Ruth Coombs outlines how the next Welsh Government could improve care for heart and circulatory disease.
In the year that the British Heart Foundation (BHF) was formed, Wales lost more than 17,600 men, women and children to heart and circulatory disease. 53 years on, BHF research has driven incredible advances in prevention, diagnosis and treatment – and the annual number of heart and circulatory disease deaths in Wales has fallen by half.
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But still more than one in four deaths in Wales are from heart and circulatory disease – that’s around 25 people every day – and 375,000 people in Wales have to live with its daily challenges. An ageing and growing population and improved survival rates from heart and circulatory events could the burden rise still further.
Excellent clinical research is conducted within the NHS and the maintenance of the National Institute of Health Research budget at £1 billion in the 2015 spending review was a very positive outcome. However, there remains a belief within the medical research sector that research is insufficiently prioritised within the NHS. This is based on specific incidents, for example the ongoing challenges in getting Excess Treatment Costs paid, and in a more general sense that the senior leadership of the NHS has failed to engage on these issues in meetings with the sector.
The Welsh Government’s ambition is that Wales is a place where research prospers as a vehicle for health and social care wellbeing. To achieve this ambition the Division for Social Care and Health Research (DSCHR) is committed to funding a research infrastructure that will facilitate improvements to the health, wealth and wellbeing of the people of Wales. On 1 April the NHS became part of the new integrated Health and Social Care Research Wales Support and Delivery Infrastructure. This development will contribute towards achieving better outcomes for patients and the public by increasing the opportunities to participate in high quality research.
A key priority in the Health and Care Research Wales Strategic Plan is to develop a greater public awareness and understanding of research and its benefits. Translational research is key to this so providing a dynamic environment for the life sciences sector to undertake research and innovation in Wales will provide a supportive environment for greater collaboration between NHS Wales, social services, academia and industry.
The NHS in Wales now faces its most challenging times. People with heart disease often have other long-term conditions such as diabetes and our current healthcare system is struggling to cope with increased demand in managing people who are in and out of hospital, due to fragmentation of the heath service. Delivering more comprehensively integrated services sits at the core of Welsh health and social care policies, and should support more seamless access, manage demand better and ensure a sustainable health and social care system with the patient at the centre as we move forward.
Heart failure (HF) is a common progressive life-limiting condition affecting around 31,000 people in Wales with many more undiagnosed cases. The prevalence of HF may increase with the combined effect of medical advances in the treatment of heart disease and an ageing population. One of the commonest causes of hospital admission, HF is a disabling and distressing condition which can often have a major effect on the quality of life of patients and their families. With appropriate treatment, survival rates and quality of life for many people living with HF can dramatically improve, provided they are on the right pathway and have access to the most appropriate therapies, and support.
An external evaluation of BHF-funded projects, programmes and HF delivery models, showed that people living with long-term conditions such as heart failure require an integrated approach to their care with robust care pathways to meet their needs from diagnosis through to end of life. This should include long-term follow up, social support and palliative care.
We are pleased to see that the Welsh Government’s ‘Together for Health: Heart Disease Delivery Plan’ has been extended to 2020 as it has positively impacted on our services in Wales. However, with nearly 2,400 people under the age of 75 in Wales still dying from heart and circulatory disease, we will be working closely with the next Government to stop this health inequality.