Jul 30, 2010

Are We Being Subjected to Inappropriate and Invasive Heart Procedures?

Angina patients are undergoing inappropriate and invasive heart procedures thinking they have no other option and costing the NHS millions of pounds, says the National Refractory Angina Centre (NRAC) patient group. In 2008 alone, there were over 80,300 angioplasty stent procedures done in the UK (according to BCIS) averaging £7,000 a procedure. The patient group has been told by leading cardiologists in the past that around 8% of these procedures are inappropriate. If that’s the case, then that means over 6,400 people have inappropriate and invasive procedures done on them, costing taxpayers over £45 million a year. Have you had an inappropriate procedure or multiple procedures? We would like to hear from you!

The NRAC patient group claims that people are being subjected to repeat procedures (costing taxpayers more money), which compromises the quality of life for that person. In one case, they say one of the NRAC patients has had 10 stents placed! Whistle Blower is also aware of an individual who had the wrong stent placed in him and is still living with it. The NRAC patient group argues that if more heart patients were aware of alternatives, everyone would benefit.

According to the NRAC patient website:

There is a lot of confusion about when angina patients should be allowed to choose the low risk options available in specialist refractory angina clinics. Many doctors seem to think that as long as an operation is technically possible it is OK not to tell patients about simpler alternatives. This is illogical and is at odds with professional and legal guidance on informed consent.

It is wrong that angina sufferers should not be told about simpler alternatives to heart procedures. Invasive procedures should be the last resort and for most patients and their carers the very fact that an operation is mentioned means that there are no alternatives. Patients wrongly assume that heart specialists only offer invasive procedures as a last resort. Patients referred to patient-centred angina clinics are shocked to discover that the only way to find out about the low risk options is to refuse to have the operation. Many patients agree to invasive procedures because they wrongly think it is life prolonging and assume that if there was a simpler alternative the specialist would have mentioned it.

NRAC offers patient centred care, where patients are encouraged to participate in classes to help them learn how to live with their condition and to avoid non-lifesaving procedures. While NRAC has received many accolades for its patient treatment and is frequently cited as an NHS success story, the sustainability of this centre is threatened, as there is no back-up plan for when Dr. Chester, the only cardiologist at the centre, is no longer able to practice (due to health or age or both). The centre  is also run by Dr.  Chester. This is compromising patient safety. Politics between mainstream NHS cardiologists and treatment centres, money and NRAC appear to be at the centre of this situation. As well, there are serious issues regarding medical ethics with respect to patient care and best practices, unnecessary spending that could be used elsewhere

If you are someone who has been referred to NRAC or has had a negative experience after receiving a heart procedure, we at Whistle Blowers would like to hear from you!

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