Welsh Cardiovascular Society. Spring 2018

Transcription

1 Welsh Cardiovascular Society Spring 2018

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3 NHS Wales Atlas of Variation for Cardiovascular Disease Context In the NHS Wales Heart Conditions Delivery PlanJanuary 2017, unwarranted variation in practice and in the delivery of services was identified as one of the key remaining challenges in cardiac care in Wales Comparisons, benchmarks and clinical audit have been difficult to establish and maintain in many areas of the country Aims To identify unwarranted variation in key aspects of cardiovascular care To investigate the reasons for unwarranted variation, whether of overuse, underuse or both To use the Atlas as a tool to effect culture change and to support the development of value-based and population-based healthcare in Wales 3

4 Prevalence (%) of hypertension by GP cluster 2016/17 Range: % Fold-difference: 2.31 The most likely reason for the degree of variation is differences in the identification of people with hypertension in different local areas, especially among GP clusters that have similar populations demographically. 4

5 Prevalence (%) of coronary heart disease (CHD) by GP cluster 2016/17 Range: % Fold-difference: 2.63 The most likely reason for the degree of variation is differences in the identification of people with CHD in different local areas. Other reasons include differences in: the prevalence of risk factors in different local areas the level of service provision 5

6 Emergency admissions to hospital for people with heart failure per 100,000 population by GP cluster 2016/17 Directly standardised by age Range: Fold-difference: 3.21 Reasons for the degree of variation observed include differences in: prevalence and severity of heart failure in different local areas identification of, and referral rates for, people with suspected heart failure timely access to diagnostic tests access to local heart failure teams and specialist care access to rehabilitation programmes specifically designed for people with heart failure the level of care and support in the community competency for self-care among people with heart failure 6

7 From unwarranted variation to the reallocation of resources For indicators where unwarranted variation represents overuse, it is possible to increase value by shifting resource from the overuse of interventions into: increasing the use of effective interventions currently being underused introducing innovations of proven effectiveness meeting currently unmet need in the population being served 7

8 Expert Reference Groups Key role in developing Atlas eg 1. ACS service provision in Wales 2. Acute and Chronic Heart failure services 3. Arrhythmia services

9 Working groups Expert reference groups Academic Acute Coronary Syndromes Cardiac surgery / Structural intervention with Welsh Cardiothoracic Surgeons Society GUCH Heart Failure Heart rhythm and Genetics Imaging

10 Working groups Autumn meeting Each group to present its workplan

11 Working groups Cardiac surgery / Structural intervention with Welsh Cardiothoracic Surgeons Society TAVI WHSSC policy Imaging Statement of intent for imaging in Wales

12 All Wales Accelerated Cardiac Informatics (AWACI) Project Vital for transforming pathways Need clinical champions Rob Bleasdale sits on the AWACI board Local support

13 Cardiac MR Several health Boards have CMR in their IMTP s Cwm Taf have a new scanner Cardiff and Vale mobile scanners ABMU no new investment Betsi Cadwallader plans for new scanner Aneurin Bevan With SCCC

14 Cardiac MR Chair SAC asked if we have a solution as concern re ability to train (BCS Council) STC chair Wales and WCVS write again to CEO s and directors of planning Copy in CEO NHS Wales 8 week HB delivery target

15 ACHD Deliver phase 2 of service development new consultant appointments Develop patient registry Atlas of variation

16 Train the trainer day Future plans: Society investments Trainee day how to prepare for research Regional cardiac updates Co-host research meetings with Health and Care research Wales Continue annual prizes for basic and clinical research

17 Peer Review It is anticipated that there will be a cardiac peer review process implemented in 2018/19 across Wales. WCVS should be engaged in developing the process

18 Thanks Prof Zaheer Yousef Dr Tim Kinnaird The Exec Cardiac network leads Working groups

19 Highlights Formation and acceptance of WCVS working groups Strong links to Cardiac Network Professional relationship with WHSSC Inclusive nature of the society Positive focus on research

20 Highlights The Choir

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