Wales Cardiac Care at Risk of Falling Behind

Gemma Roberts calls on the Welsh Government, and all political parties, to commit to a bold heart and circulatory disease plan for Wales.

COVID-19 has impacted every aspect of the lives of people across Wales.

Wales has been consumed with immediate and reactive action and policy making to navigate the unprecedented demands of the pandemic.  

British Heart Foundation (BHF) Cymru has written a new heart and circulatory disease plan for Wales in collaboration with over 70 clinicians as well as patients and members of the public. Disease specific planning must feature in manifesto promises to provide the best possible care for the people of Wales. 

While we know that we can’t quite see the end of the tunnel yet, the 2021 Senedd election is an opportunity to imagine what the end of the tunnel will look like and what the future could be for our NHS in Wales.  

COVID-19 has pushed us to think short term and the focus has been on firefighting since March 2020. But other diseases haven’t stopped. The 340,000 people in Wales living with heart and circulatory diseases deserve robust, forward planning which ensures the best possible care. 

Where is heart and circulatory disease care now?  

Like all health services across Wales, cardiology has been impacted by COVID-19. We have seen an impact on all parts of the heart and circulatory disease pathway, including deferral of diagnoses and therapeutic interventions; and reduced access to specialist care in the community and identification and management of risk factors, including high blood pressure. 

“The Welsh Government is unsure about where disease specific delivery plans will fit into the new structure – and so are not prepared to commit to new plans.”

These impacts are not being felt equally across the country. The pandemic is serving to highlight health inequalities and regional variation – feeding the postcode lottery for patients accessing services and treatments. 

In 2017 the Wales Cardiac Network implemented a plan for the next five years of care for people with heart disease. But this plan comes to an end this year and, so far, there is no commitment by the Welsh Government for a renewed plan.  

We know that the Welsh Government are working on a new structure for the NHS and the creation of an NHS Executive. Because of this, the Welsh Government is unsure about where disease specific delivery plans will fit into the new structure – and so are not prepared to commit to new plans. 

Why do we need a new plan?

Disease specific plans outline the next five-year strategy for making improvements in the NHS, but by their definition are limited within particular diseases. They outline what can and should be done to make sure the best possible care is accessible to everyone in Wales. They should provide measurable deliverables and accountability. 

 Ultimately, we need to improve the detection, diagnosis, treatment and care of people who develop a heart or circulatory condition in their lifetime.

BHF Cymru wants a clear commitment from all Wales’ political parties to a new, properly financed disease specific plan for heart and circulatory disease care.”

The World Health Organisation recommends countries must ‘develop and implement national service frameworks for tackling major diseases with a high disease burden, such as diabetes and cardiovascular disease (heart and circulatory disease), where specific characteristics exist, recognizing the needs of patients already living with these diseases, their families and health care professionals.’

And the disease burden of heart and circulatory disease is massive:  

  • Ischaemic (coronary) heart disease is the leading cause of death nationally and globally.
  • Heart and circulatory diseases cause 9,100 deaths in Wales every year- that’s more than 1 out of every 4 deaths.  
  • Around 340,000 people in Wales are living with these conditions,  that is around 10% of the Welsh population.  

An ageing population, an increase in many risk factors and widening health inequalities are all likely to increase the burden of heart and circulatory disease in Wales.  

Now, more than ever, to save lives which could be lost to heart and circulatory diseases and reduce the burden on the health of our nation, we need to see commitments to a new plan. The new heart and circulatory disease plan must not only restore services impacted by COVID-19; effective action is required to improve services for patients for the next five years. 

A New Heart and Circulatory Disease Plan for Wales

BHF Cymru has written a new heart and circulatory disease plan for Wales. This is a consensus document on the future of heart and circulatory disease care in Wales, and written in collaboration with over 70 clinicians, as well as patients and members of the public. 

Our plan identifies three priorities to improve heart and circulatory disease care in Wales: 

  1. Improve detection and support people to manage conditions such as high blood pressure and high cholesterol which often precede heart and circulatory diseases. 
  2. Easy and equitable access to All Wales Cardiac Pathways, which provide patients across Wales with the best possible care. 
  3. Better collection, dissemination and use of data.  

These priorities have been agreed by clinicians and represent the first steps in achieving improved heart and circulatory disease care in Wales.  

And there are already pockets of fantastic work going on in Wales.

During the Covid-19 crisis, Swansea Bay University Health Board clinicians paused routine hospital and community heart failure clinics and designed a temporary community-based heart failure hub.

This was distanced from acute hospital sites and ensured rapid access for patients with a potential new diagnosis, and support for existing patients at greatest risk of hospital admission.

The Aneurin Bevan University Health Board’s heart failure team have worked closely with the Value Based Health Care Team over the past three years to improve rehabilitation. 

A national delivery plan for heart and circulatory disease would allow for these examples of service excellence to be co-ordinated and rolled out for people across Wales. 

Our vision is for resources to be used as effectively as possible to prevent illness, support people to manage their health and wellbeing, and have personalised care delivered as close to home as possible.

We want to see an emphasis on shifting care into the community, working in partnership, investing in the workforce, and ensuring quality improvement to reduce variation and waste.

BHF Cymru wants a clear commitment from all Wales’ political parties to a new, properly financed disease specific plan for heart and circulatory disease care. This must be prioritised to prevent, diagnose and treat some of Wales’s biggest killers, and to improve heart health for the population. 

BHF Cymru’s Heart and Circulatory Disease Plan for Wales can be read in full at www.bhf.org.uk/walesheartplan and in Welsh at www.bhf.org.uk/cynlluncymru.

All articles published on the welsh agenda are subject to IWA’s disclaimer. 

 

Gemma Roberts is BHF Cymru’s Policy and Public Affairs manager.

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