News and views

We continue our series in which Consultant Interventionist Dr Michael Norell takes a sideways look at life in the cath lab…and beyond. In this column, he considers radial access....

Correspondence from the world of cardiology. ...

NHS Improvement: what is the future for heart and stroke services? On the eve of his retirement, the outgoing National Director for Heart Disease and Stroke, Professor Sir Roger Boyle, has cautioned against reckless change in the new NHS, describing this as a threat to the continuous improvement that has been made over the past past decade.  Speaking to the BJC he said: “My criticism of this government is that they have been so busy condemning what’s happened before, when (actually) the NHS has improved more than it’s ever done”.  Sir Roger commented on current changes in the NHS at an event held by NHS improvement (NHSI) ‘Celebrating Clinical Leadership in Heart and Stroke – the Improvement Story so far’.  “To say that we are an over-managed health service is complete baloney,” he added, highlighting the NHS’ low transaction costs among developed nations. “We’ve done smaller commissioning in the past and we’ve tried bigger commissioning - we’ve settled for something in between and that seems to have been the best compromise”. He warned that in any major reorganisation, authority has to be re-earned in order for anything to change. “I’m very wary about where we’re going to over the next couple of years because corporate memory is lost,” he said.  Later in a panel discussion at the meeting with NHS Medical Director Professor Sir Bruce Keogh and National Clinical Director for Cancer Care Professor Mike Richards, Sir Roger said that his opposition to major NHS reorganisation was amongst the reasons for his retirement in July. “I’m partly leaving because I’m opposed to substantial reorganisation of this service I love deeply, and which is regarded across the world as one of the best”. Asked about the future role of clinical networks, Sir Roger criticised the abolition of strategic health authorities and primary care trusts (PCTs). “What we need at the moment is stability, not more change. Where we know we have tried things and they have worked, great. But we have also tried things that haven’t worked and we need to learn from that as well, otherwise…we just re-learn the same lessons time and time again”.  He also emphasised the importance of national clinical audits in monitoring the performance of new strategies, to ensure continued improvement, warning against the complacency of a “task and finish” approach: “If you go back and look at the National Service Framework…we started writing it in 1998, and there’s not a lot we’d want to change. But I think we are in a different decade, and we really ought to be revitalising our approach. We need to get further upstream, get better at prevention, as well as maintaining the excellence of improved care…we have to keep monitoring to ensure we are improving”. Sir Roger paid tribute to the improvements that have been made. “Over the last decade we have seen a transformation in heart services across England. The National Service Framework outlined what needed to be done and the NHS has delivered almost every aspect laid out in March 2000. Service improvement does not happen spontaneously. It requires organisation, leadership, and a great deal of hard work. This is what NHS Improvement has provided in spades over the years. Their industry and commitment have been consistent levers for change over the years working with the local delivery mechanisms and the 28 cardiac networks”....

News in brief from the world of cardiology...

HEART UK – The Cholesterol Charity held its 25th annual conference at Warwick University from 6th-8th July 2011, entitled ‘Partners in Prevention - Lipids in Cardiovascular Disease and Beyond’. The conference looked at past, present and future strategies for assessing and reducing risk of cardiovascular disease. Highlights included news of the upcoming Joint British Societies guidelines update, and the launch of a new campaign to map variations in coronary heart disease mortality across England. Tim Kelleher reports....

Manual of perioperative care in adult cardiac surgery, 5th edition Author: Bojar, RM Publisher: Wiley-Blackwell, 2010 ISBN: 978-1-4443-3143-1 Price: £42.99...

In this sixth article from the British Cardiovascular Society (BCS), Dr Sarah Clarke, BCS Vice-President Education & Research, writes about this year’s Annual Conference and plans for the year ahead. The British Cardiovascular Society (BCS) and its Affiliated Groups (AGs) are uniquely placed to coordinate and deliver high quality education for cardiology trainees, trained cardiologists and allied professionals. It provides education through a variety of sources....

We continue our series in which Consultant Interventionist Dr Michael Norell takes a sideways look at life in the cath lab…and beyond. In this column, he considers Latin....

Correspondence from the world of Cardiology...

Highlights of the recent American College of Cardiology (ACC) meeting, held in New Orleans, USA, on 2nd – 5th April 2011, included the promise of new, less invasive methods that might be an alternative to both aortic and mitral valve surgery. Long-term results from the STICH trial also suggest that CABG may have a role for patients with heart failure and ischaemic heart disease. ...