Systemic change needed at the heart of recovery

Head of British Heart Foundation Northern Ireland (BHF NI) Fearghal McKinney reveals how the Covid-19 pandemic has affected heart patients across Northern Ireland, with the charity calling for a strategic approach to tackle the issue. 

In January 2020 Linda Murray was referred for open heart surgery by her cardiologist to repair a damaged heart valve.

Almost a year and a half later, the Lisburn woman is still waiting for the operation and lives daily with the impact of a leaky heart valve. 

Linda’s story is not unusual. The pandemic has seriously affected cardiac services in Northern Ireland. Surgeries were cancelled and many cardiology services were paused in order to deal with the impact of Covid-19. 

In fact, BHF NI analysis of the cardiac waiting lists found 30 times more people are waiting over six months for cardiac surgery than a year ago. 

Analysis from the leading heart charity has revealed: 

• At the end of 2020 there were 30 times as many people waiting over six months for cardiac surgery compared to the same period in 2019 
• Between June and December 2020, the number of people waiting over six months for cardiac surgery doubled 
• Between the end of 2019 and the end of 2020, the number of people waiting for cardiac surgery grew by 40 per cent 

McKinney says each number on a waiting list is more than a statistic, it is a person waiting on life enhancing, and often life-saving, surgery. 

“Heart operations are not something that people can easily go without, delaying them can cost lives,” he states. 

“The significant backlog of people needing heart surgery will keep growing as there are also significant numbers of people waiting for cardiology referrals and many of these are likely to require surgery. That waiting list will only get longer and make no mistake, as this goes on people will die on that waiting list or will have died already. 

“Every number on that waiting list is a person with a family worried sick about the future. Many of them are facing anxiety and a worsening quality of life as time goes by.”

As Northern Ireland emerges from the pandemic, focus is on rebuilding the health service and where we go from here. BHF NI says cardiology should be one of the priority areas for the health service in Northern Ireland as the system rebuilds. The heart research charity said it is vital that heart services are prioritised, protected and expanded to address the significant backlog of people awaiting treatment.

McKinney believes there are no easy answers but there is a need for a different approach to dealing with cardiology.  

“Staff across our health service have worked tirelessly for more than a year now to deal with the Covid-19 pandemic. In cardiology, services were pulled or dramatically reduced in order to deal with the onslaught of the pandemic, and staff have gone above and beyond since last March,” he explains. 

“Quick fixes like assuming staff can work weekends or longer hours to tackle the waiting lists is not possible. These people are exhausted and we can’t ask any more of them. We need to look at it differently with systematic change.”

Cardiovascular Disease (CVD) Taskforce

Using BHF NI convening power and relationships the charity has brought together a panel of experts, including cardiologists and health officials in a Cardiovascular Disease (CVD) Taskforce. 

The aim is to identify key priorities to ensure that people with, and at risk of, heart and circulatory disease across Northern Ireland receive the best possible care today and in the future in line with the transformation principles within health and social care. 

“Our CVD Taskforce was set up pre-pandemic because we believe we needed a new CVD Strategy for Northern Ireland and we were perfectly placed to bring the right people around the table to deliver that,” says McKinney. 

 “Services are operating within the context of no new strategic framework since 2014. There has been a lot of change in the health care system since then, not least the transformation agenda and this year as we consider the impact of the Covid-19 pandemic. Heart and circulatory patients are now, more than ever, vulnerable.

“An ambitious, long-term, strategic plan, informed by innovative thinking along with significant and recurrent funding for cardiac care will ensure that services build back better. We must see this commitment to cardiac services from the Department of Health in the form of a heart disease strategy.”

“The impact of the pandemic on already struggling waiting lists shows just how bad it is for heart patients.”

McKinney says the taskforce will now produce a CVD Strategy that will take into account the impact of the pandemic on cardiac services as well as putting people living with CVD at the heart of the strategy by involving them in its development. 

“Heart disease is a major cause of ill health and death in Northern Ireland and the pandemic has only exacerbated the situation,” he adds. 

“We estimate that around 225,000 people are living with heart and circulatory diseases here and people living with these conditions are at significantly higher risk of serious ill health and death from Covid-19. 

“An ambitious, long-term, strategic plan, informed by innovative thinking along with significant and recurrent funding for cardiac care will ensure that services build back better. We must see this commitment to cardiac services from the Department of Health in the form of a heart disease strategy.

“In BHF NI patients are at the heart of everything we do. It is important to us that we are including patients as we develop a strategy that meets their needs.”

The CVD taskforce is looking at the key areas of detection, diagnosis and optimal management of high-risk conditions, including high blood pressure, high cholesterol and atrial fibrillation. Variation in treatment and long-term support, so that people can live well with their conditions. The effective use of health data, issues in workforce and governance are also being explored.

“We have an opportunity to look at these challenges and beyond them to identify what our priorities should be to ensure that people with heart disease in Northern Ireland today, and in the future, receive the best possible care,” McKinney concludes. 

For more information contact Fearghal McKinney on mckinneyf@bhf.org.uk