Bringing Cardiology Expertise to the heart of Primary Care

With myocardial infarction being the number one cause of death in the UK the issue of delivering efficient yet effective cardiac care within the NHS is an important issue which the Government is seeking to address.

How can you improve patient cardiac care whilst simultaneously easing the operational and financial challenges it places on secondary care providers? 

At an estimated £34 billion per annum the cost of diagnosing, treating and caring for patients with cardiac related problems represents the single largest financial burden on the NHS every year.

With myocardial infarction being the number one cause of death in the UK the issue of delivering efficient yet effective cardiac care within the NHS is an important issue which the Government is seeking to address.
 
To ease the financial and operational burden placed upon secondary and acute cardiac care providers a model of more proactive and preventative cardiac care in a primary healthcare setting needs to be developed. 

Primary care cardiology
Early detection facilitates early action. Delivering timely and preventative treatment to patients will help to prevent avoidable hospital admissions, cut costs and release valuable resources in secondary care.

Southampton City Primary Care Trust (PCT) has over 250,000 registered patients and is committed in developing innovative ways to support people with cardiac care issues in order to provide excellent care and treatment for patients. In view of this it was crucial to find a solution that was both clinically effective and supported by an infrastructure capable of ensuring effective resource management.

Deciding the best approach
Southampton City PCT has been developing community based cardiac specialist services for some time. As a result of this we were keen to explore models of care, which guaranteed quick, reliable results to enhance the development of its community provision and help reduce the financial and operational burden of cardiac care on hospitals and acute care providers. 

Southampton City PCT opted for a cardiac telemedicine service provided by Manchester based telemedicine specialist Broomwell Healthwatch, as the PCT was  extremely interested in the technology and services they have offered.


Electrocardiograms (ECG) in primary care practice
This new technology is easy to use. Staff training can be completed within a couple of hours and readings can be carried out by all grades of staff, from GPs to nurses, before being sent off for analysis.  The ECG is taken with the Heartview Professional and then transmitted as a sound signal by landline or fax in just 45 seconds to Broomwell’s monitoring centre, where it is displayed on screen for interpretation by trained cardiac clinicians. 

Broomwell staff are able to give an immediate verbal interpretation by phone so that rapid action can be taken, if necessary.  A written ECG report is also returned by fax for inclusion in the patient’s clinical notes. For local cardiac nursing staff it offers the opportunity for instant diagnostics in decision-making.

Ultimately the clinical responsibility does rest with the patient’s GP, who treats all chest pains cautiously in accordance with PCT guidelines. However the telemedicine service has proved to be an invaluable clinical aid in preventing hospital admissions. 

Weighing up the benefits
Delivering optimal patient care is the PCT’s priority and the Broomwell service has delivered clear benefits across the PCT. The ECG service delivers immediate diagnosis from qualified clinicians at a primary care level and will have considerable impact on diagnostic efficiency, in turn contributing to achieving a higher level of patient care.

Cardiac telemedicine means fast and accurate diagnosis can be made, reassuring the majority of patients that their symptoms are not indicative of an immediate, threatening condition – therefore preventing unnecessary hospital visits - whilst those in immediate danger are transferred to definitive care.

For Southampton City PCT, the Broomwell service has been of great value.  It is flexible, available round-the-clock and staff are always helpful. We are currently exploring the further roll out of devices to support the management of other long-term conditions.

Cardiac telemedicine has brought the expertise of leading cardiac clinicians straight to the heart of community care. This proactive, preventative approach is what is needed across the NHS as it not only provides a more effective model of care for cardiac patients, but also helps ensure NHS resources are optimised and used as effectively as possible.


Chris Webb
Specialist and Clinical Equipment Services Manager
Southampton Primary Care Trust
 Southampton

References:
British Heart Foundation Statistics Database, 2006
Dr Foster Intelligence, 200