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Feature Cardiology

Capacity problems in the NHS’s cardiac cath labs are harming patients

BMJ 2023; 382 doi: (Published 13 September 2023) Cite this as: BMJ 2023;382:p1953
  1. Jacqui Thornton, freelance journalist
  1. London, UK
  1. jacqui{at}

Clinicians say that patients with heart valve disease are dying while waiting, as they increasingly have to battle for space in vital but pressed catheterisation labs—but Jacqui Thornton finds that solutions are possible

Cardiac catheterisation laboratories or “cath labs”—a cross between operating theatres and x ray rooms—are an essential part of the NHS. The clinicians working in them are not the most vocal or well known, but in the face of increased pressure their voice is growing louder.

This June a survey of 125 clinicians working in 36 cath labs throughout the UK revealed concern that a lack of capacity and beds was leading to more valve procedures being done non-electively, with poorer outcomes.1 Some 97% of respondents said that non-elective procedures were putting moderate to severe pressure on lists, and 72% said that patients were dying while waiting to be treated.2

The survey was carried out by Heart Valve Voice, a UK heart valve disease charity, and the All Party Parliamentary Group for Heart Valve Disease, which has written to NHS England about the issue and planned to table an early day motion when parliament returned on 4 September after the summer recess.

Cath labs carry out ablation, angiogram, angioplasty, and insertion of pacemakers or implantable cardioverter defibrillators, as well as newer procedures such as transcatheter aortic valve implantation (TAVI) for heart valve disease, which affects 1.5 million people in the UK and can be fatal if left untreated.

At the survey launch in June, Jonathan Byrne, a consultant interventional cardiologist based at King’s College Hospital NHS Foundation Trust, said, “Every centre faces the same battle to help their patients, and staff sadly watch while patients are denied lifesaving treatment due to a lack of capacity.”

“Tsunami of need”

Two months on, Byrne, who is the trust’s clinical director of …

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