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National variations in the provision of cardiac services in the United Kingdom: second report of the British Cardiac Society Working Group, 2005
  1. N Boon,
  2. M Norell,
  3. J Hall,
  4. K Jennings,
  5. L Penny,
  6. C Wilson,
  7. J Chambers,
  8. R Weston
  1. British Cardiovascular Society, London, UK
  1. Correspondence to:
    Dr Nicholas Boon
    British Cardiovascular Society, 9 Fitzroy Square, London W1T 5HW, UK; boons{at}lineone.net

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In 1998 the UK government devolved power to elected assemblies in Scotland, Wales and Northern Ireland. Although the powers of these political bodies differ, they all have important freedoms with respect to health care and have pursued different policies. In England, the emphasis has been on targets introduced through National Service Frameworks. Scotland has concentrated on health promotion and the development of managed clinical networks led by healthcare professionals and patients. Wales has focused on public health partnerships, and developments in Northern Ireland have stalled since the elected assembly was suspended in 2002.

The National Service Framework (NSF) for coronary heart disease (CHD)1 was published in 2000 and has facilitated dramatic and tangible improvements in the provision of cardiac services in England. Amid concerns that the devolved nations had been disadvantaged by exclusion from the NSF, the Council of the British Cardiac Society (BCS)* appointed a working group to examine variations in the provision of cardiac services within the UK in 2004. Despite some methodological difficulties, the working group found clear evidence of major differences in service provision, activity and planning that were not related to need.2 The report attracted a lot of interest and an accompanying editorial highlighted the need to monitor progress by conducting further surveys.3 The Council of the BCS therefore conducted a second survey of the provision of cardiac services in the four UK nations.

THE WORKING GROUP

The working group comprised representatives from each of the four devolved nations and the British Society of Echocardiography (see appendix).

SCOPE OF THE REPORT

The group has not attempted to report on every aspect of cardiac services but has instead collected data on some core activities, many of which were described in the first report. To assess rate of change of data, annual statistics have, whenever possible, been presented for the …

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