NHS Makes Outstanding Progress In Treatment Of Heart Disease, UK
The target of reducing deaths from CVD for people under 75 by 40 per cent has been met by the Department of Health five years early, according to the Coronary Heart Disease (CHD) National Service Framework (NSF) Progress Report.
Contributing factors to early delivery of this target include the following service improvements to the treatment of heart attack:
Emergency care is delivering thrombolysis more quickly for people suffering a heart attack. In early 2001, 24 per cent of patients received thrombolysis within 60 minutes of a call for help; now it is almost 70 per cent
Waiting times for heart surgery have dropped dramatically since the inception of the NSF - no patients are waiting over three months for heart surgery compared with over 5,500 in 2000
Prescriptions for cholesterol-reducing statins have more than doubled over the last three years, cutting both mortality from CHD and the yearly number of heart attacks
The report also reflects on the considerable success of the £735 million Capital Programme in providing world-class facilities for treating patients with CHD.
The programme has provided new and refurbished buildings, equipment and technology, including cardiothoracic centres.  An additional 72 additional catheter laboratories have been provided and 18 others have been replaced.
These new facilities have provided the setting for substantially increased numbers of cardiologists.  Latest figures show that in September 2006, numbers of cardiologists increased by 61% and numbers of cardiothoracic surgeons increased 32% since 1999/2000.
The National Service Framework for CHD (March 2000) set out a ten year framework for action to prevent disease, tackle inequalities, save more lives, and improve the quality of life for people with heart disease. We are now saving more than 22,000 lives per year.
Health Minister, Ann Keen said:
"We have made ongoing and sustainable improvements to the treatment of heart disease that have dramatically reduced mortality rates. This is an outstanding achievement by all NHS staff and I would like to pay tribute to all the hard work and dedication that has made it possible.
"Our substantial investment in this area through the Capital Programme has made a significant contribution to patients' quality of care by both improving diagnosis and reducing waiting times."
The interim results of the National Infarct Angioplasty Project (NIAP), also published today, further demonstrate the Government's commitment to tackling CVD and improving the treatment offered to patients.
This joint Department of Health / British Cardiovascular Society study, examines the feasibility of offering primary angioplasty as the nation's first line treatment for heart attack.
Currently, thrombolysis is the most common method for unblocking arteries carrying blood to the heart muscle. An alternative, coronary angioplasty, is widely believed to provide superior outcomes compared to thrombolysis, provided that it can be delivered quickly.
The NIAP interim report presents findings from 'real life' services which accord with findings from recent clinical trials. It has been looking at the practicalities and challenges of offering angioplasty as an emergency treatment in different medical settings and geographical locations across the country.
Key findings include:
- The development of primary angioplasty services is feasible in a variety of geographic settings;
- Establishing a primary angioplasty service requires a multidisciplinary approach and good communication between all stakeholders; and
- Acceptable times to treatment are achievable by direct, or indirect, admission to a primary angioplasty centre. Direct admission to the catheter laboratory at a primary angioplasty centre achieves the fastest times.
National Clinical Director for Heart Disease and Stroke, Roger Boyle said:
"The interim results of the study are encouraging and suggest that for a large part of the country, a primary angioplasty strategy is both feasible and would improve patients' outcomes. "The Department of Health's investment in the study is a testament to its ongoing commitment to tackle cardiovascular heart disease."
The NIAP exemplifies the Government's use of clinical evidence to identify the most effective health services.  Its interim results will be useful in supporting local work on the second stage of Lord Darzi's NHS Review, which is looking at how to deliver a world class service for the NHS."
A further report on NIAP, to be published later this year, will consider costs, workforce implications, the patient experience and patients' follow up data one year on.
Notes:
1. Two capital development programmes have supported locally determined priorities with total investment of £735 million:
- Revascularisation capital programme - started in 2001 and due to complete in 2009 - £613 million funded by the Department of Health (DH) and Strategic Health Authorities
- Big Lottery Fund catheter laboratory programme - started in 2001 and completed in 2006 - £122 million, funded half by the Lottery and half by the DH
2. The aims of these programmes were to:
- improve and increase local access for appropriate interventions provide modern state of the art facilities and equipment for patients and clinicians
- replace old and out of date equipment
- support the transfer of appropriate services from tertiary to secondary settings
- provide more catheter laboratory facilities in District General Hospitals
3. Inequalities in the death rate from heart disease, stroke and related diseases among the under 75s have been narrowing for the past eight years. The absolute gap between the England average and the fifth of areas with the worst health deprivation scores has reduced by 32% since 1995-7.
4. Thrombolysis is a treatment for unblocking arteries with clot busting drugs.
5. Coronary angioplasty involves inserting, then inflating, a small balloon in the blocked coronary artery, leaving a rigid support, or 'stent', which restores blood flow. This procedure is carried out in a cardiac catheter laboratory.
6. There are different models of delivering primary angioplasty, for example, some patients are assessed first in the nearest hospital's A & E then transferred to a primary angioplasty centre, to the catheter lab. Some are assessed by ambulance crew and taken to a hospital which is primary angioplasty centre where they arrive in A & E first before transfer to the catheter lab. The ideal model which achieves the fastest times is assessment by ambulance crew and transfer directly to a catheter lab in a primary angioplasty centre bypassing more local hospitals and A & E in the centre
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NHS face progrese remarcabile în tratamentul bolilor de inima, Marea Britanie - NHS Makes Outstanding Progress In Treatment Of Heart Disease, UK - articole medicale engleza - startsanatate