Health bosses respond to Star questions

VITAL questions over heart attack care in Suffolk have today been answered.

VITAL questions over heart attack care in Suffolk have today been answered.

The East of England Strategic Health Authority and Specialised Commissioning Group answered a series of questions posed by The Evening Star.

The key issues were put to the health bodies following an outcry from patients over the plans.

A selection of the questions and answers are published here and the full responses to all 25 questions can be found on the Star's website,

Who took the decision not to have a full, public, consultation on the SHA proposals for changes to serious heart attack care which will have such an impact on Suffolk's health service?

There is strong clinical evidence for Primary Percutaneous Coronary Intervention (PPCI), also known as primary angioplasty. This is supported by the British Cardiovascular Intervention Society and is the recommended approach in the report from the National Infarct Angioplasty Project.

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Creating Heart Attack Centres which could deliver PPCI treatment will save an estimated 50 lives per year in the east of England. PPCI treatment will also reduce the number of future heart attacks, this is because PPCI treatment reduces the likelihood of patients suffering another heart attack in the future.

The proposal to create Heart Attack Centres in the east of England was consulted on as part of 'Towards the best, together'.

During the consultation the public gave nearly 90 per cent approval to the proposals to create Heart Attack Centres and staff saw them as the second most important change to acute services in the vision, second only to a guaranteed future for all acute trusts, including Ipswich.

The Overview and Scrutiny Committees across the east of England created a specific regional group to scrutinise these proposals. The NHS discussed with the Overview and Scrutiny Committees the plans for implementing PPCI across the region and who advised that further consultation was not required as the changes were in line with those already consulted on in 'Towards the best, together'.

Did any discussion take place about the Suffolk 'black hole' in the regional thinking.

There is no 'black hole' - all areas of the east of England are within the travel and clinical effectiveness parameters that make PPCI the best treatment for STEMI heart attacks, according to experts in the field.

The ambulance service has confirmed that all Suffolk residents are within the 90 minute travel time by carrying out modelling using real patient journey times. This means everyone living in the east of England will receive PPCI within the 165 minute call to balloon time, which evidence shows is the most effective treatment for STEMI heart attacks.

Why was a regional centre not planned for Ipswich? What discussion took place about Ipswich?

Ipswich Hospital does not currently undertake any angioplasty services (elective or emergency) and does not have sufficient specialised staff and equipment to be able to do so. There are very stringent clinical requirements for designating a hospital as a specialist Heart Attack Centre, as such it was clear early on in discussions with Ipswich Hospital that it would not be able to provide a PPCI service. The decision on which hospitals would be able to deliver PPCI was made on the criteria that they must be able to deliver a safe service and meet the required standards. Ipswich Hospital is not put at a disadvantage by this.

There is a longer term possibility for Ipswich Hospital to develop an elective angioplasty service and then to be considered as a 9 to 5 centre for emergency angioplasties, in the future.

Was the fact ever considered that Suffolk and North Essex have been identified as a growth point by the Government and therefore will see the population increase substantially? Did you investigate this?

We work with local authorities and the Government Office for the East of England on plans for all service developments to ensure NHS plans incorporate projected population growth. This issue was also considered by the ambulance service in their modelling. The projected growth in the local population is not, at this stage, sufficient to warrant an additional 24/7 PPCI service at Ipswich. It is also unlikely to do so in the future but this will, of course, be kept under review.

Has the SHA considered whether or not it, or any of its officers, may face corporate manslaughter charges if any patients denied treatment at Ipswich Hospital subsequently dies before treatment can be reached at the new centres?

National, and international clinical evidence shows that PPCI is the most effective treatment for these types of heart attacks. It would be negligent not to take the best clinical evidence and ensure the best possible service to all people in the East of England, including Suffolk, and the NHS is committed to doing whatever it takes to save as many lives as possible.

Heart attack debate

Currently emergency heart attack victims are given clot-busting drugs by paramedics or in hospital

The plans would see them instead taken to specialist primary angioplasty centers, also called PPCI centres, set up in Norwich, Papworth in Cambridgeshire, and Basildon in Essex.

Health bosses at the East of England Specialised Commissioning Group and Strategic Health Authority say primary angioplasty gives people more chance of survival than the drugs.

But to be effective any heart attack treatment needs to be given as quickly as possible.

In Suffolk patients, politicians and doctors have expressed fears that the long distances people will face for treatment could put them at risk.

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