Asked by: Philippa Whitford (Scottish National Party - Central Ayrshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department plans to take to support increases in auscultation using a stethoscope in primary and community care settings to detect heart murmurs characteristic of heart valve disease.
Answered by Will Quince
NHS England has assessed that the use of clinical auscultation using a stethoscope is not a sensitive way of identifying the presence and clinical significance of heart valve disease or the detection of heart murmurs.
To support the early detection and diagnosis of heart valve disease NHS England has committed to launch at least 100 community diagnostic centres (CDCs) by 2024/25. These CDCs will provide services to detect heart murmurs, which are characteristic of heart valve and cardiovascular disease, through physiological measurement tests such as echocardiography and electrocardiograms, pathology tests, computerised tomography and magnetic resonance imaging scans.
In addition, the National Health Service is investing in cardiac networks to support whole pathway improvements. These networks have been developed to take an evidenced based, clinically led, whole pathway approach to improvement from prevention, diagnosis, treatment and end-of-life care.
Asked by: Philippa Whitford (Scottish National Party - Central Ayrshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what services breathlessness clinics will provide to support the early detection of heart valve disease; and whether those clinics will refer patients for auscultation using a stethoscope in primary care or community diagnostic centres.
Answered by Will Quince
NHS England has assessed that the use of clinical auscultation using a stethoscope is not a sensitive way of identifying the presence and clinical significance of heart valve disease or the detection of heart murmurs.
To support the early detection and diagnosis of heart valve disease NHS England has committed to launch at least 100 community diagnostic centres (CDCs) by 2024/25. These CDCs will provide services to detect heart murmurs, which are characteristic of heart valve and cardiovascular disease, through physiological measurement tests such as echocardiography and electrocardiograms, pathology tests, computerised tomography and magnetic resonance imaging scans.
In addition, the National Health Service is investing in cardiac networks to support whole pathway improvements. These networks have been developed to take an evidenced based, clinically led, whole pathway approach to improvement from prevention, diagnosis, treatment and end-of-life care.
Asked by: Philippa Whitford (Scottish National Party - Central Ayrshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will take steps to support the increased use of stethoscopes in (a) primary care settings and (b) CDCs for the detection of heart valve disease.
Answered by James Morris
NHS England has assessed that clinical auscultation using a stethoscope is insufficiently sensitive to identify the presence and clinical significance of heart valve disease. Clinicians are expected to consider the history of the patient and undertake an examination to ensure the appropriate test is requested, which would normally include auscultation of the heart, with other assessments such as blood pressure. While some community diagnostic centres may have facilities to examine patients, its aims are to provide diagnostics tests such as echocardiograms.
Asked by: Philippa Whitford (Scottish National Party - Central Ayrshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to tackle (a) the number of preventable deaths caused by heart valve disease and (b) the variation in quality of diagnostic services for CVDs.
Answered by James Morris
People with heart failure will be supported by multi-disciplinary teams in Primary Care Networks and greater access to echocardiography within community diagnostic centres (CDCs). This will improve the investigation of those with breathlessness and the early detection of heart failure and heart valve disease. NHS England is working with the British Heart Foundation to raise awareness of heart valve disease to ensure earlier diagnosis, enable patients to receive treatment and prevent avoidable deaths.
We have committed £2.3 billion to launch at least 100 CDCs by 2024/25, increase the volume of diagnostic activity and further reduce waiting times for patients with cardiovascular disease. In addition, the National Health Service is investing in cardiac networks to support whole pathway improvements. These networks have been developed to take an evidenced based, clinically led, whole pathway approach to improvement from prevention, diagnosis, treatment to end of life care.
Asked by: Philippa Whitford (Scottish National Party - Central Ayrshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of how breathlessness clinics will support the (a) the detection of and (b) referral into CDCs for diagnosis of heart valve disease.
Answered by James Morris
People with heart failure will be supported by multi-disciplinary teams in Primary Care Networks and greater access to echocardiography within community diagnostic centres (CDCs). This will improve the investigation of those with breathlessness and the early detection of heart failure and heart valve disease. NHS England is working with the British Heart Foundation to raise awareness of heart valve disease to ensure earlier diagnosis, enable patients to receive treatment and prevent avoidable deaths.
We have committed £2.3 billion to launch at least 100 CDCs by 2024/25, increase the volume of diagnostic activity and further reduce waiting times for patients with cardiovascular disease. In addition, the National Health Service is investing in cardiac networks to support whole pathway improvements. These networks have been developed to take an evidenced based, clinically led, whole pathway approach to improvement from prevention, diagnosis, treatment to end of life care.
Asked by: Philippa Whitford (Scottish National Party - Central Ayrshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the Stickels June 2022 BMJ paper on aortic stenosis waiting times, what steps his Department plans to take to facilitate the conversion of SAVR to TAVI for aortic stenosis treatment for the purposes of expediting the recovery of the heart valve disease backlog.
Answered by James Morris
The National Institute for Health and Care Excellence (NICE) makes recommendations on interventions for aortic stenosis in its guideline ‘Heart valve disease presenting in adults: investigation and management’. It has no current plans to review or update this guideline. For adults unsuited to heart valve surgery, NHS England recommends transcatheter aortic valve implantation (TAVI) to treat aortic stenosis.
We have committed £2.3 billion to launch at least 100 community diagnostic centres by 2024/25 to increase diagnostic activity and reduce waiting times for patients with heart valve disease, such as aortic stenosis. In addition, the National Health Service is investing in cardiac networks to support whole pathway improvements. These networks have been developed to take an evidence based, clinically led, whole pathway approach to improving prevention, diagnosis, treatment and end of life care.
Asked by: Philippa Whitford (Scottish National Party - Central Ayrshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the findings of the Stickels, June 2022 BMJ paper on recovering aortic stenosis waiting lists, whether his Department has plans to use those findings to inform best practice guidance on reducing mortality from that disease.
Answered by James Morris
The National Institute for Health and Care Excellence (NICE) makes recommendations on interventions for aortic stenosis in its guideline ‘Heart valve disease presenting in adults: investigation and management’. It has no current plans to review or update this guideline. For adults unsuited to heart valve surgery, NHS England recommends transcatheter aortic valve implantation (TAVI) to treat aortic stenosis.
We have committed £2.3 billion to launch at least 100 community diagnostic centres by 2024/25 to increase diagnostic activity and reduce waiting times for patients with heart valve disease, such as aortic stenosis. In addition, the National Health Service is investing in cardiac networks to support whole pathway improvements. These networks have been developed to take an evidence based, clinically led, whole pathway approach to improving prevention, diagnosis, treatment and end of life care.
Asked by: Baroness Masham of Ilton (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps they will take to ensure that GP surgeries with low performing Quality and Outcomes Framework (QOF) data are provided with additional support for (1) diagnosing, and (2) treating, heart failure.
Answered by Lord Kamall
The Quality and Outcomes Framework (QOF) is an annual voluntary incentive programme for general practitioner (GP) practices in England, which rewards practices for meeting the required thresholds for each indicator. No additional support is offered specifically to low-performing practices.
NHS England is implementing measures to raise awareness of the symptoms of heart failure and ensure early and rapid access to diagnostic tests and treatment, overseen by the National Clinical Director for Heart Disease and supported by an Expert Advisory Group of clinical experts. This includes the launch of community diagnostic centres which could deliver over one million additional computerised tomography, magnetic resonance imaging, ultrasound scans, echocardiograms scans and X-rays. This will support Primary Care Networks to increase diagnostic capacity for the detection of conditions such as heart failure and heart valve disease.
NHS England has developed five ‘NHS@Home’ pilots to support patients with heart failure in the community. The ‘Managing Heart Failure @home’ scheme aims to support people living with heart failure to manage their condition at home through patient education and remote monitoring. Working with a specialist clinician, patients are supported to understand their medications, reduce salt intake, monitor and record daily weight and blood pressure measurements and recognise symptoms which may indicate deterioration. The ‘Blood Pressure @Home’ initiative allocated more than 220,000 blood pressure monitors in England to enable at-risk patients to measure their blood pressure remotely and share the results with their GP practice, reducing the need for appointments and travel. These schemes aim to reduce hospital admissions and increase patients’ quality of life, through improved understanding of the management of the condition and communication with primary, community and specialist teams.
Asked by: Baroness Masham of Ilton (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps they are taking to ensure that those most at risk of heart failure have immediate access to primary care services for the (1) diagnosis, and (2) monitoring, of their condition.
Answered by Lord Kamall
Multi-disciplinary teams within Primary Care Networks provide greater access to echocardiography to investigate the symptoms of patients with breathlessness and accelerate the early detection of heart failure and heart valve disease.
We have committed to creating an additional 50 million appointments a year in general practice by increasing and diversifying the primary care workforce. This will improve access for patients, including those at risk from heart failure and ensure staff can provide a range of care options for patients outside of hospital.
Asked by: Feryal Clark (Labour - Enfield North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department plans to implement a new referral to treatment pathway for patients with severe aortic stenosis.
Answered by James Morris
We have no specific plans to do so as there is an existing referral to treatment pathway for patients with severe aortic stenosis. The National Health Service is investing in cardiac networks to support improvements to the care pathway from prevention, diagnosis, treatment and end of life care.
We have committed £2.3 billion to launch at least 100 community diagnostic centres by 2024/25, to improve the early detection and diagnosis of heart valve disease in England.
Adults requiring an aortic valve replacement will be assessed to determine the appropriate procedure. Treatment usually involves surgical aortic valve replacement or transcatheter aortic valve implantation (TAVI). Cardiac centres have increased the number of TAVI procedures, which have a lower requirement for intensive care beds and a shorter length of stay in hospital.