Heart care success story shows benefits of consolidation

Date published: 10 June 2019

In the region of 40% of patients with heart attacks can be eligible for a specialised emergency procedure to treat the blocked artery in their heart. Following an ECG, such patients are taken to just two expert units in NI, often bypassing other hospitals and their Emergency Departments.

The units – at the Royal Victoria and Altnagelvin hospitals – provide this specialised treatment, which is called primary PCI.

N Ireland’s primary PCI service will this year reach two landmark anniversaries. December will see the 10th anniversary of the first 24 hour pilot service in Belfast.

2019 also sees the fifth anniversary of the start of the Altnagelvin service, which meant the procedure was available round the clock provincewide for the first time.

PPCI - primary percutaneous coronary intervention - is performed in a patient with an acute heart attack where there is a complete blockage of a heart artery. It involves a fine catheter being passed through the wrist into the artery. The clot is removed and a balloon is then inflated, allowing a metal stent to be deployed to keep the artery open.

Department of Health Permanent Secretary Richard Pengelly said: “Primary PCI is one of the unsung heroes of health care and health transformation.

“We should all be very proud of this success story and I would pay tribute to everyone involved in providing it and making it possible.”

Figures for the NI service show it takes 30 minutes on average between a patient reaching the door of a primary PCI unit and restoration of blood flow to their heart. This compares very favourably with other UK regions.

Mr Pengelly added: “Where appropriate, concentrating certain types of hospital care in regional centres of excellence is in the best interests of patients.

“We all naturally take comfort from having services on our doorsteps, particularly in emergencies. However, there is a careful balance to be struck between accessibility and quality of treatment.

“When it comes to highly specialised treatments like primary PCI, consolidation of expertise is the right approach.”

Consolidation of hospital services is very much in focus at present, with Departmental proposals to reshape stroke and breast assessment services.

About 2100 patients suffer some form of heart attack per year in NI. Between 800-850 suffer the most serious type – STEMI attacks – most of which are appropriate for primary PCI.

In its early pilot years, the service typically dealt with 200 to 250 patients a year. That’s now up to the 800-850 mark.

There is also a cross-border dimension to the service, as the Altnagelvin unit treats patients from Co Donegal.