{"id":30355847,"url":"https://github.com/the-strategy-unit/1199_core20plus5","last_synced_at":"2025-08-19T05:16:06.239Z","repository":{"id":286095308,"uuid":"960323882","full_name":"The-Strategy-Unit/1199_core20plus5","owner":"The-Strategy-Unit","description":"Quantitative analysis for the Core20PLUS5 evaluation. Initialy will be an exploratory analysis of metrics of hypertension from the CVDPREVENT audit site informing whether a subsequent impact analysis is undertaken.","archived":false,"fork":false,"pushed_at":"2025-06-19T09:01:57.000Z","size":5431,"stargazers_count":1,"open_issues_count":1,"forks_count":0,"subscribers_count":1,"default_branch":"main","last_synced_at":"2025-06-19T09:45:15.045Z","etag":null,"topics":["core20plus5","cvdprevent","england","evaluation","evaluation-metrics","exploratory-data-analysis","impact-evaluation","nhs"],"latest_commit_sha":null,"homepage":"","language":"R","has_issues":true,"has_wiki":null,"has_pages":null,"mirror_url":null,"source_name":null,"license":"mit","status":null,"scm":"git","pull_requests_enabled":true,"icon_url":"https://github.com/The-Strategy-Unit.png","metadata":{"files":{"readme":"README.Rmd","changelog":null,"contributing":null,"funding":null,"license":"LICENSE","code_of_conduct":null,"threat_model":null,"audit":null,"citation":null,"codeowners":"CODEOWNERS","security":null,"support":null,"governance":null,"roadmap":null,"authors":null,"dei":null,"publiccode":null,"codemeta":null,"zenodo":null}},"created_at":"2025-04-04T08:34:09.000Z","updated_at":"2025-06-19T09:02:03.000Z","dependencies_parsed_at":"2025-04-04T10:32:58.356Z","dependency_job_id":"46c21427-66f8-4767-88f8-ac46b50274d2","html_url":"https://github.com/The-Strategy-Unit/1199_core20plus5","commit_stats":null,"previous_names":["the-strategy-unit/1199_core20plus5"],"tags_count":0,"template":false,"template_full_name":"The-Strategy-Unit/template-repository","purl":"pkg:github/The-Strategy-Unit/1199_core20plus5","repository_url":"https://repos.ecosyste.ms/api/v1/hosts/GitHub/repositories/The-Strategy-Unit%2F1199_core20plus5","tags_url":"https://repos.ecosyste.ms/api/v1/hosts/GitHub/repositories/The-Strategy-Unit%2F1199_core20plus5/tags","releases_url":"https://repos.ecosyste.ms/api/v1/hosts/GitHub/repositories/The-Strategy-Unit%2F1199_core20plus5/releases","manifests_url":"https://repos.ecosyste.ms/api/v1/hosts/GitHub/repositories/The-Strategy-Unit%2F1199_core20plus5/manifests","owner_url":"https://repos.ecosyste.ms/api/v1/hosts/GitHub/owners/The-Strategy-Unit","download_url":"https://codeload.github.com/The-Strategy-Unit/1199_core20plus5/tar.gz/refs/heads/main","sbom_url":"https://repos.ecosyste.ms/api/v1/hosts/GitHub/repositories/The-Strategy-Unit%2F1199_core20plus5/sbom","scorecard":null,"host":{"name":"GitHub","url":"https://github.com","kind":"github","repositories_count":271103202,"owners_count":24699646,"icon_url":"https://github.com/github.png","version":null,"created_at":"2022-05-30T11:31:42.601Z","updated_at":"2022-07-04T15:15:14.044Z","status":"online","status_checked_at":"2025-08-19T02:00:09.176Z","response_time":63,"last_error":null,"robots_txt_status":"success","robots_txt_updated_at":"2025-07-24T06:49:26.215Z","robots_txt_url":"https://github.com/robots.txt","online":true,"can_crawl_api":true,"host_url":"https://repos.ecosyste.ms/api/v1/hosts/GitHub","repositories_url":"https://repos.ecosyste.ms/api/v1/hosts/GitHub/repositories","repository_names_url":"https://repos.ecosyste.ms/api/v1/hosts/GitHub/repository_names","owners_url":"https://repos.ecosyste.ms/api/v1/hosts/GitHub/owners"}},"keywords":["core20plus5","cvdprevent","england","evaluation","evaluation-metrics","exploratory-data-analysis","impact-evaluation","nhs"],"created_at":"2025-08-19T05:15:58.745Z","updated_at":"2025-08-19T05:16:06.226Z","avatar_url":"https://github.com/The-Strategy-Unit.png","language":"R","funding_links":[],"categories":[],"sub_categories":[],"readme":"---\noutput: github_document\n---\n\n\u003c!-- README.md is generated from README.Rmd. Please edit that file --\u003e\n\n```{r, include = FALSE}\nknitr::opts_chunk$set(\n  collapse = TRUE,\n  comment = \"#\u003e\"\n)\n```\n\n# Evaluation of the Core20PLUS5 approach\n\n\u003c!-- badges: start --\u003e\n\n\u003c!-- badges: end --\u003e\n\nThe goal of this project is to provide a descriptive analysis of hypertension metrics available from the CVDPREVENT audit website, as part of a wider evaluation of the Core20PLUS5 approach.\n\n## Using this Repo\n\nAll data used in this analysis is within the public domain.\n\nThe analysis uses the R language and has been written into a [Quarto](https://quarto.org/docs/computations/r.html) .html document.\n\nThe recommended approach to re-create the analysis is:\n\n1.  Install dependencies,\n2.  Ensure necessary folder structure\n3.  Gather the data from the CVDPREVENT application programming interface (API),\n4.  Render the Quarto document.\n\n### 1. Installing dependencies\n\nRun the [`get_dependencies.R`](scripts/get_dependencies.R) script to identify the packages used within this analysis. NB, this file requires at least `renv`, `janitor` and `dplyr` to first be installed on your system to run.\n\n### 2. Folder structure\n\nRun the [`set_folders.R`](scripts/set_folders.R) script to ensure the necessary folder structure is in place to receive data.\n\n### 3. Gather the data\n\nRun the [get_cvdprevent_data.R](scripts/get_cvdprevent_data.R) script to download the hypertension indicator data from the CVDPREVENT API.\n\nThis script downloads indicator data at England and at Integrated Care Board (ICB) levels and over all time periods for which data is available. ⌛ This process may take a few minutes.\n\nYou will likely receive messages in your console during this download process about data not being available. This is to be expected as some indicator data is not available for all time periods.\n\n### 4. Render the Quarto document\n\nOpen the [`hyp_eda_wip.qmd`](outputs/hyp_eda_wip.qmd) quarto file.\n\nIf this is your first time, then ensure the parameter `flag_calc_expensive_operations` is set to `TRUE`, as below:\n\n``` yaml\nparams:\n  # should expensive calculations be re-calculated?\n  # default = FALSE. Set to TRUE if running for the first time\n  flag_calc_expensive_operations: TRUE\n```\n\nSetting to `TRUE` will ensure some essential, but computationally heavy, calculations are performed and the results stored in your `data` folder.\n\nOnce the file is rendered the [analysis](outputs/hyp_eda_wip.html) file can be found in the outputs folder. Your IDE may open this file for you automatically.\n\n# About the evaluation\n\nThe Strategy Unit has been commissioned by the Healthcare Inequalities Improvement Programme (HiQiP) team to evaluate the Core20PLUS5 approach. The evaluation will be longitudinal and mixed methods and will examine changes on both process and outcomes. Scoping activities for the evaluation took place January-June 2024. Work on the evaluation commenced in October 2024 following sign-off for both the evaluation framework and a high-level evaluation delivery plan.\n\nThe programme theory for the Core20PLUS5 approach, which is being tested through the evaluation is **whether a national approach to tackling healthcare inequalities** - which focuses on specific population groups and clinical areas - **can provide a structured approach to achieving equitable access, provide excellent experience, and deliver optimal outcomes for all**.\n\nThe focus of this quantitative element of the evaluation is around **hypertension**.\n\n### About this repo\n\nThis repo supports collaboration of work to provide a descriptive analysis of indicators of hypertension prevalence and care across England from the [CVDPREVENT audit](https://www.cvdprevent.nhs.uk/) website.\n\n+----------------+----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------+\n| Indicator code | Description                                                                                                                                                                                                                                                                                                                                                                                  |\n+:===============+:=============================================================================================================================================================================================================================================================================================================================================================================================+\n| CVDP001HYP     | **Hypertension: Prevalence**                                                                                                                                                                                                                                                                                                                                                                 |\n|                |                                                                                                                                                                                                                                                                                                                                                                                              |\n|                | Prevalence of GP recorded hypertension and no subsequent recorded hypertension resolution, in patients aged 18 and over                                                                                                                                                                                                                                                                      |\n+----------------+----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------+\n| CVDP002HYP     | **Hypertension: Treated to appropriate threshold (age \\\u003c 80)**                                                                                                                                                                                                                                                                                                                               |\n|                |                                                                                                                                                                                                                                                                                                                                                                                              |\n|                | The percentage of patients aged 18 to 79 years with GP recorded hypertension, in whom the last clinic blood pressure (BP) or equivalent home or ambulatory blood pressure reading (measured in the preceding 12 months), is to the age and setting appropriate treatment threshold.                                                                                                          |\n+----------------+----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------+\n| CVDP003HYP     | **Hypertension: Treated to appropriate threshold (age \\\u003e= 80)**                                                                                                                                                                                                                                                                                                                              |\n|                |                                                                                                                                                                                                                                                                                                                                                                                              |\n|                | The percentage of patients aged 80 years or over, with GP recorded hypertension, in whom the last clinic blood pressure (BP) or equivalent home or ambulatory blood pressure reading (measured in the preceding 12 months), is to the age and setting appropriate treatment threshold.                                                                                                       |\n+----------------+----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------+\n| CVDP004HYP     | **Hypertension: BP monitoring**                                                                                                                                                                                                                                                                                                                                                              |\n|                |                                                                                                                                                                                                                                                                                                                                                                                              |\n|                | The percentage of patients aged 18 and over with GP recorded hypertension, with a record of a blood pressure reading in the preceding 12 months.                                                                                                                                                                                                                                             |\n+----------------+----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------+\n| CVDP005HYP     | **Hypertension: High risk – one high BP with no recorded hypertension**                                                                                                                                                                                                                                                                                                                      |\n|                |                                                                                                                                                                                                                                                                                                                                                                                              |\n|                | The percentage of GP registered patients aged 18 and over with a single blood pressure reading of systolic \\\u003e=140mmHg and diastolic \\\u003e=90mmHg (indicating increased risk of hypertension), but with no hypertension diagnosis (and no recorded hypertension resolution) in the GP record. The single high blood pressure reading is recorded more than 3 months prior to the audit end date. |\n+----------------+----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------+\n| CVDP006HYP     | **Hypertension: Potential antihypertensive overtreatment**                                                                                                                                                                                                                                                                                                                                   |\n|                |                                                                                                                                                                                                                                                                                                                                                                                              |\n|                | The percentage of patients 18 and over with GP recorded hypertension, prescribed antihypertensive medication in whom the last systolic blood pressure (BP) reading was low (\\\u003c=100mmHg) who have been prescribed antihypertensive medications after the date of the low systolic BP value.                                                                                                   |\n+----------------+----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------+\n| CVDP007HYP     | **Hypertension: Treated to appropriate threshold (all ages)**                                                                                                                                                                                                                                                                                                                                |\n|                |                                                                                                                                                                                                                                                                                                                                                                                              |\n|                | The percentage of patients aged 18 and over with GP recorded hypertension, in whom the last clinic blood pressure (BP) or equivalent home or ambulatory blood pressure reading (measured in the preceding 12 months), is to the age and setting appropriate treatment threshold.                                                                                                             |\n+----------------+----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------+\n| CVDP009HYP     | **Hypertension: Monitoring with ACR**                                                                                                                                                                                                                                                                                                                                                        |\n|                |                                                                                                                                                                                                                                                                                                                                                                                              |\n|                | The percentage of patients aged 18 and over, with GP recorded hypertension (excluding patients with chronic kidney disease (CKD) (G3a to G5)), with a record of a urine albumin:creatinine ratio (ACR) or protein:creatinine ratio (PCR) test in the preceding 12 months.                                                                                                                    |\n+----------------+----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------+\n\n: Hypertension indicators to be analysed\n\n### About Core20PLUS5\n\n[Core20PLUS5](https://www.england.nhs.uk/about/equality/equality-hub/national-healthcare-inequalities-improvement-programme/core20plus5/) is an approach designed by the Healthcare Inequalities Improvement Programme (HiQiP) team at NHS England to reduce healthcare inequalities. Developed between 2021 and 2022, it is intended to influence practice at a national, regional and system level.\n\nThe approach focuses on the most deprived 20% of the population and locally determined ‘PLUS’ groups who experience barriers to accessing healthcare.\n\nIt highlights five clinical areas which require accelerated improvement. For adults, these are maternity, severe mental illness, chronic respiratory disease, early cancer diagnosis and hypertension case finding. For children and young people, these are asthma, diabetes, epilepsy, oral health and mental health.\n\n![Infographic outlining the components of the Core20PLUS5 approach in adults](outputs/images/core20plus5-infographic-v3-scaled.jpg)\n\n# \n","project_url":"https://awesome.ecosyste.ms/api/v1/projects/github.com%2Fthe-strategy-unit%2F1199_core20plus5","html_url":"https://awesome.ecosyste.ms/projects/github.com%2Fthe-strategy-unit%2F1199_core20plus5","lists_url":"https://awesome.ecosyste.ms/api/v1/projects/github.com%2Fthe-strategy-unit%2F1199_core20plus5/lists"}