It’s been a fortnight of education for me. The week before last I was asked to give a talk at the British Geriatric Society annual meeting in Nottingham about frailty in heart failure, and then last week I was in London for the British Society for Heart Failure, and gave a talk on new medical therapy for cardiomyopathies. It’s always an honour to be asked to speak at these events, I just have to try and keep my imposter syndrome in check as I rub shoulders with professors who I regards as world leaders in their fields! Public speaking is something I guess I’ve done since school however, so hopefully by now any nerves I may feel on the inside aren’t on show!
I have a few take away thoughts from the conferences. There was much talk of the Government’s new NHS 10 year plan, the themes of which will likely affect everyone in one way or another, so I thought worth outlining today.
The first of these is the intention to move from hospital care to community care. So how will care be different for patients? The idea is that more care is available locally and from the comfort of your own home. It will be easier and faster to see a GP. There will be more neighbourhood health centres with a variety of practitioners under one roof. There will be better access to dentists. Referrals to a specialist will be quicker and outpatient care will be re-designed. Access to pharmacists for prescriptions will be improved. New mental health A&E centres will be developed.
The second theme is a move from analogue to digital. The intention here is to liberate staff from time wasting admin, and make booking appointments and managing care as easy as online banking or shopping. A new single patient record means patients won’t have to repeat their medical history. AI assisted doctors and rapid self-referrals for specialist care will be at your fingertips through the NHS app. Access to appointments will be more equal, ending the postcode lottery.
The third theme is to shift focus from sickness to prevention. If you catch a disease early in the process, you may either be able to prevent it altogether, or at least minimise the impact. The government plans to ban energy drinks for under 16s, and increase access to nutritious foods. Open up access to new weight loss services and treatments to tackle obesity. Introduce new screening programmes, and improve financial support for those on low incomes.
There is also a real focus on cardiovascular disease. When I was a junior doctor 20 years ago, national service frameworks were introduced to accelerate certain therapies for example stents. These NSFs are to be modernised, and called ‘modern service frameworks’. Due to be published in early 2026, they intend to support more consistent delivery of high-quality, evidence-based, digital-by-default care in conditions where there is potential for rapid and significant improvement in both quality and productivity.
With respect to cardiovascular disease which is ear-marked for inclusion, it is expected this will include an uptick in wearables, so that all NHS patients have access to these technologies by 2035. Personalised nudges will help with healthier behaviours and alert medics if issues arise. Community models to tackle variation in care of high risk heart conditions and diabetes will be trialled. Genomic testing (checking people’s genes to see how they affect an individuals risk, or response to a specific treatment or medication) will be made a universal offer
I feel over the last several paragraphs I sound like a part-political broadcast! I truly truly hope these good intentions and plans manifest, but also fear my cynicism from having worked in the system for so long prevents me from getting too excited. In fact, many of the questions from the audience during these conference sessions spoke to the huge gap between current reality and these lofty ideals. My own son had a specialist referral to a hospital service recently, and I just got a letter last week advising that his appointment had been cancelled – for November 2027! Clearly we have much work to do, but it’s a good start to have a plan. Hopefully these are plans that do not get derailed by politics too, as they need to be long term no matter who is in power.
In today’s research video, I discuss a new trial presented at the recent American Heart Association looking at LDL cholesterol and stroke. Clearly as a cardiologist my focus is the heart, but for many patients, and myself included, a disabling stroke would be considered a worse fate than a heart attack. My wife finally got round to getting her cholesterol checked last week. She is fit and well, with no family history of premature heart disease, a normal body weight, very healthy diet, and yet….. a cholesterol that was far higher than either of us would have expected. It just shows you don’t now until you get yourself checked. I hope you enjoy the video.