Heart health leaders across Scotland have written to the Public Health Minister expressing ‘deep concern’ over proposals they believe will undermine efforts to improve cardiology outcomes.

The letter expresses serious alarm about the Scottish government’s consultation on plans for a Long Term Conditions Framework.

The consultation document calls for a cross-cutting, unified approach to multiple long-term conditions, rather separate condition-specific plans.

Senior representatives from Royal Colleges and specialist clinical cardiovascular groups are warning the new approach could have ‘significant unintended negative impacts’ on cardiology services.

They say the ‘unique challenges’ involved in heart disease management, including early detection, timely intervention and ongoing management, cannot be effectively addressed through the new approach.

With one in eight Scots living with some form of cardiovascular disease, and rates of ill health and death caused by heart disease increasing, they argue the condition must instead be retained as a standalone priority for the Scottish government.

In the letter to minister Jenni Minto MSP, the signatories say government should reconsider its approach and commit to developing a refreshed, fully funded and resourced Heart Disease Action Plan:

‘We are deeply concerned that within the reasoning of this consultation and suggested approach the way in which resources and focus will be prioritised has not been sufficiently detailed.

‘Given the substantial impact of heart disease on individuals and the healthcare system, it is imperative that strategic thinking and focused efforts are directed towards this condition.’

While recognising the importance of addressing the growing burden of long-term conditions, the signatories emphasise the need for heart disease to see specific responses across the health and care system.

David McColgan, Head of the British Heart Foundation which led the letter, says:

“At a time when survival rates from heart and circulatory diseases are declining, rolling back over 60 years of progress, now is not the time for the Scottish government to deprioritise its commitment in this area.”

Co-signatories of the letter say the previous version of the plan has been ‘instrumental’ in making significant steps to improve cardiology services – including the development of national pathways and putting in place clinical and government oversight – and must be maintained.

Professor Adrian Brady, the Scottish Cardiac Society President, says the cardiovascular community welcomes the government’s plans to focus on chronic conditions but long-term strategic change is still needed for heart disease:

“Any focus must be supported by an evidence base that shows lives will be saved by intervention and long term strategic change.

“Such evidence abounds for cardiac disease and we look forward to working with Scottish government and the British Heart Foundation to achieve these aims.” 

The proposals have already been criticised by national health charity Stroke Association, which says a one-size-fits all could also see stroke improvements fall by the wayside.

A Scottish government spokesperson told healthandcare.scot that the long-term conditions framework will still allow for specific care planning:

“We have been consulting widely on the new long term conditions framework and will carefully analyse and consider responses before agreeing next steps.

“The framework aims to encourage fairer care across all long term health conditions, better recognising that many people need the same type of support regardless of their circumstances.

“It will also still allow for specific care and help where appropriate to build on progress through the Heart Disease Action Plan.”

Signatories:

David McColgan - Head, British Heart Foundation Scotland

Heather Probert – President, British Association for Cardiovascular Prevention and Rehabilitation

Jo Sopala – Chief Executive Officer, British Society of Echocardiography

Fiona Brownlie – Chair, Cardiac Rehab Interest Group Scotland

Prof Raj Thakkar – President, Primary Care Cardiovascular Society

Professor Hany Eteiba – President, Royal College of Physicians and Surgeons of Glasgow

Prof Rowan Parks – President, Royal College of Surgeons of Edinburgh

Prof Adrian Brady – President, Scottish Cardiac Society 

Prof Mary MacLeod – Chair, Scottish Heart & Arterial Disease Risk Prevention (SHARP)

Dr Jonathan Malo – Chair, Scottish Lipid Forum

35 patient and clinical representatives of the Inherited Cardiac Conditions community.

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