Putting prevention at the heart of care
At the Barts Heart Centre, a quiet revolution is underway – one that’s changing the way cardiac care is delivered by focusing on what happens before illness takes hold.
In a bold shift from the traditional model of treating disease, clinicians at Barts Heart Centre are leading efforts to prevent people from becoming so unwell that they need hospital care. Prevention not only leads to better health outcomes for patients, but also reduces the strain on the NHS by lowering admissions and associated costs.
“Treating someone after a heart attack will always be part of our job,” says Andrew Wragg, medical director at St Bartholomew’s Hospital. “But preventing that heart attack in the first place – that’s where we can make the biggest difference.”
A personalised approach to prevention
At the heart of this approach is the recognition that good health is shaped by more than clinical care. Alongside managing risk factors like blood pressure and cholesterol, the team focuses on the social and lifestyle influences that affect heart health.
Social prescribing – which connects patients with non-clinical support such as debt advice, housing help or fitness groups – is now fully embedded in the cardiac pathway. It reflects a more holistic view of healthcare: that financial insecurity, poor housing and social isolation can increase the risk of heart disease and make recovery harder.
“Health doesn’t start at the hospital doors,” says Tara Mastracci, consultant vascular surgeon and lead for social prescribing. “It starts at home, at work, and in our communities. We have a duty to reach beyond the ward and play our part.”
Much of this work is delivered in partnership with the Bromley by Bow Centre – a trusted community organisation helping to bridge the gap between clinical services and wider support. Their role has been vital in scaling up social prescribing across east London.
Real results for patients and the NHS
The results speak for themselves. More than 1,100 patients have been screened through the new pathway. Early findings show that those receiving social prescribing support are more likely to attend follow-up appointments, stay engaged in their recovery, and avoid unnecessary readmissions.
The wider benefits are equally compelling. A prevention-first mindset is expected to generate significant savings – with smoking cessation services alone projected to save £106 million and 345 lives each year.
An anchor in the community
As one of the UK’s largest NHS Trusts, Barts Health sees itself as a community anchor – committed not just to treating illness, but also to tackling the root causes behind it.
That commitment includes looking after staff as well as patients. Through the award winning East London Cardiovascular Disease Prevention Programme, over 1,500 NHS colleagues have received on-site cardiovascular checks, with follow-up care and free blood pressure monitors supporting their ongoing health. The team's efforts were recognised with a Barts Health Heroes award in February.
“This programme is about advocating for our colleagues, near and far, by looking after the people who look after others,” says Dr Mohammed Khanji, consultant cardiologist and clinical lead for the initiative. “We’re finding early signs of poor health and stepping in before things get worse – that’s the essence of prevention.”
The team also runs education programmes in local primary schools, and holds regular community events and health screenings across north east London – all aimed at raising awareness and encouraging heart-healthy habits.
A system built around prevention
This work at Barts Heart Centre is part of a broader trust-wide strategy to embed prevention across all services – from children and young people’s care to diabetes and alcohol support. These efforts are laying the groundwork for Integrated Neighbourhood Teams, where hospitals, GPs, voluntary groups and councils work together to keep people healthy and supported.
A blueprint for others
Barts Health has also partnered with Transformation Partners to publish a secondary care prevention toolkit – designed to help other hospitals adopt similar approaches.
With over one in four people in England living with long-term conditions, and major illness set to rise by 37% in the next 15 years, the need for new models of care has never been more urgent.
Barts Heart Centre is showing that with compassion, collaboration and a shift in focus, prevention really can be the best medicine.