DR VINOD ACHAN

Consultant Interventional Cardiologist

Frimley Park Hospital, Surrey

I have been a consultant interventional cardiologist at Frimley Park Hospital for thirteen years after training at Oxford University and spending two years at Stanford University on a Fulbright Scholarship. Frimley Park is now a regional heart attack centre in Surrey (serving patients from Surrey, Berkshire and Hampshire) where we provide a 24/7 primary or emergency coronary angioplasty service for approximately 300 heart attack patients per year. As part of the heart attack team, the cardiologist inserts a small tube or catheter into the artery at the wrist, manoeuvres it to the heart, and restores blood flow to heart muscle as quickly as possible by inflating a tiny balloon and deploying a stent within the coronary artery.

Over the last six months, we have been very busy. Heart attack patients have continued to arrive but have been presenting later than normal. These delays in presentation have been attributed to patient concerns about access to emergency treatments during lockdown, and have increased the risk of complications. Also, we have seen cases of Covid-19 myocarditis mimicking heart attacks.

A major reorganisation of the hospital and our wards allowed us to maintain all emergency cardiology services. Now we are trying to catch up with a huge backlog of elective or planned work before a likely second wave strikes.

I am proud of the fact that despite wearing full PPE and having to adapt protocols for all emergency coronary intervention procedures, we managed to maintain our average door to balloon time (that is the time between a patient arriving at the hospital to the moment a balloon is inflated in the coronary artery) at 35 minutes (well within the national 60 minute target).

What was the hardest or most frustrating part of your job?

One of the hardest personal challenges has been striking a balance between the risk of taking the virus home and infecting family members, and the need to be at the frontline and fully immersed in patient care. Commuting from London to Surrey has taken longer and at one stage I lived in the hospital for a week to circumvent these issues

How do you think the country coped with the pandemic?

There are many things in retrospect that could have been done better. Public health messages like asking people to ‘stay alert’ have been too vague. U-turns in policy and advice, about mask wearing and social distancing for example, have led to confusion. There has been a failure by government to listen to diverse opinions from a range of public health experts, a failure to act quickly in the beginning, and more recently a failure of our test and trace strategy that relied too heavily on inadequate technology and an inexperienced private sector.

At the other end of the spectrum, I have also been so impressed and moved by those NHS colleagues and co-workers who stood up to the challenges of the pandemic, some of whom gave up their lives.

When do you see things returning to ‘normal’? Or do you think they never will? Things will eventually return to a ‘new normal’, possibly after the development of a vaccine, rapid on-the-spot virus testing, and a better understanding of the science.

Has anything positive come out of the pandemic?

The development of virtual or telephone out-patient clinics and virtual international conferences have been positive changes during the pandemic.