Comprehensive cardiological service should be provided in the DGH

All patients with acute coronary syndromes (including myocardial infarction) and other important cardiac disease should be assessed by a cardiologist by the next working day (see 6.7)

More consultants are urgently required in DGHs, as are cardiac nurses and CCSOs

A commensurate reduction in commitment to general internal medicine is required for the district cardiologist to go some way to accommodating the presently unmet need for cardiology expertise

DGHs have a very important role in coordinating both acute and longer term cardiac care, both in their hospital and outside their health district

Uniform high standards of care should be available across all DGHs and the regional (tertiary) centre of any cardiac care network. This requires close liaison with both primary and tertiary care

Computerisation of departments is essential to maintain standards and provide accurate data

PCI can now be a safe procedure in the DGH with careful case selection if relevant quality issues are satisfied

District cardiologists should be experts in rehabilitation and preventive cardiology and also in modern non-invasive investigations.