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Bob Blackman MP: Britain shouldn’t fail on heart failure

Blackman Bob 2013Bob Blackman is the MP for Harrow East.

This week I am hosting a reception in Parliament with two charities: Pumping Marvellous and the Cardiomyopathy Association. As part of the Don’t Fail on Heart Failure campaign, we will be briefing Parliamentary colleagues on heart failure, the condition whereby someone’s heart is unable to pump sufficient blood to meet their body’s needs. Causes can range from hypertension to a heart attack to a virus.

Patients suffering heart failure develop increasing breathlessness and fatigue when carrying out daily activities – and ultimately at rest. Ability to work is greatly impaired along with health.

Janey, who lives near my Harrow constituency, describes how “Usual tasks others take for granted such as doing the washing, hanging it up, cooking dinner, going to the shops for groceries and changing bed sheets can be a struggle”.

Heart failure affects more than 600,000 people in the UK – almost 1,000 in the average Parliamentary constituency. Untreated, it has a survival rate similar to cancer - and over a third die within a year of diagnosis

Heart failure also imposes huge direct costs on all taxpayers. It accounts for 5% of all emergency hospital admissions and 2% of all NHS hospital bed days.

NICE currently recommends both ICDs and CRT-Ds for the treatment of patients with heart problems. New research into 12,000 patients reveals the scale of the benefits. Patients who received CRT-Ds and ICD implants had a death rate 25% to 45% lower than those who instead took the best available drugs.

They also reduce admissions to hospital – which is better for patients, medical staff and the NHS. For patients with mild to moderate heart failure, ICDs and CRT reduced monthly admission rates to hospital by 20% to 35%. The effect on patients with severe heart failure is even more pronounced, with CRT offering a reduction of about 40% in monthly admission rates. The research also supports the cost effectiveness of these devices.

Falling device costs and increasing battery life ought to mean that more patients can be helped each year. In practice, implant rates are often determined by other factors, and the UK falls embarrassingly far behind other countries in provision and care for heart failure patients.

In the United States, there are 577 CRT-D or ICD implants per 1 million. The European average is 155 per million. In the UK, there are only 104 implants per million. At 70 per million population, the UK ranks well below countries such as Poland and Slovakia for ICD implant rates. Device implantation rates also vary considerably within England and Wales.

The implant use suggested by NICE for both devices has not been reached, and the UK remains in the lower quartile of European averages. As a result, heart failure is killing people, lowering quality of life and the UK is spending a lot of money treating it badly.

More should be done to improve heart failure patients’ quality of life, better manage their condition to reduce unnecessary hospitalisations and save the NHS money, and help reduce mortality.

The NICE is currently reviewing ICDs and CRT-Ds. New and improved guidance can help improve implant rates and ensure the credibility of NICE and the UK as a centre for medical technology innovation.

More people need to know about heart failure and the effect this disease can have. This is why we are calling for greater patient access to life-enhancing technologies that NICE is reviewing in January.

Please contact me, Pumping Marvellous or the Cardiomyopathy Association if you would like to help us make this a reality.


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