Why the Cardiovascular Disease Modern Services Framework matters – and why our brain aneurysm community MUST be included
- 13 hours ago
- 3 min read
At HBA Support, our mission has always been clear: to make sure people affected by brain aneurysms and subarachnoid haemorrhage (SAH) are seen, heard and properly supported.
This summer, the Department of Health and Social Care published the Cardiovascular Disease Modern Services Framework (MSF) – a major national plan aiming to reduce premature cardiovascular deaths by 25% within a decade. It’s an ambitious and welcome step forward. But there’s a problem…
Brain aneurysms and SAHs are almost entirely absent from the MSF, despite nearly three million people in the UK living with a brain aneurysm, and more than 5,000 ruptures every year. This omission repeats decades of policy neglect – and risks leaving our community behind once again.
Today, we want to explain what the MSF means, why this matters for patients, and what HBA Support is doing next.
Aneurysms and SAH: A Major Cardiovascular Issue – Missing from the Framework
Brain aneurysms and SAH sit in a strange space: common enough to affect huge numbers of families, yet still treated as rare when it comes to national policy.
One in 30 people has an aneurysm. More than 1,700 people die from SAH each year in England and Wales. The average age of rupture is just 54, meaning many people are still working, raising families and contributing to society. And every year, thousands of survivors’ face life‑changing disability, with more than 2,200 unable to live independently.
These realities make aneurysms and SAH major contributors to premature cardiovascular mortality – yet the MSF barely acknowledges them.
Where the Framework Falls Short
Our review of the MSF highlights several important gaps that must be addressed if the framework is to deliver for everyone.
One of the most significant omissions is familial and genetic risk. Around 13% of aneurysms run in families, and someone dies from a preventable familial SAH every other day. Despite this, hereditary risk and cascade screening are not mentioned at all. We believe the MSF’s ABCDE model should evolve to reflect modern cardiovascular science by explicitly including familial and genetic risk.
Women’s cardiovascular health is another area where the MSF falls short. Women are more likely than men to develop aneurysms, and after menopause the risk rises sharply. Perimenopause and menopause are critical windows for cardiovascular assessment, yet these vulnerabilities are not recognised within the framework.
The MSF also overlooks the needs of SAH survivors within stroke pathways and rehabilitation. SAH patients are not counted in national stroke metrics, are often excluded from stroke rehabilitation services, and neurosurgical units are not recognised within the MSF’s improvement plans. This creates a postcode lottery in care, leaving many survivors without the cognitive, psychological and physical rehabilitation they urgently need.
Finally, SAH is missing from the “Living with CVD” section – despite being one of the most disabling cardiovascular events. This absence reinforces the long‑standing gap between national policy and the lived experience of SAH survivors.
What HBA Support Is Doing Next
As a charity, we are now actively engaging with policy colleagues across DHSC and NHS England to support the next phase of MSF development. This includes contributing evidence, shaping delivery plans, and ensuring that the voices of aneurysm patients and SAH survivors are represented at every stage.
This work is part of our wider national policy programme, which aims to secure better screening, clearer pathways, improved rehabilitation and stronger recognition of hereditary and genetic vascular disease. Alongside this, we are working with Costello Medical on new research exploring SAH recovery, system barriers and real‑world patient experience. We will share this evidence with policymakers later this year.
A Call for Change
The MSF is a promising step forward – but without recognising hereditary aneurysm risk, women’s vulnerability and the needs of SAH survivors, it will miss a major opportunity to save lives.
Our community has been overlooked for decades. We will not allow that to continue.
HBA Support stands ready to work with national leaders, researchers and clinicians to ensure that future cardiovascular policy finally delivers for the millions of people affected by aneurysms and SAH.
