Current targets: where are we today?

Implementation of the National Service Framework (NSF) for coronary heart disease has particular workload implications for primary care. Studies conducted in general practices known to be representative of practices across the country suggest that, in order to meet current targets, the average general practitioner with a 2000 patient list would need to address 444 disease control measures in 210 patients. These relate primarily to smoking cessation and control of blood pressure, cholesterol, and blood sugar. Despite the enormous scale of cardiovascular disease, a considerable degree of recording and activity is going on within primary care in response to the NSF. However, some areas of cardiovascular care appear to need particular improvement. For example, with respect to lipid management, many high risk patients have not had their lipids measured, while many of those on lipid lowering drugs are not achieving current targets.