Background

On 11 April 2025 the Scottish Government issued a letter to NHS Boards describing the funding being made available for the Cardiovascular Disease prevention scheme Directed Enhanced Service (CVD DES). The objective of the CVD DES is to find those living with key modifiable risk factors that they are currently unaware of, and to optimise early intervention and care to reduce patients’ risk of developing CVD, with a particular focus on communities experiencing higher levels of deprivation.  

Funding was made available for General Practice contractors to:

• identify eligible patients
• carry out a bundle of checks for the following key CVD risk factors: high blood pressure, high cholesterol, high blood sugar, obesity and smoking
• provide a follow-up clinical review appointment, including providing lifestyle advice and help to manage any risk factors which have been identified

Scotland’s Programme for Government 2025 to 2026 commits to support 100,000 patients through the CVD DES by March 2026. Investing in the CVD DES also appears as a commitment in the NHS Scotland operational improvement plan. The service is also noted as an example of preventative care being delivered in the Health and social care service renewal framework.

Patients without pre-existing CVD are eligible for the CVD DES if they meet the following criteria:

• are aged 35-60; and
• have not received the full suite of CVD checks in the last three years:
  • blood pressure assessment
  • lipid profile assessment
  • weight/body mass index (BMI) check
  • glycated haemoglobin (HBA1c) or fasting glucose (as per local board arrangements) assessment
  • smoking status asked

General Practice contractors were asked to invite eligible patients, using a software tool and local knowledge to target patients living in areas of higher deprivation. Contractors were also asked to consider use of innovative consultation methods to reach patients who may not otherwise engage with healthcare.

Available funding was allocated among practices opting to participate, according to the number of patients in that practice weighted by the Standardised Mortality Ratio for Coronary Heart Disease Death and by Scottish Index of Multiple Deprivation (SIMD).