Coronary Heart Disease

Background

 
HeartCoronary Heart Disease (CHD) is a leading cause of death in the United Kingdom, and particularly in Wales, where the death rate is greater than in the majority of the countries in Western Europe. (Source: Tackling Coronary Heart Disease in Wales Welsh Assembly Government).
 
The Welsh Assembly Government has tasked the NHS in Wales with tackling CHD as a matter of high priority.
 

 

Strategy and policies

The Cardiac Disease National Service Framework NSF 2009 is the the key policy document for the delivery and development of cardiac services in Wales. It updates the Coronary Heart Disease NSF 2001 and takes into account Designed for Life, Review of Health and Social Care in Wales and Health Evidence Bulletin: CHD.together with developments in clinical practice. It includes arrhythmia and adult congenital heart disease services.
Designed for Life sets out the direction of travel and specific requirements for the NHS and describes the kind of health and social care services the people of Wales can expect by 2015.

The Review of Health and Social Care in Wales 2003 (Wanless Report) determined that Services need to be realigned to focus on prevention and early
intervention.and that where and how care is provided needs to change, with health and social care services needing to be brought closer together.

Health Evidence Bulletin: CHD. This Bulletin is designed to summarise the best current evidence to support the development of implementation tools such as guidelines and care pathways at national and local levels.

The Coronary Heart Disease NSF is a plan to implement evidence-based standards for tackling CHD in Wales. Its purpose is to drive up quality, tackle variations in access and clinical care, increase the cost-effectiveness of care, and enhance the users’ experience.

The Cardiac Quality Requirements (QRs) describe the standards of hgh quality care that will be in place once the Cardiac Disease NSF has been fully implemented.

Services

The Cardiac Networks of Wales were established in September 2002 to progress the implementation of the NSF for Coronary Heart Disease and continue to to take forward the work associated with the Cardiac Disease National Service Framework for Wales.

Regional Cardiac Networks

Mid & South West Wales Cardiac Network brings together key people and organisations involved in planning and delivering services for people with, or at risk of heart disease, across the Mid & West Wales region.

South East Wales Cardiac Network does the same across the South East Wales region

National Programmes

Health Challenge Wales has been developed to help contribute towards preventing ill health. It signposts members of the public to information or activity to help them improve their own health.
 
Physical Activity and Nutrition Networks Cardiovascular page contains information, advice, support and counselling which is provided from a wide range of professional staff on lifestyle changes, diet, exercise, smoking, weight control, symptom recognition, weight control, smoking and stress management.

The Welsh Assembly Government is investing over £4 million over three years (2008 – 2011) to support, develop and evaluate exercise referral schemes in Wales.
Exercise referral or GP referral describes the process by which patients are 'prescribed' a programme of physical activity. This guide details specific advice on setting up, running and evaluating exercise referral schemes

Stop Smoking Wales is the smoking cessation service in Wales and offers free, friendly support for smokers who are ready to stop.

 

Local Initiatives

Aneurin Bevan Local Health Board (through its Torfaen locality office) runs a Coronary Heart Disease Project and GP Exercise Referal Scheme

Caerphilly  Local Public Health Team runs a Healthy Heart Project with the aims of reducing mortality and morbidity by prevention of first heart attacks and strokes.


Service Planning

The Health Information Analysis Team of the Public Health Wales collates data on the levels of coronary heart disease in the Welsh population. Such data allows significant trends and any particular groups of the population affected to be identified, and enables effective delivery of high quality, accessible and appropriate specialist public health services, both in partnership and support of other national and local bodies.


Public Health Wales Wider Determinants and Health Inequalities Team has produced Frameworks for Action on Physical Activity, Nutrition and Tobacco Control. These make recommendations for activity to be delivered by local partners. Through its health improvement programmes, the Trust aims to use evidence based interventions to reduce tobacco smoking and alcohol intake, improve diet and increase physical activity levels for the population of Wales.


Public Health Wales has produced a series of interactive tools to help NHS organisations estimate the capacity of cardiac rehabilitation required to meet National institute of Health and Clinical Excellence (NICE) standards. Cardiac rehabilitation has been proved to be effective and has the potential to prevent premature deaths.

Resources

Map of Medicine provides a visualisation of the ideal, evidence-based patient journey for common and important conditions including CHD. NICE Cardiovascular Guidance is designed to promote good health and prevent ill health. NHS Evidence is a web-based service that provides access to high quality clinical information aimed at health professionals.
 

 

Statistics

 The Office for Narional Statistics ONS produces data on circulatory dseases mortality, the Welsh Health Survey reports on lifestyles and illness in Wales and the Quality and Outcomes Framework includes primary care data by clinical summary (CHD etc) and by Local Health Board.

Satistics on referral to treatment times for cardiac services are produced by the Welsh Assembly Government according to the arrangements approved by the UK Statistics Authority.

IPU manages and maintains the main NHS Wales repository for all-Wales health data, especially that relating to hospital activity. The Welsh Health Information and Statistics internet site has been developed to help meet the information requirements of NHS, Government and other public bodies, researchers and the general public 

Health Maps Wales is an interactive tool that can be used to explore a variety of health indicators grouped under broad categories, such as CHD, common procedures and causes of injury. The first release concentrates on data relating to hospital admissions from the Patient Episode Database for Wales (PEDW)

Annual Patient Episode Database Wales (PEDW) Tables offers Headline figures relating to hospital admissions (inpatient, day case admissions) available for download for  in Portable Document Format (PDF).