Peripheral Arterial Disease: Health Services

In 2022, NHS England commissioned a two-year Commissioning for Quality and Innovation (CQUIN) scheme, which incentivised the adoption of the Vascular Peripheral Arterial Disease Quality Improvement Framework, to support timely interventions for revascularisation. This measures the proportion of patients who have a diagnosis of chronic limb threatening ischaemia (CLTI) who undergo revascularisation within five days of a non-elective admission to vascular providers.

NHS England commissions the National Vascular Registry (NVR) to provide information on the quality and outcomes of care for adults who have major vascular procedures. The NVR provides annual and quarterly reports for emergency and elective vascular procedures, including for those people with peripheral arterial disease who undergo either a lower limb angioplasty/stent, lower limb bypass surgery, or a major lower limb amputation. From quarter one of 2022 to quarter four of 2024, NVR data demonstrated that vascular providers achieving the CQUIN standard had increased from 47% to 55%. During this period, the number of providers submitting data to the NVR had increased by approximately 14%, and every National Health Service region showed an improvement in CLTI revascularisation quality.

Furthermore, NHS England has commissioned the NVR to facilitate an ‘outliers’ process, in which vascular providers are monitored on several key performance metrics, including CLTI revascularisation. NHS England continues to monitor all specialised vascular disease services via the NVR, working in collaboration with NHS England’s regional teams and the integrated care boards.