Date of prep: December 2020
Prescribing information and
adverse events reporting
For healthcare professionals only
A leading heart disease charity is calling for urgent investment in clinical services for people with heart and circulatory conditions – and those at highest risk of developing them – amid evidence that as many as one in four patients in some parts of Scotland is having to wait more than six months for crucial diagnostic tests.
The British Heart Foundation (BHF) Scotland says the progress in reducing deaths that has been made in recent years could be put in jeopardy as government funding for fighting heart disease, they say, is slipping behind other killer conditions such as cancer and diabetes.
Heart and circulatory diseases cause around 50 deaths a day in Scotland – one in eight of them amongst people of working age – while an estimated 700,000 people are living with often life-limiting heart conditions.
BHF Scotland says, although there has been a significant reduction in deaths over the last 50 years, wider progress seems to be stalling.
The Scottish government published a Heart Disease Improvement Strategy in 2014, but BHF says that, since then, funding to support new strategies for cancer and Type II diabetes have left investment in heart disease trailing behind.
In a recent answer in the Scottish parliament, Cabinet Secretary for Health and Sport Jeane Freeman promised a refreshed improvement plan in spring this year. She pointed to a reduction in deaths from coronary heart disease of nearly a third from 2009 to 2018, and committed to continuing to implement the 2014 plan in the meantime.
BHF has meanwhile been working with clinicians and patients to draft a plan of their own, centred on three priority areas: tackling risk factors, including obesity, high blood pressure and high cholesterol; ensuring everybody has equal speedy access to diagnosis, treatment and care; and improving the use and access to data to understand the full scale of need and services across Scotland.
Freedom of Information requests by the charity have shown waiting times for diagnostic tests such as echocardiograms vary from one in 50 people waiting six months – to one in four.
David McColgan, Senior Policy and Public Affairs Manager at BHF Scotland, says the need for a new strategy is greater than ever:
“Heart disease is a major cause of ill health and death in Scotland and yet the Scottish Government’s plans to tackle heart disease haven’t been updated since 2014. During this time, there have been a lot of changes in the health care system, not least due to the Covid-19 pandemic.”
BHF points out that research suggests that people with underlying health conditions such as coronary heart disease and heart failure are at increased risk of severe complications from coronavirus and an increased risk of death.
“Health inequalities also remain,” says Mr McColgan.
“Rates of heart and circulatory diseases in the most deprived areas of Scotland are significantly higher than those in the least deprived areas. Dealing with these challenges and years of underinvestment means that new national priorities for addressing heart disease in Scotland are needed.
“That’s why BHF Scotland has been working with the clinical community and heart patients to identify them. As we look forward to the Scottish Elections at Holyrood in May, we are calling on all political parties to commit to work with us to tackle these issues.”
Consultant Physician and Cardiologist, Dr David Murdoch, is Chair of the National Advisory Committee for Heart Disease. He says it is important to ensure everyone has access to the best diagnosis and treatment wherever they are in Scotland:
“There’s no doubt there has been great success in improving survival rates from acute events like heart attacks in Scotland over recent decades. While this is hugely positive, it also means there are now more people living with heart conditions than ever before.
“We are working hard to improve access to prevention, efficient diagnosis with modern cardiac imaging and the latest treatments.”
The President of the Scottish Cardiac Society, Consultant Cardiologist Dr David Northridge, says planning is being made more difficult by gaps in information:
“We know that the earlier heart patients can be diagnosed and treated, the better the outcome for them and for the NHS as a whole. But the lack of consistent data on cardiac care means we don’t have a true picture of the scale of services and access to them across the country and that is a huge concern and one that we would like to see addressed in any future plan.”
BHF, which launches a manifesto for the Holyrood elections this week to coincide with the start of National Heart Month, says an ageing population and more people living longer with multiple health conditions, means there is a need to look at future care and treatments in the community to enable people to live well longer.
By John Magill
Pharmacy in Practice is a UK pharmacy publication with its roots in Scotland.