Secondary care

A typical acute district general hospital secondary care cardiology service for 300,000 people (without a cardiac catheter laboratory) may be staffed by the following healthcare professions (actual numbers will depend on links to other secondary and tertiary services):

  • consultants: 3–5 WTE including subspecialty interests in coronary intervention, imaging, heart failure, arrhythmias
  • middle grade trainees, staff grades, clinical assistants or GPwSI 2–4 WTE
  • generic physician trainees F1, F2, CT1, CT2 1–2 WTE
  • rapid access chest pain clinic/AF/HF specialist nurses 3–6
  • admin and secretarial 2–4 WTE
  • physiology/cardiac investigations: 1 Band 8, 2–4 Band 7, 2–4 Band 6, 2–3 HCA/cardiographers

The service would typically provide:

  • daily ward rounds for cardiology patients, including acute admissions
  • consults for acute medicine and other specialties
  • a rapid access chest pain clinic (often nurse specialist-led)
  • general cardiology clinics (approximately 4,000 new referrals/ year)
  • subspecialty clinics (possibly led by a visiting consultant)
  • heart failure nursing
  • a cardiac prevention and rehabilitation service
  • network arrangements for patients with pulmonary hypertension, adult congenital heart disease or inherited cardiac disease.

24/7 care

  • Acute admitting hospitals should have provision for 24/7 cardiology consultation including on-site consultant review where clinically indicated.
  • Local or network based pathways should be available for 24/7 management of ACS cases and patients with acute brady- and tachy- arrhythmias (including rhythm management device-related problems), including the availability of echocardiography. The British Heart Rhythm Society has produced a position statement on the out of hours management of bradyarrhythmia services.

A British Cardiovascular Society working group on 24/7 services is due to report in 2016.

Patient representation

Patients are represented locally through clinical commissioning groups and cardiac rehabilitation programmes, regionally through Strategic Clinical Networks and nationally through the Cardiovascular Care Partnership (UK) and British Heart Foundation. The NHSE Clinical Reference Groups and the CVD national audits include patient representatives and there are cardiac disease related organisations, often charities, which include genetic and paediatric interests.

There have been rapid advancements in cardiology over the last decades and this is continuing through active research. In the UK, research is sponsored by the British Heart Foundation as well as by the Medical Research Council, Wellcome Trust and other grant giving bodies, universities and industry.

Professional support

The British Cardiovascular Society is the national professional group for cardiologists. A range of affiliated groups offer support to other cardiovascular healthcare professionals and cardiac patients.

Back to  Overview of cardiology services