Published: Monday, February 14th, 2011
Cabinet Secretary announces new developments to benefit heart failure patients
A national 'heart hub' will ensure patients with advanced heart failure from throughout Scotland get access to potentially lifesaving treatment.
The Scottish National Advanced Heart Failure Strategy – launched today at the Golden Jubilee National Hospital, home of Scotland's Advanced Heart Failure Service – will enhance the care and treatment of heart failure patients across the country.
The strategy identifies clear priorities including:
- improving access to specialist expertise through outreach arrangements to local hospitals and communities to ensure a consistent, equitable, Scotland-wide referral pathway for those with the most advanced heart failure;
- increasing the number of heart transplants; and
- enhancing the current Scottish mechanical 'heart' service (Ventricular Assist Devices) at the Golden Jubilee National Hospital.
Health Secretary Nicola Sturgeon said: "This strategy will ensure that patients with advanced heart failure get access to expert advice and, where necessary, the most modern treatment available, regardless of where they live in Scotland.
"Heart transplants are a key part of this work and it's vital that we drive up the number of them by both increasing the numbers on the Organ Donor Register and making best use of available organs.
"But ventricular assist devices – so-called artificial hearts – also have a valuable role to play and can buy patients the time they need until their own heart recovers or a transplant becomes available.
"Patients can be referred to the national service from throughout Scotland. Arrangements are also in place to provide outreach services, with plans being developed to trial a telehealth link to the Western Isles, supporting the heart failure service there. Heart failure affects around 100,000 people in Scotland and it's important that they get the best possible care and treatment."
Heather McIntyre, a mum-of-three from Airdrie, received a short term VAD in July when she became critically ill as the result of advanced heart failure. She said: "When I came into the Golden Jubilee National Hospital I was suffering from multi-organ failure; my heart, kidneys and liver were all shutting down.
"I don't remember much of what happened at the time but there is no doubt that the VAD saved my life as it allowed my own heart to rest and to fully recover.
"The care and dedication of the staff at the Scottish National Advanced Heart Failure Service is superb and I am delighted that other people will have the same opportunity as me as part of this new strategy."
Jill Young, Chief Executive of the Golden Jubilee National Hospital, said: "This strategy supports the Golden Jubilee and Scottish National Advanced Heart Failure Service to become a nationally and internationally recognised centre of excellence.
"By being at the forefront of new technology and techniques, we will ensure that patients receive the best possible care and outcomes. This is a development that will have a positive impact on the health of future generations."
Ventricular Assist Devices (VADs) can be short or long term and help the failing heart by pumping blood around the body.
Short term VADs act as a bridge to either recovery, a heart transplant or a long term VAD. It can also be used to support a transplanted heart if it initially fails. Long term VADs can be used as bridge to transplant, as a bridge to recovery (which can allow full organ recovery). The intention is that, once their clinical effectiveness is fully proven, they could be used as 'destination' therapy for patients who are not eligible for transplant.
Saleem Haj-Yahia, Cardiothoracic Transplant Surgeon at the Golden Jubilee National Hospital, said: "When long term VADs are used as a bridge to transplantation, 79 per cent of extremely sick patients are now alive at 18 months and when VADs are used in other parts of the world as "destination therapy" the number of patients alive two years following implantation has increased from 23 per cent to 60 per cent over the last decade. The Golden Jubilee is acting as a centre of evaluation to help the development of the VAD programme in the UK."
While heart failure patients will continue to be managed locally in accordance with the Better Heart Disease and Stroke Action Plan, those with the most advanced disease will be referred to the national service if they need a transplant or VAD.
Dr John Payne, Consultant Cardiologist at the Scottish Advanced Heart Failure Service, said: "The Advanced Heart Failure Service will ensure we support local health boards. This will be primarily by raising awareness and educating health professionals and providing clear referral guidelines. In addition, we will continue our role in providing advice to clinicians to improve care locally.
"By doing this we will have a consistent, equitable, Scotland-wide referral pathway for patients with advanced heart failure."
While transplant activity is increasing overall, there are issues in relation to the number of donor hearts becoming available.
Mr Udim NKere, Lead Transplant Surgeon at the Golden Jubilee, said: "NHSScotland must make the best use of those organs that are donated. To do this our multi-disciplinary team have put in place a number of review and scrutiny mechanisms in relation to donation and implantation. These include arrangements for transporting hearts and better communication links with Intensive Care Units across Scotland."