Coronary Heart Disease National Service Framework

As you are aware I launched the Coronary Heart Disease National Service Framework, 'Tackling Coronary Heart Disease in Wales: Implementing through evidence,' here in the Assembly, July last year and I am now giving an update on its progress.

Heart disease is the major cause of death in Wales, resulting between 7,500 to 8,000 deaths each year with around 20% of the adult population requiring treatment. Many more are at risk. So, tackling coronary heart disease remains one of the Welsh Assembly Government's top priorities.  As the biggest killer it is being tackled from all angles, from prevention and managing those at risk through to diagnosis, treatment and finally rehabilitation.  

The Coronary Heart Disease National Service Framework is being implemented across Wales and is the key to driving up standards and improving the quality and availability of services for the population of Wales.  

A substantial amount of investment is going into  supporting the progressive implementation of the NSF from both central Government and Health Authorities.

During a recent visit to Morriston cardiac unit, I was pleased to announce that the Welsh Assembly Government's target of reducing waiting times for heart surgery to no one waiting more than 12 months was met, by March 2002.  As a measure of my commitment, I made £2million available in 2001- 2002 to achieve this and to ensure this target is maintained, capacity is being increased at both Morriston and the University Hospital of Wales to carry out additional heart operations, this financial year.

A key NSF milestone for 2002-03 is to bring down waiting times for angiography (a diagnostic test for heart disease) to no more than 6 months by next March. I am pleased to announce today, that I am making an additional £900,000 available to the Specialised Health Service Commission for Wales to ensure delivery of both Coronary Heart Disease waiting times targets.  We will need to look very carefully at the strategic development of angiography services across Wales and to look at the role of District General Hospitals in that provision.  This is clear and tangible evidence of my commitment to reducing waiting times for the diagnosis and treatment of those with coronary heart disease in Wales.
 
Last year,  £3 million capital was made available to improve equipment and facilities for diagnosing and treating coronary heart disease and cancer. Two significant projects funded from this were a new coronary care unit at Nevill Hall Hospital and a new cardiology day unit at UHW.   This year that funding will be increased to £5 million.

The implementation of the NSF is being reinforced further by our Inequalities in Health Fund which is being geared entirely to the prevention of heart disease.  The Fund has been particularly successful in its aim of stimulating and supporting new local action to address inequalities in health and the factors that cause it, including inequities in access to health services.

I expect the £10.5 million being made available through the New Opportunity Funding to be targeted directly at supporting the NSF's implementation and improving prevention, diagnosis, treatment and rehabilitation of people suffering and at risk from coronary heart disease.

Three clinical networks for coronary heart disease services are now being developed to ensure that all those involved in the care of those with, or at risk from this disease, work together efficiently and effectively to deliver high quality services to the standards set out in the NSF.  

Networks will be required to produce local service development plans. These plans will build upon those developed by Health Authorities last year and will demonstrate the action being taken, in both the short and long term, to meet the NSF milestones, analyse and address the workforce and financial implications and provide a means of monitoring and performance managing progress.

At a national level, we are setting up an all Wales multi-disciplinary group to oversee, support and co-ordinate activity, and this will be in place by the end of 2002.  In the meantime, in recognition of the need to develop the 3 Networks, we have established an interim Coronary Heart Disease Services Co-ordinating Group along with the appointment of a dedicated NSF Programme Co-ordinator.  There will be direct clinical input at both network and national level and today I am announcing that we will appoint a Director of Coronary Heart Disease Services, whose role will be to support the professional advice in the strategic development of these services.  

As some of you may know, I visited the North Karelia area of Finland recently which like Wales is in receipt of Objective 1 funding.  The project funded was to reduce the exceptionally high death rates from heart disease.  As a result, by 1995, the annual death rate from heart disease in people of working age had fallen by 75%, compared to that before the project.  A remarkable decline has taken place in smoking among men, major changes in people's diets and levels of cholesterol and blood pressure have fallen.

We are also supporting National Heart Week, by holding an awareness-raising event at the Bay on 13th June, in partnership with the British Heart Foundation, the British Cardiac Patients Association and Fitness Wales.  The focus will be on the prevention of heart disease and the need to reduce health inequalities in this area.  The event will also be the occasion to announce the results of the health screening of Assembly members and their staff, undertaken in June 2001.

Our strategy for tackling heart disease is long term.  There has been progress but there is a lot more work to be done over the coming years.  We must ensure that we tackle the causes of heart disease and that the services and treatments are readily available for those who need them.  What I have said today demonstrates that this is what we are doing and I remain fully committed to continuing these efforts in working towards attaining high standards and improving outcomes for patients.