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National variations in cardiac service provision: how united is our kingdom?
  1. M S Norell1,
  2. K P Jennings2
  1. 1Department of Cardiology, The Heart and Lung Centre, Wolverhampton, UK
  2. 2Department of Cardiology, Royal Infirmary, Aberdeen, UK
  1. Correspondence to:
    Dr Michael S Norell
    The Heart & Lung Centre, Wolverhampton WV10 0QP, UK; michael.norell{at}

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Has devolution in the UK brought about a disparity in cardiological resources, putting those citizens in the devolved countries at a disadvantage?

A report from a British Cardiac Society working group has shown that the provision of cardiac services in England, Scotland, Wales, and Northern Ireland varies considerably. Could one effect of devolution of the UK be a disparate application of cardiological resources to the disadvantage of citizens in the devolved countries?

While the National Service Framework (NSF) for coronary artery disease (CAD)1 has heralded tangible improvements in cardiac services across England, these changes are not so apparent in Wales, Scotland, or Northern Ireland where the NSF had no mandate. Similarly, the Myocardial Infarction Audit Project (MINAP) and the National Institute for Health and Clinical Excellence (NICE) have driven change in England, but in Scotland, for example, these instruments do not apply. Predictably this has generated concern that the effect of devolution may have been to allow the development of different management priorities and thereby potentially to disadvantage citizens with cardiac disease

As a result of this concern the British Cardiac Society set up a working group to examine this variation and their report has now been published. …

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