Why cardiovascular, kidney and metabolic care must move beyond silos

The first CVRM Professional Care conference has called for joined-up, person-centred treatment to replace isolated management of heart, kidney and metabolic conditions.

At the first CVRM Professional Care conference, Kevin Fernando argued that cardiovascular, renal and metabolic medicine needs to move away from isolated disease management and towards care built around the whole person. Fernando, a portfolio GP with an extended role in diabetes at NHS Lothian, opened the two-day meeting on Tuesday, 20 October, with a session on defining CVRM and said the aim was to raise awareness of the model among primary care colleagues.

Fernando said the traditional habit of treating heart disease, kidney disease, diabetes and obesity as separate problems no longer reflects how these conditions interact in practice. That view closely matches the American Heart Association’s Cardiovascular-Kidney-Metabolic Health Initiative, which promotes coordinated care across these overlapping conditions, and the work of the CKM Collaborative, a professional network pushing for a more integrated approach.

He set out five messages for delegates: think beyond single diagnoses; focus on the person rather than just readings and targets; dismantle professional silos; spot risk before disease becomes established; and choose treatments with benefits across more than one organ system. Fernando said that kind of approach would improve outcomes for patients while also reducing pressure on clinicians and NHS resources.

The conference is set to feature examples of centres of excellence where integrated care already sits at the heart of practice, with discussion about how similar models could be introduced more widely. Fernando’s own background reflects that philosophy: he is also co-director of IYASU Healthcare in East Lothian, a practice built around personalised care, and has long worked across diabetes, obesity and wider CVRM conditions.