Primary Care Acute Chest Pain Awareness Project Alison Turner & Marc Thomas Project Managers Cardiovascular Disease in Primary Care PCCS/South Wales Cardiac Network Wednesday 18 May 2011

Background Myocardial Ischaemia National Audit Project (MINAP) report requested by WAG in 2007 Looked at 2005-6 data Higher proportion of people in Wales called/visited their GP rather than calling 999 with chest pain

Background MINAP Analysis – Network Level

Aims To raise awareness within Primary Care of the importance of immediate admission via 999 for suspected MI “1 minute delay = 11 days loss of life”1 To reduce Pain-to-call time Pain-to-needle/balloon time ¹Boersma E, Maas AC, Deckers JW, et al. Early thrombolytic treatment in acute myocardial infarction: reappraisal of the golden hour. Lancet 1996; 348 pp771-5

Project Implementation Resources Education and awareness sessions Measurement of staff confidence and knowledge

Project Implementation Pilot Study Interim Analysis Final Report

Pilot Implementation

Full Implementation

Outcomes Beneficial to both clinical and non-clinical primary care staff Staff confidence Staff knowledge Changes in practice

Admission Routes Comparing pre and post project implementation Concerns Were areas comparable? Would improvements have happened anyway NE England SE Wales

Concerns Increase in 999 calls for chest pain?

Incidental Benefits HM Prison Service Scotland GP UK-wide implementation through BHF Wider non-clinical public domains

Conclusion/Discussion Demonstrable positive outcomes Clinical and non-clinical impact Generic resources Same message for all reperfusion Thrombolysis/pPCI Value of educational component Access to educational forums ?web-based package