Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps she is taking to help increase the availability of heart valve surgery for (a) women and (b) ethnic minorities.

Answered by Andrew Stephenson

NHS England continues to work with its partners in raising awareness of aortic stenosis, with a particular focus on women. NHS England is also working to increase access to cardiac surgery. The breathlessness pathway, launched in April 2023, encourages general practitioners to examine all patients for the signs of valvular heart disease. Heart valve disease is a focus for cardiac networks, with pathways in in place to improve early detection of valve disease in the community.

In November 2023, a dedicated Heart Valve Disease (HVD) Expert Advisory Group was convened to provide NHS England’s Cardiac Transformation Programme with leadership, advice, quality assurance, expert review, and endorsement of the projects and deliverables that comprise the HVD workstream, with a focus on improving the speed and equity of access to high quality treatment for heart valve patients.

To improve the early detection and diagnosis of heart valve disease across England, including aortic stenosis, £2.3 billion has been committed to open 160 community diagnostic centres by March 2025. This will increase the volume of diagnostic activity and further reduce patient waiting times. The centres have delivered over 5 million additional tests since July 2021, including those that detect cardiovascular disease.

In addition, the National Health Service is investing in cardiac networks to support whole pathway improvements. These networks have been developed to take an evidenced based, clinically led, whole pathway approach to improvement, from prevention, diagnosis, treatment, and through to end-of-life care.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps she is taking to help increase awareness of the symptoms of heart valve disease in women.

Answered by Andrew Stephenson

NHS England continues to work with its partners in raising awareness of aortic stenosis, with a particular focus on women. NHS England is also working to increase access to cardiac surgery. The breathlessness pathway, launched in April 2023, encourages general practitioners to examine all patients for the signs of valvular heart disease. Heart valve disease is a focus for cardiac networks, with pathways in in place to improve early detection of valve disease in the community.

In November 2023, a dedicated Heart Valve Disease (HVD) Expert Advisory Group was convened to provide NHS England’s Cardiac Transformation Programme with leadership, advice, quality assurance, expert review, and endorsement of the projects and deliverables that comprise the HVD workstream, with a focus on improving the speed and equity of access to high quality treatment for heart valve patients.

To improve the early detection and diagnosis of heart valve disease across England, including aortic stenosis, £2.3 billion has been committed to open 160 community diagnostic centres by March 2025. This will increase the volume of diagnostic activity and further reduce patient waiting times. The centres have delivered over 5 million additional tests since July 2021, including those that detect cardiovascular disease.

In addition, the National Health Service is investing in cardiac networks to support whole pathway improvements. These networks have been developed to take an evidenced based, clinically led, whole pathway approach to improvement, from prevention, diagnosis, treatment, and through to end-of-life care.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps her Department is taking to tackle disparities in access to medical treatment for heart valve disease.

Answered by Andrew Stephenson

In the development of the Major Conditions Strategy, we are committed to focusing on the six major groups, which includes cardiovascular disease. As part of the policy development process, the Major Conditions Strategy will consider the full range of health disparities that may be experienced by different groups, including ethnic and gender disparities.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether she plans to include additional material on heart valve disease in the Major Conditions Strategy.

Answered by Andrew Stephenson

In the development of the Major Conditions Strategy, we are committed to focusing on the six major groups of conditions, which includes cardiovascular disease. Aligning work across several groups of conditions allows us to focus on where there are similarities in approach to ensure care is better centred around the patient, health and care resources are used most effectively, and that there is effective integration, both within and between treatment pathways.

This strategy does not seek to describe everything that is being done or could be done to meet the challenges of specific diseases within the major conditions. Instead, we are focusing on developing a strategic approach to inform the wide range of decisions health and care organisations make when determining how best to care for the people they serve.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether she has made an estimate of the number of heart valve disease patients treated in non-elective settings in the last 12 months; and whether she has made an assessment of the potential impact of this treatment on (a) hospital capacity and (b) patient's quality of life.

Answered by Andrew Stephenson

NHS England’s Hospital Episode Statistics tell us that there were 11,581 non-elective hospital admissions for heart valve disease in 2022/23. There has been no specific assessment made of the potential impact of this treatment on hospital capacity or on patients quality of life. The National Health Service will, at all times, aim to provide patients with the care which responds to their needs. This includes patients who are admitted to hospital through non-elective routes for heart valve disease.

The NHS is also taking action to identify cardiovascular disease before a patient is admitted to hospital. The NHS has rolled out free blood pressure checks to people over the age of 40 in community pharmacies to detect thousands more people living with hypertension earlier. This means more people can access simple, low-cost treatments that will reduce their risk of death or serious illness from cardiovascular disease. Furthermore, 108 community diagnostic centres have opened that have delivered more than 3.9 million tests, including those that detect cardiovascular disease.

NHS England has included hypertension case-finding, optimal management, and lipid optimal management as one of its five clinical areas of focus requiring accelerated improvement within the Core20PLUS5 approach. The Core20PLUS5 informs action to reduce healthcare inequalities at both national and system level.

Found: attack, or cerebral haemorrhage; peripheral arterial disease; atrial fibrillation and other arrhythmias; heart

Found: commissioning considerations • Analyses from the economic evaluation done for NICE ’s guideline on heart

Found: Related NICE guidance Related NICE g uidelines: Heart valve disease presenting in adults: investigation

Found: valve disease across the National Health Service. 2021 January 2024 ongoing May declare

Found: attack, or cerebral haemorrhage; peripheral arterial disease; atrial fibrillation and other arrhythmias; heart

Found: attack, or cerebral haemorrhage; peripheral arterial disease; atrial fibrillation and other arrhythmias; heart

Found: In Diagnostics guidance [DG14] - Atrial fibrillation and heart valve disease: self-monitoring coagulation

Found: Related NICE guidance Related NICE g uidelines: Heart valve disease presenting in adults: investigation

Found: Heart valve disease in adults

Found: NICE guidelines • NICE guideline on Heart valve disease presenting in adults: investigation and management