1. An Investigation into the Effects of Opening a Cardiac Centre in Middlesbrough Neil Macknight Senior Information Manager

2. Background Pre 1993- Cardiac Centre at Freeman Hospital, Newcastle Perceived geographical bias for specialised cardiac treatment 1993- Additional Cardiac Centre opened in Middlesbrough What was the impact of the opening of the Middlesbrough cardiac centre on Revascularisation rates?

3. Numerator- HES Data for Revasc Procedures 1989-1997 Proxy indicator for need- HES Admissions for IHD Proxy indicator for need- Deaths from IHD 1989-1997 Population Data: PROBLEMS Methodology

4. Before opening Middlesbrough Cardiac Centre 0 5 10 15 20 25 30 0102030405060 MI admissions in 89-90 to 91-92 - revascs (sq rt) Revascularisations in 89-90 to 91-92 (sq rt) Middlesbrough Gateshead Sunderland Newcastle North Tyneside Blyth Valley Castle Morpeth Redcar & Cleveland

5. After opening Middlesbrough Cardiac Centre 0 5 10 15 20 25 30 0102030405060 MI admissions in 94-95 to 96-97 - revascs (sq rt) Revascularisations in 94-95 to 96-97 (sq rt) Redcar & Cleveland South Tyneside Sunderland Hartlepool Middlesbrough Darlington Berwick Tynedale Chester-le-Street Durham

6. Geography

7. 0 10 20 30 40 50 60 70 80 90 89-9090-9191-9292-9393-9494-95 95-9696-97 Rate of revascularisations per 100 MI admissions Deprivation quintile 1 Deprivation quintile 2 Deprivation quintile 3 Deprivation quintile 4 Deprivation quintile 5 Deprivation

8. Revascularisation Provision 2005/06 (Provisional HES Data)

9. Patient Flow 2005/06 (Provisional HES Data)

10. Next Steps Journal Paper Drive time analysis What next?