Description

The National Service Framework for Coronary Heart
Disease requires that the rate of revascularisation should
be at least 1500 per million population. North East London
is an area with high deprivation, a large Asian population
and high levels of coronary heart disease. There was dissatisfaction
amongst local cardiologists that angiography services were
poorly organized and that delivery did not meet local needs.
In addition it was known that Treasury Capital Monies would
be made available for the development of cardiac catheterisation
laboratories.A piece of work therefore needed to done so that
bids could be submitted in a strategic manner.

A needs assessment was conducted and a participative
approach was taken to agree the best model for service delivery.

It was found that there was a fifty per cent deficit
in the provision of angiography and it was agreed that the
most clinically effective model of service delivery was a
hub and spoke model with interventional procedures being conducted
at the hub and diagnostic angiography being conducted at both
the hub and the two spokes.