In early 2025, our outpatient lipid service faced significant safety concerns, with patients waiting over 52 weeks for specialist review and the service placed on the Trust risk register due to the risk of 65-week breaches. This was particularly concerning in North West London, where >50% of patients with established cardiovascular disease are not achieving recommended treatment targets.
To address this, the lipid care pathway was redesigned across the Trust incorporating demand–capacity modelling and PDSA cycles. Pharmacist-led lipid clinics and pharmacist triage were introduced alongside a new clinic at Northwick Park Hospital to improve access for underserved populations.
Within six months, referral-to-treatment time fell from >52 weeks to 13 weeks, and performance against the 18-week standard improved from 47% to 100%. The redesigned service strengthened cardiovascular prevention through earlier identification and optimisation of lipid therapy.
Between August 2025 and February 2026, 26 new cases of familial hypercholesterolaemia were identified. 84% of patients with established cardiovascular disease were treated in line with NICE guidance, versus a regional baseline of 49% across North West London. Among primary prevention referrals, 73% achieved treatment targets compared with 51% locally.
Establishing a clinic at Northwick Park Hospital also improved equity of access, reducing patient travel time by 63% and lowering DNA rates. By the end of the 2025/2026 financial year, the waiting list for first appointments is expected to fall below four weeks.
This work demonstrates the value of pharmacist-led services in reducing waiting lists, improving access to care and delivering high-quality cardiovascular prevention.