"We’re waiting too long for heart care"

Dot (pictured above) has spent more than 18 months waiting for a procedure to open up a blood vessel which, if left untreated, could lead to a heart attack or stroke.

She struggles with breathlessness, chest tightness, and pain in her left shoulder, neck and arm, which come on when she exerts herself.

“Just carrying the vacuum cleaner up the stairs today brought the symptoms on,” says the 80-year-old, who lives on her own in her home of 28 years in Faversham, Kent.

“My health is worsening. I can do less and less every day. It’s getting more difficult to be independent and do the things I love, like bird watching. I used to go out with my local group all the time, now I only go once a month.”

Dot’s ill health is caused by a build up of fatty plaques in her right coronary artery. That means not enough blood and oxygen can get to her heart, causing the angina-like symptoms she describes.

Dot felt so unwell two months ago that she went to A&E and doctors said they’d put her on the ‘urgent’ waiting list for the procedure she needs to unblock her artery and put in a wire-mesh tube, called a stent. The procedure is called a percutaneous coronary intervention (PCI).

She was told the waiting time for ‘urgent’ cases was four weeks.

Eight weeks later, Dot’s still waiting.

• Read more about Dot's story.

18-hour wait to get into A&E

It’s not just people like Dot with diagnosed heart disease who are waiting for care.

Those needing emergency heart treatment have been hit by delays too.

Glynn Evans (pictured below) waited 18 hours to get hospital treatment after having a heart attack when he was in Cornwall looking after his grandkids.

“My wife, Lyn, called 999 in the evening. She kept phoning, and they kept saying ‘we’re very, very busy, you’re on the list’.

“It went on and on like that until the ambulance eventually arrived the next morning,” says the 76-year-old from Bourne in Lincolnshire.

Glynn then waited for hours in a queue of ambulances to get into hospital. He was there for so long an A&E doctor came out to the ambulance to do the blood tests to see if he’d had a heart attack.

The doctor seemed very worked up about the situation, Glynn remembers.

The delay meant Gynn missed what’s known as the ‘golden hour’ for heart attack care.

Being admitted to hospital within an hour of heart attack symptoms starting means doctors can perform treatments quickly, which can help prevent more serious damage to the heart and death.

These include a PCI – the same procedure Dot’s waiting for – to open up any coronary arteries that have been blocked by blood clots, which are the cause of most heart attacks, or giving medications to dissolve the clots.

Once in hospital, Glynn had more tests to see the extent of his heart attack and had a PCI to put two stents into his coronary arteries.

But Glynn, who ran marathons until he was 60, says: “The fact is I waited too long for heart care.

“And I do wonder if my health would be better now if I’d been seen sooner.”

• Read more about Glynn's story.

Health services under enormous pressure

Ambulance waiting times in England have improved since Glynn’s 18-hour ordeal in April 2022, which occurred in a part of the country with some of the worst delays at the time.

Now, people wait 30 minutes on average for an ambulance if they are having symptoms of a heart attack or stroke, according to NHS England figures for April. This time meets the current NHS target for these calls.

However, this is masking a dramatic rise in the number of people waiting more than 12 hours to be admitted to hospital via A&E in England – sitting in waiting rooms, admissions units, or in ambulances like Glynn.

NHS England figures show this was a rare occurrence up until early 2021 (see graph below). But since then, numbers have shot up with more than 42,000 people waiting more than 12 hours to be admitted to hospital via A&E in April this year.

Meanwhile, hundreds of thousands of people with diagnosed heart and circulatory diseases, like Dot, are waiting for appointments, tests, treatments and procedures.

More than 414,000 adults were on heart care waiting lists in England in March this year, according to NHS data.

This is a record high.

In February 2020, before the Covid-19 pandemic, this waiting list stood at around half that figure at just over 233,000.

As Dot points out, the delays in heart care are “no one person’s or department’s fault”. The data show the whole of NHS England is under immense pressure.

“You wait to see a GP, you wait to see a specialist, you wait for investigations, you wait for the results, then you wait for treatment. It all adds up, until you’re waiting too long,” Dot says.

Glynn agrees: “The ambulance guys were superb. The doctors and nurses were superb. But they were under enormous pressure. I just got the feeling they could not cope.”

But, as Dot and Glynn’s experiences highlight, waiting too long for heart care can come at a hefty price.

It can lead to more severe disabilities and complications – and even earlier death.

Deaths from heart disease rising

A British Heart Foundation (BHF) analysis of publicly available data for 2022 reveals deaths  in the under 75s from heart and circulatory diseases in England have risen to a 14-year high.

This reverses decades of progress made in reducing the number of people dying prematurely from heart and circulatory diseases.

And people in the poorest parts of England are being hit the hardest, with death rates from heart disease in the under-75s rising twice as quickly in the most deprived areas compared to the least deprived.

'Care crisis' leaving people in limbo

It’s the “worst heart care crisis in living memory,” says Dr Sonya Babu-Narayan, BHF’s associate medical director and consultant cardiologist (pictured below).

“Nearly 11,000 people are waiting over a year for heart care, including procedures like stents and even surgery. This was unheard of in the past. Only 28 people in England were waiting this long in February 2020.

“People are also facing delays in emergency care for heart attacks and strokes – where every minute matters – and for treatments and services to help address health issues that raise the risk of heart disease such as high blood pressure, high cholesterol, excess weight and smoking,” adds Dr Babu-Narayan.

“We know NHS staff are doing all they can, but heart patients have told us they’re worried and frustrated.

“They feel like they’re in limbo, and while they wait their heart condition may be getting worse because they’re missing out on time-sensitive treatment.”

Hearts need more, says BHF

In response, BHF has launched a campaign to put heart care at the centre of the national debate ahead of the UK General Election on 4 July.

Called ‘Hearts need more’, the campaign urges the incoming government to take bold action in three areas:

• Focus: To prioritise heart care to minimise the time it takes to get help.
• Protection: To better prevent heart disease and stroke by addressing risk factors.
• Breakthroughs: To supercharge research to unlock future treatments and cures.

To do so, BHF is calling on the next government to ensure the NHS has the resources and staff it needs to reduce waiting times for heart care.

It also wants the new government to create a healthier food environment, introduce a ‘polluter pays’ tax for the tobacco industry, and set stricter limits on harmful air pollution in line with updated World Health Organization guidelines.

Ongoing funding for research into heart and circulatory diseases, which still cause about a quarter of all UK deaths, is another key factor in making sure people get the best possible care.

“BHF wants to relieve the unrelenting pressure on NHS services and make sure the progress that’s been made in improving outcomes for people living with heart disease is not lost,” explains Dr Babu-Narayan.

“This can only be done with more focus on delivering timely heart care, providing better protection for people at risk of heart disease, and putting more funding into heart research.

“The scale of the challenge facing heart care is immense,” she warns.

“That’s why we need everyone’s support to ensure heart care is at the top of the new UK Government’s agenda.”

What to read next...