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British heart attack victims face longer journey for surgery

Armen Hareyan's picture

As only 54 hospitals can now operate heart attack patients unrealistic theory threatens lives in UK.

Thousands of heart-attack patients will be forced to travel further for emergency treatment because of a change in the techniques used to save their lives. The Department of Health will announce tomorrow that balloon angioplasty – administered to treat heart attacks caused by blocked arteries – will be made available to nearly every eligible patient. But the procedure is available at only 54 centres across England – about one in every four hospitals – which means instead of being taken to the nearest accident and emergency department, as now, about 25,000 patients will be taken straight to their nearest specialist angioplasty clinic, which could be many miles away.

One of the concerns is that, in practice, patients could still be taken to A&E before being transferred to a specialist unit, which may increase the time it takes to get lifesaving treatment. However, paramedics are to be given training to spot heart attacks that have been caused by blood clots so that patients can be taken directly to an angioplasty centre. Angioplasty is used to treat patients whose heart attacks have been caused by blocked arteries.

About 25,000 of the 60,000 heart attacks treated each year are of this type, and a quarter of those patients are, at present, given the procedure, in which a tiny balloon is inserted into the artery and inflated to clear the blockage. The Government says it aims to treat 97 per cent of eligible heart-attack patients by using angioplasty within three years.

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But experts admitted that although the number of centres offering the specialist treatment had risen from 35 in 2006/07 to 54 this year, a further increase was not likely. Cardiologists have described the proposal as a ‘challenge’, as specialist angioplasty units will have to be staffed by an expert team 24 hours a day, seven days a week. For the treatment to be effective it should be given within two hours of the heart attack, meaning some hospital trusts may need to double their number of cardiology consultants.

The proposals are the latest stage in the centralisation of NHS care. The Government has long pushed for the creation of ‘superhospitals’ – vast regional centres with specialist clinics catering to population areas of up to two million. Maternity services also face being moved from local hospitals to larger regional units and GPs could move from local surgeries to multi-purpose health centres, or polyclinics.

But Katherine Murphy, spokeswoman for The Patients Association, said the Government had got it ‘completely wrong’. She added: ‘What the Government always fails to consider is the convenience of access for patients. They should be providing a service at local level because that is what patients want.’

At the moment, most patients whose heart attacks have been caused by a clot are treated using thrombolysis – an injection of drugs to dissolve blockages. Professor Peter Weissberg, medical director of the British Heart Foundation, said the NHS had to commit ‘sufficient resources’ to turn the proposals into reality, especially for people in rural areas. He added: ‘We must not replace a first-class thrombolysis service, which is proven to save lives, with a second-class angioplasty service, which might not.’

The Department of Health said: ‘It is preferable to travel further to achieve a better outcome. However, if the journey time is too long, then early thrombolytic treatment is given instead.’

The author of this story is Dr. John Ray, who blogs at Socialized Medicine.