners, and the organisations that help the NHS and industry work together effectively. The question is not whether the NHS should prioritise cardiovascular care; the question is how and who is equipped to help deliver it.
For common cardiovascular conditions, the detection challenge is partly one of scale and capacity. Primary care is under significant pressure, and the systematic identification of patients at elevated risk requires time, structured data review, and clinical focus, or indeed skill, that are difficult to apply during routine consultations.
For less common cardiovascular conditions, the challenge is compounded. Less common forms of cardiomyopathy, diseases of the heart muscle, are among the most consistently underdiagnosed conditions in UK cardiology. One such condition, caused by the accumulation of abnormal protein deposits in the heart tissue, is historically identified very late in its progression. Research has found patients experiencing misdiagnosis or missed diagnosis over a median of 17 secondary care visits before reaching the correct diagnosis. The estimated number of diagnosed patients in the UK sits in the low thousands; the number who remain unidentified in the system is unknown, but likely considerably higher.
The reasons are familiar. Awareness of the condition's red flags among primary care clinicians is variable. As one GP cardiac lead described it, "it's not on our radar." The symptom profile overlaps with more common cardiac conditions, making it easy to attribute presentations to something more familiar. And the interoperability gap between primary and secondary care, where referral letters and discharge summaries still travel by email or hard copy in many settings, makes it difficult to build a coherent picture of a patient's journey across the system.
The 10-year plan's push towards integrated neighbourhood health, with better data sharing and coordinated care across settings, creates an environment in which this kind of missed diagnosis becomes less likely. But this alone won’t change practice. Targeted intervention is still needed.
Healthtech innovation has a genuine role to play in closing the cardiovascular detection gap. AI-enabled diagnostic tools, wearable ECG devices, and point-of-care screening tools are all capable of identifying cardiac conditions earlier and more accurately than traditional methods. One example involves an AI-enabled stethoscope, trialled across more than 200 GP practices in northwest London in one of the largest implementation studies of its kind anywhere in the world, with findings published in The Lancet.
The headline finding, at the highest level, was that there was no statistically significant difference in the number of cases detected between practices that received the technology and those that did not.
But within that headline is a more revealing story. When the stethoscope was applied in more than 13,000 patient encounters, it detected a significant number of cases of undiagnosed cardiac disease. The problem was two-fold. First, by 12 months into the trial, 30% of GP practices had stopped using the device altogether. Second, even among practices that continued, the workflow around reviewing and acting on the results was insufficiently integrated into day-to-day clinical processes. The stethoscope worked, but the system around it did not.
This finding is instructive rather than discouraging and tells us precisely where the focus needs to be. Clinicians in busy primary care settings cannot sustain the use of any additionaltool that adds meaningful time and extra steps without fitting the rhythm of the consultation. Electronic health record integration matters: if a result does not flow directly into the patient record and prompt an appropriate review, it risks being missed entirely. And training needs to address not just how to use a tool, but when, why, and what to do with what it finds.
The practices that continued using the device had a higher detection rate for all the cardiac conditions of interest. The lesson is not that the technology failed. It is that technology deployed without workflow integration, training, and a clear action pathway will not deliver at scale, however well it performs in isolation.
Technology is one part of the answer; people and process are the other. And this is where NHS-industry partnerships, well-designed and well-delivered, could play a distinctive role.
CHASE has years of real-world experience working at the interface between the life science industry and the NHS. We design and deliver collaborative programmes that connect pharmaceutical and medtech partners with NHS organisations in a way that is clinically credible, operationally sound, and compliant with ABPI guidelines. In cardiovascular care, we see considerable unmet need and, with the 10-year plan now providing a clear strategic framework, a genuine window of opportunity to address it.
The approach we bring to this disease area draws on our experience across NHS–Industry Partnership work. A programme focused on cardiovascular care might, for example, centre on pharmacist-led structured reviews of patients already on the heart failure register in primary care, working through the established EMR infrastructure to identify those who may be at elevated risk of conditions that are being missed, optimising their treatment, and supporting GPs with a clear diagnostic and referral pathway into secondary care cardiology.
To illustrate what this could look like in practice, CHASE developed a detailed service proposal for exactly this kind of programme, focused on identifying patients at high risk of a rare but underdiagnosed form of cardiomyopathy within primary care. The service model was built around pharmacist-led reviews of existing heart failure registers, using validated clinical search criteria and red flag indicators developed alongside a consultant cardiologist, ICB directors, federation leaders, and GPs. Mapping the EMR landscape across EMIS Health andTPP SystmOne to ensure searches were deliverable within the real-world infrastructure of primary care, we outlined the stakeholder engagement approach, the governance structure, the project management framework, and the compliance pathway.
The approach reflects CHASE’s view of what it takes to create a workable NHS–Industry Partnership project. It can’t be transactional. It needs to be a genuine partnership and requires clinical expertise, the right NHS relationships, and a realistic understanding of what it takes to get a project through an ICB governance committee, a GP federation board, and into actual delivery.
Priyanka Hinton, Customer Solutions Director at CHASE, sees significant potential in this space:
'Cardiovascular care is one of the areas where well-designed NHS–Industry Partnerships can make a genuine difference to patients. The need is clearly there. The 10-year plan creates the strategic context. What it takes to realise the opportunity is the right expertise, the right NHS relationships, and a model that delivers for patients, for the NHS, and for the life science companies with treatments that need to reach the right people. That is exactly what CHASE is able to provide.'
For organisations with cardiovascular portfolios, particularly those working in areas where diagnosis rates are low and treatment access is limited, now is the time to exploreinnovative ways to help patients access new treatments and diagnostics. ICBs are being asked to prioritise the identification and management of complex cardiovascular conditions closer to home. Primary care is under pressure to improve management of patients already on cardiac registers. Secondary care cardiology teams need well-prepared, appropriately selected referrals, not volume.
A programme that identifies genuinely at-risk patients, equips primary care clinicians with the awareness and tools to act, and supports a clear pathway into specialist care serves all of those objectives simultaneously. It also builds the kind of NHS relationships and clinical evidence base that supports longer-term access for novel therapies in disease areas where the treatment landscape is evolving.
The stethoscope example is a useful frame. The technology detected disease when it was used. The gap was in everything surrounding the tool: the workflow, the training, the integration, and the sustained clinical engagement. That is a gap that people-centred solutions, not technology alone, are positioned to close.
Cardiovascular care is a national priority. The 10-year plan provides the framework, and the clinical need is well-evidenced. What determines whether patients benefit from the ambition is whether the organisations involved have the right partners to design, govern, and deliver programmes that reach people who are currently being missed.
If you are working in cardiovascular care and want to explore how an NHS–Industry Partnership could help identify more patients, improve treatment access, or support earlier diagnosis in your disease area, contact the CHASE team.
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