New cardiovascular screening programmes planned

Br J Cardiol 2008;15:7–11 Leave a comment
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As part of a larger focus on prevention of disease in the NHS, Prime Minister Gordon Brown has announced that new screening programmes for early signs of heart disease, stroke and kidney disease will be introduced in the UK.

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Speaking to health professionals at King’s College, London, the PM said that, over time, everyone in England will have access to the right preventative health check-up. He said the first priority was to offer men over 65 a simple ultrasound test to detect early abdominal aortic aneurysm, which should save more than 1,600 lives each year.

The government is also planning to introduce on the NHS a series of tests to identify vulnerability to heart and circulation problems.  “So there will soon be check-ups on offer to monitor for heart disease, strokes, diabetes and kidney disease – conditions which affect the lives of 6.2 million people, cause 200,000 deaths each year and account for a fifth of all hospital admissions,” the prime minister said, adding: “And we will extend the availability of diagnostic procedures in the GP surgery – making blood tests, ECGs and in some cases ultrasounds available and on offer, not only when you are acutely unwell or if you can pay, but when you want and need them, where you need them, at the local surgery.”

Initially the tests will be available to the most vulnerable, and money has been set aside to pay for the procedures in the health budget for 2008–11, Mr Brown said. He said the extra screening should start to be rolled out in 2008–9, but details of who exactly should be screened and the funding to cover this initiative are not expected to be announced until February.

The NHS will also focus on preventative care in relation to so-called ‘lifestyle’ diseases, such as obesity and better management of long-term conditions, such as asthma and diabetes. With 60 % of the population projected to be clinically obese by 2050, the Prime Minister stressed new measures, such as an increase in activity-based prescriptions and the provision of at least five hours of sport a week for schoolchildren.

The medical community has had a mixed reaction to the news of new screening programmes. Dr Alan Maryon-Davies, president of the UK Faculty of Public Health, said: “If you identify people with high cholesterol or glucose levels, you have then got to have the proper services to help them. This will mean extra dietitians, exercise co-ordinators, practice nurses and public health specialists would be needed.”

Dr Peter Weissberg, Medical Director of the British Heart Foundation, had a similar view. He said: “Screening has the potential to save many lives in the UK from heart disease, which is why doctors have been asking for this for some years. But screening will only save lives if appropriate treatment is funded and accessible for those identified by the programme as being at high risk – there is little point in identifying someone at risk without providing the resources to treat them.

“A national screening programme will cost a lot of money and cannot work unless it is underpinned with sound investment – and not at the expense of other health services. Public health screening programmes are notorious for not reaching the highest-risk groups, including people living in deprived areas and ethnic communities. If it is down to individuals to decide whether to take part in this screening programme, then the NHS will need to think of ways to encourage high-risk groups to attend.”

Dr Richard Vautrey, deputy chairman of the GPs committee at the British Medical Association, said: “What I do find extraordinary is just two or three weeks ago the prime minister insisted that funding be taken away from the treatment of patients with heart failure, hardening of the arteries and kidney disease – the very conditions that he’s now proposing to screen for”.