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Nearly 900 more cardiologists needed because of cut in working hours

Zosia Kmietowicz London

Patients with heart disease in the United Kingdom are still not getting an adequate level of care, with many never getting to see a specially trained doctor, says a report out this week.

The report, from the British Cardiac Society and the Royal College of Physicians, finds that although many aspects of coronary care have improved since 1993, when the last report was produced, others continue to flounder.

Some patients—especially those with coronary heart disease, for which there is a national service framework in England—are getting more attention from health planners. However, warns the report, patients with problems not included in the guide (such as heart muscle disease, complex heart rhythms, valvular heart disease, and congenital heart disease) are in danger of being forgotten.

The report, the Fifth Report on the Provision of Services for Patients with Heart Disease, acknowledges that some clinical areas, such as restabilising blood flow and dissolving blood clots, are being better managed than a few years ago. But it says that infrastructures and use of resources are still often poor. Gaps are also appearing in coronary services across UK borders because there is no equivalent to the national service framework in Scotland, Wales, and Northern Ireland, it says.

The report highlights the severe shortage of cardiologists, cardiac surgeons, cardiac nurses, technicians, and support staff, without whom it is not possible to run a modern and effective cardiovascular service. With only 630 consultant cardiologists in the United Kingdom, many patients with heart conditions never get to see a specialist doctor. Nearly 900 extra consultants will be needed by 2010 to compensate for a reduction in doctors’ hours with the introduction of the European Working Time Directive, estimates the report.

It calls for more patients to be included in the planning of coronary services, better technology systems with more computing staff, and a reorganisation of working practices to make better use of existing staff. The report has been published as a supplement to the November issue of the journal Heart (2002;88(suppl 3)).
 
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