"Hugh" Knew

Who knew it was European Heart Failure Awareness Day earlier this month? Not many people I would suspect and, in fact, even the health community that asked me to speak at their conference got the day wrong – oops! Having said that, it was an excellent event but it was only able to go some way to raising awareness of the need to significantly improve heart failure care because:

·         Who knew that heart failure is the reason why Coronary Heart Disease remains the country’s biggest killer?

·         Who knew over 900,000 people in the UK have heart failure, with many more people currently undiagnosed, and the incidence of the disease is increasing?

·         Who knew the NHS spends £625m per annum on treating heart failure, with 70% of this due to hospitalisation?

·         Who knew patients who receive care and support from integrated services and a specialist heart failure team have significantly better outcomes and a better quality of life?

·         Who knew Dr Mark Dancy, national clinical lead for heart failure, believes ‘Every network in the country can deliver heart failure services better and so improve quality of life for patients and the bank balance of the NHS’?

·         Who knew rumour has it that Mark is related to the one and only Hugh Grant? J A fact I found out recently but I digress...

·         Who knew improved quality of care for heart failure patients is now a big priority area for our Cardiac Network?

·         Who knew we are working with two acute trusts in the first instance to redesign acute heart failure care with the intention of sharing and rolling out the learning across the region?

·         Who knew the Network will be providing regular updates on this project, which it is calling Heart Felt Success, via its website and other media in the coming months...

Who knew that the first stage of achieving the service transformation required is all about raising awareness and dissatisfaction with current heart failure services? For those that knew please pass the message on because we need everyone that has a responsibility and involvement in heart failure services to know!

Networks have got Talent

This last week has not only been memorable for the climax of Britain’s Got Talent 2012, it has also seen the successful conclusion of our Cardiac Network’s specialist heart attack centre project.

In 2008, results from the Myocardial Infarct National Audit Programme showed significant variation (0-100%) in the percentage of eligible patients receiving primary angioplasty within England. At this time no heart attack patients were receiving this innovative treatment in Derbyshire, Lincolnshire and Nottinghamshire whilst Leicestershire, Northamptonshire and Rutland reported delivery for just 17% of their cases.

Since this time the East Midlands, in keeping with the rest of the country, has made the step change and now has specialist heart attack centres (providing primary angioplasty) for all our population.

Dr John Perrin, former president of the British Cardiology Interventional Society, who joined the region’s cardiology teams and myself at our learning event on Thursday, said he wasn’t aware of another NHS change project which has been implemented with such speed and success across the whole of the country. John isn’t the first to comment on this service transformation, which got me thinking about the factors that have contributed to our achievement including:

·         The development of specialist heart attack centres has been one of a small number of regional priority projects in the East Midlands, with commissioners and providers coming together in a collective, improvement effort;

·         We have had strong leadership including a proactive chief executive sponsor, well respected clinical leads together with external support from national cardiac clinical experts;

·         Our clinicians have influenced and been engaged in every stage of the project particularly the development of the new pathway, model and standards of care;

·         We put robust project and programme management arrangements in place and communicated at length;

·         Where required providers have funded additional cardiac catheter laboratories and an increase in members of the specialist cardiology multi-disciplinary team in order to be able to meet the required standards to provide the service.

It’s estimated 75% of NHS change projects fail to achieve their objectives and as such it’s not surprising the new NHS Commissioning Board will soon be publishing a change model to guide quality improvement. The learning derived from cardiac networks in changing the face of heart attack services should not be lost though as it seems it’s not only Ashleigh and Pudsey that have got talent!