Cardiology - Belfast Health and Social Care Trust

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- Insertion of pacemakerPacemakers can be used in patients when the heart‟s own natural pacemaker is notfunctioning effectively. This may happen if the right and left side of the heart are notbeating together because the generation or conduction of electrical impulses is nothappening as normal.- Implantable cardiac defibrillator (ICD)An implantable cardiac defibrillator (ICD) can be inserted in a similar way to apacemaker if the heart rhythm is prone to developing a life threatening arrhythmia. Inthese instances, the ICD will deliver electrical pulses to correct the rhythm of theheart.This is what differentiates tertiary cardiology services from general cardiologyservices. A range of procedures are delivered as part of tertiary services, such as:Table 2 - Examples of General and Tertiary Cardiology ServicesCardiology serviceExamples of servicesDiagnostic and interventional methods that do not requirethe use of cardiac catheterisation laboratories:GeneralcardiologyservicesTertiarycardiologyservices Inpatient cardiology services including Coronary CareUnit (CCU) Consultant-led outpatient clinics Nurse-led heart failure clinic Rapid Access Chest Pain Clinic Full range of non-invasive cardiac investigations Day case and in-patient TransesophagealEchocardiogram Exercise stress test Nurse-led cardiac rehabilitation and secondaryprevention service Emergency department support from a chest painnurse.Diagnostic and interventional procedures that do require theuse of a cardiac catheterisation laboratory such as: Percutaneous coronary intervention (PCI) Primary PCI Electrophysiology studies / Ablation Insertion of Pacemaker / ICDPage 12 of 30
Procedures undertaken in CatheterisationLaboratories 2009-2010Patients can access cardiology in one or more of the following ways: As an inpatient: an admission to hospital which includes an overnight stay As a day case: treatment which is carried out in a single day, without thepatient having to stay in hospital overnight As an outpatient: care provided on an appointment basis without requiringadmission to hospital. Cardiology outpatient services are not part of thisreview and will continue to be provided at the Belfast City, Mater and RoyalHospitals.Cardiology services can be delivered along one of two key patient pathways: Elective: This is when treatment has been planned and booked in advance,for example, a patient who is placed on a waiting list for pacemaker insertionand then brought into hospital on a prearranged day. Non-elective or emergency: This is when a patient accesses cardiologyservices without prior planning, for example a patient suffering a certain typeof heart attack who goes to one of the Trust‟s Emergency Departments (EDs)and is then brought to the catheterisation laboratory for treatment.Figure 1 illustrates the number of procedures that have been undertaken in 2009-2010 from the Belfast City Hospital and Royal Hospitals (RGH) catheterisationlaboratories as well as the Trusts combined figure.Figure 1 - Procedures undertaken in catheterisation laboratories by Hospital &Trust 2009-2010120001000080006000400020000BCH RGH BHSCTSeries1 3782 6069 9851Series2 38% 62% 100%Page 13 of 30
Page 4: We want to do all of this to ensure
Page 7 and 8: Table 1 - Tertiary Cardiology Servi
Page 9: Provide clear directions to service
Page 14 and 15: 3. Why reorganise cardiology servic
Page 16 and 17: Trauma servicesTrauma services deal
Page 18 and 19: Royal Hospitals as the centre for m
Page 20 and 21: will not increase but this total vo
Page 22 and 23: 5. What would this mean for patient
Page 24 and 25: 6. WorkforceThe Trust would put in
Page 26 and 27: Appendix 1 - Programme of Consultat
Page 28 and 29: Appendix 2 - Equality and Human Rig
Page 30: Appendix 3 - GlossaryGlossary of ab

Cardiology - Belfast Health and Social Care Trust

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