Benefi ts of Patient Access

Benefi ts of patient access How access to new medical technology is benefi ting patients suffering from arrhythmia

Trudie Lobban, a trustee of the Arrhythmia Alliance outlines some of the evidence she submitted to the Health Select Committee inquiry into the use of new medical technologies, and highlights the benefi ts particular technologies bring to the lives of patients.

refl ex anoxic seizures—any type of blackout or non-epileptic seizure. Syncope and RAS is a type of arrhythmia (irregular heart rhythm). The Arrhythmia Alliance (A-A The Heart Rhythm charity) was formed in May 2004. The A-A is a coalition of charities, professional and medical groups and industry partners, including the ABHI, who aim to work together to promote timely and effective diagnosis and treatment of arrhythmias leading to improved quality of life for all those affected.

The following is a summary of the written evidence that I submitted to the Health Select Committee inquiry.

Left to right: Geoff Morris - Chairman ABHI; Jane Kennedy MP - health Minister; Jo Revell - The Observer; Trudie Lobban; Dr Steve Holmberg

had been asked to appear as a witness to the House of Commons Health Select Committee’s enquiry into the use of medical technologies in the NHS, alongside John Wilkinson, but was prevented from doing so due to bad weather and transport diffi culties.

I was due to appear on behalf of the Medical Technology Group (MTG), with whom I have been involved for over a year. MTG is a campaigning coalition of patients groups, medical professionals and industry. My involvement with MTG stems from my role as Chief Executive of Syncope Trust and Refl ex Anoxic Seizures (STARS) and also a trustee of the Arrhythmia Alliance. STARS works together with individuals, families and medical professionals to offer support and information on syncopes and

IThe Evidence

There is evidence that

“The total cost of a where the Department pacemaker over its ten-year life span can be signifi cantly of Health has applied focus and funding, for example, through less than the cost of drugs National Service Frameworks for a patients life” (NSF) technology uptake has been higher, allowing government targets to be reached. For this reason, the additional chapter on cardiac arrhythmias in the NSF on heart disease, published in March and on which the Arrhythmia Alliance and STARS advised the Department of Health, has the potential to reap great benefi ts for patient access to technology. However, when the focus has been less concentrated, technologies that could save lives and reduce secondary care burden on the NHS, have seen signifi cantly less uptake.

The UK still spends less on technology compared to other less developed countries, as a proportion of total health care expenditure. We also have a signifi cant workforce shortfall. For example, in cardiology, a key area of technical innovation, we have approx 650 cardiologists serving a population of 59 million. In France, Germany and Italy, each country has in excess of 6000 cardiologists. In the UK we have approx 60 Electrophysiologists (Heart rhythm specialists) - one per million of the population.

A more local problem is that budgeting decisions are often made with only a short term approach in mind. A benefi t of many medical technologies is the avoidance or reduction of re-admissions to hospitals, particularly in emergency cases. However, these factors are often not taken into consideration when purchasing new technologies. The primary consideration for assessing their use is the initial outlay of costs and the impact on a specifi c budget. There is often a failure to recognise any saving that use of a technology can realise in other parts of the hospital or the Health Service. The new system of Payments by Results should offer fl exibility, but there is a concern that the tariffs upon which it is based may not be accurate enough to give a true refl ection of the cost of treatment and care, which could threaten access to technologies.

As an example of effi ciency gains through simple diagnostic measures and use of technology, Professor Rose Anne Kenny established a falls and syncope clinic at Newcastle Royal Infi rmary, assessing the cause of all unexplained falls in older patients presenting at A & E. Falls result in huge costs to the NHS and many repeated falls are unexplained. They are often caused by arrhythmia and can be successfully treated with pacemakers. The cost of a pacemaker over its ten-year life span can be signifi cantly less than the cost of drugs for a patients lifetime. A pacemaker, once implanted, only needs checking for most patients once or twice a year, freeing NHS capacity and improving quality of life for both patients and families.

The improvements in patients’ quality of life through medical technology can be enormous. Technology can provide increased life expectancy, a reduction in further complications, improved standards of living and productivity not only for patients but also for their carers and the people closest to them. Peace of mind provided by accurate diagnosis and appropriate treatment is immeasurable. Therefore I recommended to the Committee that patients’ input in assessing quality of life should be given a higher priority than is currently the case.

One question from the Committee suggested that use of technology can shift care and treatment away from the clinical setting and that there might be some risk involved in this transfer. A key element for reducing this risk is the provision for accurate and timely information for patients, carers and medical professionals. Given the funding, support groups such as the Arrhythmia Alliance and STARS will work with all those affected by these conditions, including patients, clinicians, and industry ensuring that the advice and information provided to patients is accurate and of the highest standards.

Securing the publication of the arrhythmia chapter of the Coronary Heart Disease NSF was an example of successful campaigning by patient groups working together to convince the government to act. I hope that this enquiry leads to similar success.

Trudie Lobban

This is an extract from an article written by Trudie Lobban in the journal of the Association of British Healthcare Industries