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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

NSF for CHD is working

The BMJ has published a paper this week that examines the impact that the National Service Framework for Coronary Heart Disease (NSF for CHD) has had on secondary prevention in older patients1.

The study examined the uptake of antiplatelet, antihypertensive and lipid-lowering drugs in patients aged 69 to 74 with CHD and compared uptake rates from before (data from 1998-2001) and after (data from 2003) the introduction of the NSF. The data were analysed by diagnosis (myocardial infarction or angina) and gender.

In all cases the proportion of patients being prescribed the above classes of drugs increased, in some cases doubling. However, despite these improvements there is still considerable opportunity for improvement, for example less than half of patients with a diagnosis of angina are prescribed a statin.

Action: The NSF for CHD has had a positive impact on the care of patients with CHD. The QOF will have driven these improvements further, however some quick audit work will identify any remaining areas for improvement.


  1. Ramsay SE et al. Secondary prevention of coronary heart disease in older patients after the national service framework: population based study. BMJ 2006;332:144-5

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