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Current services in relation to need

Adults :: CVD :: Current services in relation to need

Prevention and Detection

Primary prevention concentrates on altering modifiable lifestyle factors including diet, exercise, obesity, smoking and alcohol intake. For example, Medway Exercise Referral programme accepts patients with diagnoses of stroke and CHD for a 12-week programme of support and access to activity sessions to increase levels of physical activity.

NHS Health Checks programme is offered to people without CVD aged 40-74 years at any Medway GP practice to identify those who have CVD risk score of 20% or higher. This is followed by personalised lifestyle advice, individually tailored management and treatment. The cumulative percentage (Q1 2013/14-Q1 2016/17) of the eligible population aged 40-74 offered an NHS Health Check in Medway is 68.7%, which is significantly higher than the England (61.5%) average. However, the cumulative percentage of people who have received a Health Check is slightly lower in Medway (29.3%), than England (29.8%)[1].

Of the 41,507 people on the hypertension disease register in Medway in 2016, 83% had a blood pressure less than 150/90[2], and a further estimated 28,000 people remain undiagnosed[3].

Secondary Care

Cardiology services are provided from the Cardiac Care Unit and Cardiology Ward at Medway Maritime Hospital. They include the following:

Cardiac imaging and diagnostics

A number of imaging and diagnostic test are performed in Medway, including angiograms and echocardiograms, however, there is a need for cardiac MRI, cardiac CT and stress imaging locally as this is currently being referred to London hospital trusts.

Revascularisation

Revascularisation encompasses any intervention that would improve blood flow. This includes thrombolysis (breaking up the blood clots), angioplasty (including primary Percutaneous Coronary Intervention, pPCI) and coronary artery bypass graft (CABG). The MINAP (Myocardial Ischaemia National Audit Project) clinical audit of the management of heart attack, including information on the performance of Medway Foundation NHS Trust can be seen here: http://www.ucl.ac.uk/nicor/audits/minap/reports.

Cardiac Devices

The following devices are fitted and replaced in Medway Maritime Hospital:
• Permanent Pacemaker implantation and follow up
• Internal Cardiac Defibrillator implantation and follow up
• Cardiac Resynchronisation Device Therapy and follow up

Historically, ICD implants for Medway residents were performed in London, but increasing numbers are being done locally. Implantation of left atrial appendage occluders and implantation of atrial septal defect closure devices are not performed locally.

Community services

Medway Community Healthcare CIC provides community cardiology services, including cardiac rehabilitation, arrhythmia service, diagnostic services and heart failure services. For more information, visit: https://www.medwaycommunityhealthcare.nhs.uk/our-services/heart-services/


References

[1]   Public Health England. NHS Health Check data tool
[2]   NHS Digital. Quality and Outcomes Framework
[3]   National Cardiovascular Intelligence Network. Hypertension prevalence in England 2014 October, 2016; Public Health England. http://www.yhpho.org.uk/resource/view.aspx?RID=244318 .