HC Deb 16 December 2003 vol 415 cc881-3W
Mr. Moss

To ask the Secretary of State for Health (1) what assessment he has made of external counter pulsation and enhanced external counter pulsation treatments for heart disease, with particular reference to angina pectoris; [143812]

(2) what research work he has (a) commissioned and (b) evaluated on external counter pulsation; and what conclusions about its efficacy were drawn. [143813]

Miss Melanie Johnson

External counter pulsation (ECP) is not routinely offered to patients with angina pectoris by the national health service. There is insufficient evidence currently available about its benefits to warrant its widespread use.

The available literature on this procedure has been reviewed and it has been decided not to commission any research from the Department of Health.

Although there is currently insufficient evidence to draw conclusions about the benefits of ECP, the evidence base is being monitored. Should improvements in the effectiveness of ECP be demonstrated, the position will be reviewed.

Mr. Pickles

To ask the Secretary of State for Health what advice is given to health professionals about signs and symptoms consistent with underlying cardiac conditions that could cause unexpected death. [143974]

Miss Melanie Johnson

Relatives of people who have died of sudden cardiac death, or who are diagnosed with one of the underlying conditions, should be screened because there is a genetic component in many of these cases.

The National Institute for Clinical Excellence is currently reviewing guidance, issued in September 2000 to the National Health Service in England and Wales, on the use of implantable cardioverter defribrillators (ICDs). Current guidance already suggests that ICDs should be used, where clinically indicated, for patients with a familial cardiac condition with a high risk of sudden death, such as Long-QT syndrome and hypertrophic cardiomyopathy.

Mr. Pickles

To ask the Secretary of State for Health what(a) emotional and (b) practical support is provided to (i) patients who are diagnosed with a potentially fatal cardiac condition and (ii) their carers. [143975]

Miss Melanie Johnson

Following a diagnosis of potentially fatal conditions, people can access a range of psychological therapies, which are available in every strategic health authority catchment area. The responsibility of referring patients to such services lies with the clinicians involved in their care.

All trusts provide support for patients, relatives and staff through the chaplaincy service and associated community faith representatives. In November 2003, the Department published guidance material for managers and those involved in the provision of chaplaincy-spiritual care, "Meeting the Religious and Spiritual Needs of Patients and Staff".

The new guidance sets out the contribution chaplaincy-spiritual care providers can make in directly supporting patients within the modern national health service. Meeting the varied emotional needs of such patients and of their carers is fundamental to the care provided by the NHS.

Practical support available for those diagnosed with cardiac-related illness is also widely available. Where appropriate, patients are offered surgery, and no one currently waits more than nine months for heart surgery. Those diagnosed with heart failure are offered treatments to control their symptoms, improve their quality of life and slow disease progression. Patients may also be offered advice on how to make lifestyle changes, for example, smoking cessation or dietary advice, which will improve their quality of life and reduce the risks of their condition deteriorating.

Mr. Pickles

To ask the Secretary of State for Health what advice is given to primary health care trusts to prevent those at risk from(a) sudden adult death syndrome and (b) arrhythmia death from being prescribed medications that may prove lethal to people whose hearts are sensitive to those substances and could cause them to die unexpectedly. [143976]

Miss Melanie Johnson

The British National Formulary (BNF) provides United Kingdom healthcare professionals with authoritative and practical information on the selection and clinical use of medicines in a clear, concise and accessible manner.

The BNF makes specific mention of drugs which have associated risk with arrhythmia death.

Mr. Pickles

To ask the Secretary of State for Health if he will make a statement on the British Heart Foundation study published 27 March, Urgent Call for Greater Research into So-Called Adult 'Cot Death'. [143977]

Miss Melanie Johnson

The British Heart Foundation (BHF) study suggested that sudden cardiac death should be classed as a separate condition.

We do not believe that sudden cardiac death should be classified as a syndrome in its own right. This is because it has many possible causes—neurological, metabolic or cardiac problems, or an underlying infection.

The UK National Screening Committee has advised there is insufficient evidence to warrant a national screening programme for sudden cardiac death. This recommendation is based on a report produced in 1999 by Dr. Stuart Logan of the Institute for Child Health. Dr. Logan has now updated his report in the light of recent research and, after consideration of the report by the Child Health sub-committee, the position remains the same.

The evidence base is due to be reviewed in March 2004.