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Written on 19th February 2024 by Richard Money-Kyrle

A report by leading UK think tank, the Institute for Public Policy Research (IPPR), has called on NHS and healthcare policy makers to take action to prevent avoidable injury and death from cardiovascular disease (CVD). The report, Broken Hearted - A Spotlight Paper On Cardiovascular Disease, highlights concerns about downward trends in cardiovascular (heart and circulatory) health.

Towards the end of last century, progress in cardiovascular healthcare led to significant improvements in the UK population’s health, with associated economic benefits for individuals and the UK as a whole. Recent data shows that progress on cardiovascular healthcare has stalled and appears to be reversing.

IPPR’s concerns are reflected in the British Heart Foundation’s recent analysis of data from 2024 which shows that waiting times for all types of cardiac treatment continue to put patients’ lives and health at risk. Earlier this month, BHF reported that average ambulance response times for category 2 calls, which include suspected heart attacks and strokes, were more than double the official 18-minute target, and the number of patients waiting over a year for time-critical heart tests and treatments was 10,726, compared with just 28 patients waiting this long in February 2020. In January 2024 BHF reported that the number of people dying before the age of 75 in England from heart and circulatory diseases has risen to the highest level in over a decade.  The charity pointed out that the longer people wait for cardiovascular treatment, the higher their risk of becoming disabled from heart failure or dying prematurely. They warned that extreme delays to ambulances responding to life-threatening emergencies and long waits for time-sensitive heart care should not become normalised.

IPPR says that the UK could do far better on CVD prevention and outcomes, but will not do better if people cannot access timely, effective care.

The current decline in cardiovascular health and CVD mortality and disability is particularly disappointing given that with correct and timely care around 80% of cardiovascular disease is preventable.

What is cardiovascular disease?

Cardiovascular disease (CVD) is the medical term for health conditions affecting the heart and blood vessels. These conditions can be life-threatening and often need urgent treatment by cardiology specialists, to avoid death or disability from heart failure, cardiac arrest, stroke, or injury to vital organs such as the brain.

Treatment for heart and circulatory conditions may involve emergency (A&E) treatment, surgical and invasive procedures or long-term management of chronic conditions. Most cases of CVD are preventable with correct and timely care. Despite this, CVD is one of the UK’s most common causes of death, and avoidable serious injury from negligent or delayed cardiology treatment is a leading cause of medical negligence claims.

Broken Hearted report highlights increase in preventable deaths and disability from CVD

IPPR’s Broken Hearted report highlights that, since 2010, progress on cardiovascular disease (CVD) has come to a halt with signs of a backward trend in population health and prosperity, most likely as a result of policy choices within the last 15 years.

Data analysed by leading heart health charity, the British Heart Foundation (BHF), shows that there have been nearly 100,000 more deaths involving CVD than expected since February 2020. This means that CVD is one of the leading causes of ‘excess deaths’ in the UK today. If the rate of preventable mortality (death) from CVD in the UK had improved between 2011 and 2019 at even half the rate of improvement in the previous five years, this could have avoided around 33,000 CVD-related deaths in 2019.

Lack of progress on CVD healthcare is costing lives and livelihoods  

IPPR analysed the financial impact of CVD disability and found that cardiovascular disease is now the fifth most prevalent conditions amongst people whose ill-health means they are unable to work to earn money.  By mid-2022, nearly 30% of these people had a long-term condition relating to their heart, blood pressure or circulatory system. This increased to 44% among 60–64-year-olds. The think tank concluded that stalling progress on CVD costs lives and livelihoods.

Cardiovascular disease is the condition that most sharply increases the risk of having to leave employment but the government’s efforts to help people work has been focussed on other conditions, such as mental health and arthritis. Leaving work is also associated with high blood pressure (hypertension), a highly treatable but significant risk factor for CVD. Research by the comprehensive UK health study, Our Future Health, has shown that a quarter (or one in four) of people in the UK have untreated high blood pressure. In addition, people with multiple conditions are more likely to be unable to work, and heart disease is commonly experienced alongside other conditions such as diabetes, arthritis and kidney disease.  IPPR argues that in addition to health and social justice reasons, it is in the interests of the economy to focus on policies which will lead to progress on cardiovascular disease.

UK should do more to prevent harm from cardiovascular disease (CVD)

IPPR’s Broken Hearted report on cardiovascular disease emphasises that despite CVD’s heavy contribution to the UK’s ill-health and economic loss, death and injury from CVD is highly preventable. In fact, IPPR points out that few health conditions are as preventable as cardiovascular disease, which could be prevented in four out of every five or 80% of all cases.

The report argues that the UK is doing far worse than comparable countries in tackling CVD. Their analysis reveals that if  the UK had kept up with its European peers since 2010 on acute myocardial infarction mortality (deaths from heart attack), there would have been around 30,000 fewer deaths in the UK in the decade beginning 2020. IPPR’s analysis also shows that some improvements could be made simply by addressing inequalities and wide variations between different places within the UK.  IPPR predict that if local authorities in England had performed at least as well as the top 10% performing local authority, there would have been 30,000+ fewer cardiovascular deaths in 2022 in England and Wales alone, which would account for more than 10% of all mortality. If improved performance is possible in some areas, then that suggests that the UK could do far better on CVD outcomes.

IPPR calls for progress in tackling diet, obesity, activity and exercise, smoking and pollution, which could significantly reduce preventable cardiovascular deaths. Research by the British Heart Foundation (BHF) links high BMI with one in six CVD deaths. BHF has also identified that smoking causes 20,000 deaths from CVD in the UK every year, with 11,000pa from particulate matter pollution.

Healthcare failings and delays increase risk of harm from cardiovascular disease

In relation to healthcare, the report calls for improvements in risk identification, management, and treatment of CVD risk factors such as hypertension, high cholesterol, diabetes and chronic kidney disease. For example, hypertension is a factor associated with half of all strokes and heart attacks, but only 60% of the 14 million adults in England with hypertension have a diagnosis, and 20% of those with a diagnosis are not treated according to NICE guidelines. Similar failings were found in treatment for patients with high cholesterol, even though reduction in cholesterol by statin treatment is known to significantly reduce the risks of heart attack and stroke.

IPPR call for immediate action to reduce cardiology waiting times, noting that the number of patients waiting for cardiology services more than tripled in the ten years between January 2013 and January 2023, representing a greater increase in cardiology than in the overall waiting list across all services, with a marked increase in the number of cardiovascular patients waiting more than 18 weeks.  They highlighted that policy makers should be very worried by these delays, given the urgency of many types of cardiovascular disease treatments, and suggested that these waits may be driving the significant increase in CVD-related deaths.  

IPPR’s Broken Hearted report calls for a comprehensive and urgent plan for cardiovascular disease prevention and care which provides people affected by CVD with increased access to preventative medications and personalised care and support to enable them to live full and prosperous lives. They call for a substantial investment in cardiovascular disease research funding, proportionate to the impact that CVD has on the UK’s health and economy. As a start, they suggest doing what works more consistently across the country to reduce disparities in cardiovascular care and reduce the unacceptable level of CVD-related harm. 

If you or a family member have suffered severe injury as a result of medical negligence or have been contacted by HSSIB/MNSI or NHS Resolution you can talk to a solicitor, free and confidentially, for advice about how to respond or make a claim by contacting us.