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Appalling echo waits holding back UK heart care

By Nigel Praities

Waiting times for echocardiography are ‘appalling' in the UK compared with most of Europe, a new large-scale study shows.

The research, published online by the European Heart Journal, suggests there is a long way to go in providing adequate access to echo in the UK, even with Government figures showing waiting times are failing.

A survey of 18,000 GPs across Europe found access to heart failure services was particularly poor in Britain, where only 16% of GPs could directly access echocardiography within one month, compared with 41% in France and 26% in Italy.

Access through specialists was desperately slow, with only 8% of GPs in the UK able to get patients tested within a month through this route.

The findings follow commitments from a series of SHAs to increase direct access to diagnostic tests such as echo, as part of Lord Darzi's plans to remodel primary care.

The survey was carried out in 2002 and 2003, but figures from the Healthcare Commission show nearly a third of patients were still waiting over 13 weeks for echocardiography in 2006.

The researchers, who in the UK were led by Professor Richard Hobbs, head of primary care at the University of Birmingham and a GP in the city, said it was ‘very disappointing' that lack of access remained such a problem in primary care.

They added that it was a ‘concern' that only around two-thirds of GPs regarded diagnosis of heart failure using echo as necessary.

Dr Gerald Partridge, a GP in Keighley, West Yorkshire, who runs a community echocardiography clinic, said access to echo in the UK was ‘pretty grim' and more trained GPSIs were needed. ‘We are appalling compared with Europe and there is a real lack of capacity that causes unnecessary anxiety for patients,' he said.

The researchers also surveyed patterns of prescribing, and found 22% of British GPs never used [beta]-blocker therapy for patients with heart failure – even though NICE recommends the drugs as a second-line therapy for the condition.

Dr Terry McCormack, a GP in Whitby and chair of the Primary Care Cardiovascular Society, said he did not expect this to have improved since 2003. ‘It may have improved a bit, but [beta]-blockers have had a very bad press and it is not part of QOF so it won't have shifted that much.'

Heart failure services in the UK Echo

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