Ken Timmis MBE JP LCIE President Heart Care Partnership (UK) Patient Representative Black Country Cardiovascular Network Board Chairman Wolverhampton Coronary Aftercare Support Group

What I want to know about a service and am I prepared to travel to get the quality I am after? A patient’s perspective

Most, if not all, coronary interventions these days are very expensive, and nearly all are beyond the means of ordinary patients. They are also very costly to the National Health Service budget.

As a result of the latter it has for some time been necessary to concentrate the more expensive procedures in specialist centres. In these times of austerity and cutbacks more and more procedures are of necessity being centralised.

Reasons: 1.It would be impossible to produce the infrastructure and staff in every hospital 2.It would be highly expensive 3.There would be a risk of lots of services doing small volumes of activities with possible worse outcomes overall 4.They would probably be more inefficient 5.These services need teams working together to achieve better outcomes

When faced with the possibility of undergoing such treatments as a patient, do I find this acceptable and am I prepared to travel long distances to get a better quality service?

First and foremost I have questions that must be answered before I decide what to do

I want to know : a.the options. Is the same service available nearer to home? b.the advantages of travelling c.the disadvantages of travelling d.the outcomes (i.e. survival rates) e.what is involved f.the length of stay in hospital g.is the centre easily accessible for my visitors?

Also 1. I want to know that the Surgeon or Cardiologist who will be operating on me fully understands all aspects of my case. 2.I also want to know that he/she is fully aware of my case history. 3. I need to be convinced that a Multi-Disciplinary Team (MDT) have reviewed my angiograms and have together decided the best way forward, taking into account all the facts, including my personal wishes, preferences and fitness for revascularisation.

Obviously I want the best possible treatment by the best possible surgeon with the best possible outcome If I have to travel to achieve this, then so be it

For General Services and minor operations Expect Local Treatment -o0o- For Specialized Treatment Be prepared to travel

Useful information for patients can be found on the Care Quality Commission/SCTS website: And also in British Heart Foundation literature