Deborah Bent and David Foord

This section provides a summary of the NSF for CHD from a primary care perspective. Primary healthcare professionals (e.g. General Practitioners and Practice Nurses) will be able to use this section to identify and understand the key standards and milestones highlighted in the NSF.

The NSF for CHD was published in March 2000. Paper copies of the document are available (free of charge) from the Department of Health (tel: 08701 555455). The document is A4 and comes in a pink and white plastic folder - there will probably already be a copy in your practice. You can also access the NSF via the Department of Health website: www.doh.gov.uk/nsf/coronary.htm#chdnsf

The NSF for CHD comprises of an executive summary and seven clinical chapters:

1. Reducing heart disease in the population
2. Preventing CHD in high-risk patients
3. Heart attacks and other acute coronary syndromes
4. Stable angina
5. Revascularisation
6. Heart failure
7. Cardiac rehabilitation
The key chapters for primary care are chapters 1, 2 and 6.

Within each of these clinical areas, the following issues will need to be addressed at a practice level:
· Enhanced record keeping and routine clinical audit
· Organisational change and multidisciplinary team working
· Changes to clinical practice and implementation of protocols and guidelines

This section of the resource pack contains a very brief summary of each chapter in the NSF and highlights the key points made. The practical implications, the affect on primary care teams and the implication on clinical practice for each of the seven chapters of the NSF are also included in this section. Stable angina, revascularisation and heart failure will be discussed together because these chapters in the NSF concentrate on specialist services. Also the primary care role in these areas is similar, focusing on referral criteria, commissioning, and follow-up and ongoing care post-discharge.