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Monday, 6 March, 2000, 14:49 GMT
Heart pledge: the reaction
Heart patient
Measures are designed to cut death rates
The medical profession and patient groups have warned that ambitious targets to cut heart disease must be backed by extra resources.

Health Secretary Alan Milburn on Monday unveiled a national service framework (NSF) designed to cut death rates from heart disease - which are some of the highest in the developed world.

Dr Peter Hawker, chairman of the British Medical Association's consultants committee, said the targets were tough, but action was urgently needed.

He said: "It is imperative that we reduce the time patients wait for heart treatment."

Dr John Chisholm, chairman of the BMA's GP committee, said more doctors and nurses, and better facilities would be needed.

But he added: "Doctors and other healthcare professionals will be keen to make this ambitious agenda for change work to improve health, reduce inequalities, remove postcode rationing and raise the quality of care."

Inequalities of access

Dr Peter Hawker
Dr Peter Hawker said the targets were tough
Professor Sir Charles George, medical director of the British Heart Foundation (BHF), said there were wide regional variations in the quality of care across England, and that inequality had to be addressed.

He said: "This framework has the potential to make a very significant impact on the unacceptably high levels of death and disability caused by heart disease in the UK, but achieving its objectives will require considerable resources."

In the long-term, there will be a realistic stepping up of activity which will bring great improvements in practice to help many more patients

Professor Sir George Alberti, president, Royal College of Physicians
Professor Sir George Alberti, President of the Royal College of Physicians, who worked on the new guidelines, said the guidance represented a "coherent long-term programme to tackle a major public health problem".

He said: "Although we cannot expect miracles overnight, the NSF will bring immediate benefits from next month with some of its targets, for example in the automatic giving of aspirin to patients who have already had one heart attack.

"In the long-term, there will be a realistic stepping up of activity which will bring great improvements in practice to help many more patients and relieve not just the physical suffering caused by heart problems, but the natural psychological worries patients have while waiting in a long queue to be treated."

However, Sir George warned the success of the programme would rely on an increase in the number of physicians availabe to treat patients, more back-up staff and modernised facilities.

"We must also encourage people to look after their health - the preventive aspects of the programme are no less important than the headline-grabbing issues of waiting lists for surgery."

Nurses' response

The Royal College of Nursing (RCN) said the framework was good news for patients.

Lynn Young, RCN Advisor in Community Health said: "It is not just a question of raising standards in medical treatment, it is about tackling the underlying causes of heart disease.

"This framework makes this a priority, focusing on preventive issues such as maternal health and poverty - as well as setting real targets for hospital and emergency care."

The British Cardiac Patients' Association, which contributed to the development of the document, welcomed its release.

A spokesman said: "Our help line is inundated with patients who are waiting far too long for treatment and we hope that the new initiatives will reduce incidence, raise standards of care, ensure equity and improve quality of life.

"This is not a short term fix and results may not be immediate - but if adequate resources are available to fully develop and take this forward over the next decade, then we will see the improvements we have long campaigned for."

The Chartered Society of Physiotherapy warned the government could create a "whole new category of patients on waiting lists" if it fails to back its coronary care framework with extra resources for rehabilitation.

Cardiac rehabilitation has been shown to reduce sudden death following a heart attack by up to 25%.

The national framework says that every hospital should offer rehabilitation to 85% per of patients.

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