NHS scanner and lack of radiologists contribute to thousands of deaths that can prevent heart attack, warn experts
November 8, 2018Health, irelandComments Off on NHS scanner and lack of radiologists contribute to thousands of deaths that can prevent heart attack, warn experts
The lack of modern CT sensors and trained radiologists contributes to thousands of deaths because patients with chest pain can not get the recommended controls, experts warn.
At least 56,289 patients with angina were refused access to CT examinations last year despite the NHS guidelines according to which available data from the Royal College of Radiologists (RCR) should be offered to all patients with stable chest pains.
Waiting for a test section up to 26 weeks in some parts of the UK and the RCR estimates that the actual number of skipped scans last year could reach 132,000 patients with symptoms of angina pectoris.
Early scanning can be vital. A major medical study at the beginning of 2018 found that nearly half of all deaths and severe infarctions occurred in the next five years – from 3.9% to 2.3%.
"This is a significant reduction in a large number of people, and in theory it would save thousands of heart attacks and deaths a year if we were properly occupied and equipped," Dr. Andrew Beale, Medical Director of RCR Independent.
With state-of-the-art equipment, physicians can prefer patients who need medication and monitor and those who need surgical interventions to resolve arterial narrowing. But the negative result also has significant benefits.
"With this test, I can effectively say" go home, you do not have a heart problem, "Dr Beale added." This is immense for their well-being, that means no hospital and GP follow-up, and you can stop medication if you can say that you will not have a heart attack in the next five years. "
Angina, caused by a reduced blood flow to the heart, is usually not life-threatening, but can be a warning sign of heart disease and an increased risk of serious cardiovascular problems.
Starting in 2016, the National Institute of Excellence in Health and Care (Nice) recommends that the English NHS treatment should offer a CTCA computerized tomography scan of all patients with symptoms similar to angina pectoris.
However, the UK is currently bound by the number of CT scanners with Hungary, with only nine per 100,000 people and significantly less than Germany – which has 35 per 100,000 – to test bottles.
Added to that, Dr. Beale says, "Only about half" of CT scanners is modern enough to provide a rating recommended by Nice that may favor patients for surgery. There is also a question of who will interpret these scans when the United Kingdom has the lowest number of radiologists per head of a country's population in Europe, a fact that "Brexit did not help."
Wales was the largest gap, with 7854 patients with angina, 78% of the minimum number of RCRs estimated, followed by Scotland (73%) and Northern Ireland (58%).
While England was the best performance, it is the only country where the recommendations from Nice explicitly apply, and the RCR estimates that 69886 people missed CTCA scanning – 37% of the total cases of angina.
This is in the context of cuts in training budgets and repeated government redress on NHS capital budgets, which are dedicated to maintenance and equipment, and finance the day-to-day operation of hospitals in cash.
Independent in October, revealed that confidence was £ 3bn, and the number of pending repairs in the most urgent repairs and upgrades that are believed to pose a significant risk to patients increased.
"It is unbearable that we do not have the ability to provide what should be a routine front test for all those with chest pain," Dr. Giles Roditi, chair of the British Society for Cardiovascular Imaging, who compiled data along with the RCR.
"Instead, in many hospitals it is easier for a small knee runner to get a magnetic resonance imaging than a patient on the verge of a heart attack to get CTCA.
"Fatal heart disease is omitted because we can not properly perform these controls in the UK."
The call to remove the lack of CTCA is supported by the British Heart Foundation and Charity Medical Director Professor Sir Nilesh Samani said: "It is worrying that there is no better access to CT examinations in the UK, so some patients with heart disease without a potentially life-saving diagnosis.
"Research supported by the BHF has shown that if patients with symptoms of angina pectoris have as part of their CT examination, they are less likely to have a heart attack or die."
A spokeswoman for the Department of Health and Welfare said: "We want patients to receive world-class care at world-class facilities and ensure that the NHS accepts and trains the talented staff they need. We have announced new capital investments of 3.9 billion crowns and our the historic long-term plan for the NHS, which will support an additional £ 20.5 billion annually by 2023/24, will provide our health services with a long-lasting base.
"The number of clinical radiologists in England has increased by 29% since 2010, but we want to see that numbers continue to grow, so over the next three years we will allow more doctors to specialize in clinical radiology."