Better care of people with the heart rhythm disorder atrial fibrillation (AF) could help prevent an additional 11,600 strokes and save the NHS as much as £124 million a year. A new report from the national NHS improvement organisation, NHS Improving Quality, reveals current prescribing of warfarin, the main anticoagulant used in the UK to prevent blood clots from forming in the heart, is only half what it should be. It goes on to demonstrate how full implementation of new best practice guidelines could avoid almost 28,000 strokes each year and lead to overall savings of £293 million for the NHS in England.

To help drive improvements in the care of people with atrial fibrillation (AF) NHS Improving Quality has published an analysis of the costs and benefits of using the anticoagulant drug warfarin to help prevent stroke in people with AF. Using data from NHS Improving Quality's GRASP-AF audit tool, the report estimates that just over half of people with AF are getting drug treatment in line with recently updated best practice guidelines from the National Institute for Health and Care Excellence (NICE).

Should warfarin be prescribed for all people diagnosed with AF (apart from where anticoagulants are not suitable for or declined by the patient), in line with NICE guidance, a further 11,626 strokes would be avoided, saving an estimated 3,200 lives, compared to current prescribing. This would also save the NHS an additional £124m per year. There are further estimated savings to social care. The full report is available to download here.

Approximately 900,000 people in England have been diagnosed with AF, a condition that causes an irregular heartbeat. AF is known to increase the risk of stroke and heart failure. The latest best practice guidelines from NICE state that people with AF who are assessed as having the highest risk of stroke should be offered anticoagulation.

The analysis is based on data from GRASP-AF, an audit tool developed by NHS Improving Quality in conjunction with PRIMIS and supplied free of charge to the NHS in England. Over one third of GP practices across the country use the tool to help them manage the care of AF patients and reduce their risk of stroke. The report is based on data from over 1,000 GP practices that ran the audit in 2011-2012.

The analysis estimates that current prescribing of warfarin in AF patients helps prevent over 16,000 strokes per year. However, if all AF patients were being managed appropriately with warfarin a total of almost 28,000 AF-related strokes would be averted each year. The overall savings to the NHS alone of appropriate AF management with warfarin is estimated at £293 million a year, and £1.7 billion over a lifetime perspective.

Speaking about the report, Hilary Walker, Head of NHS Improving Quality's Living Longer Lives programme, said: "We know that effective anticoagulation really reduces the risk of having stroke. Data from the GRASP-AF audit tool shows us that currently not everyone is being managed as well as they should be. This is putting patients' lives at risk and costing the NHS and social care millions of pounds every year. GP practices can use the GRASP-AF tool for free to quickly identify patients who have, or might have AF, and check their management plan. We encourage all GP practices not currently using GRASP-AF to download the tool and start to audit their care of people with AF."

GPs in England can start using GRASP for free by signing up for free PRIMIS Hub membership at www.primis.nottingham.ac.uk/hub