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Appendix S. Tayside Health Board - Uptake of Cardiology Services
Topics: Hard to Reach Groups
Background
People living in deprived communities have lower uptake of specialist cardiac services than patients from more affluent areas. This means that some patients are missing out on effective cardiological care with resultant poorer outcomes, higher morbidity and reduced survival.
Funding allocation
The pilot was allocated £692,708
Aim(s)
To improve access to modern evidence-based cardiology services for those people most at risk from coronary heart disease ( CHD). Therefore all services, which can feasibly be delivered away from the main cardiology department, were to be provided in deprived communities where the prevalence, morbidity and mortality of CHD is highest.
Methodology
The project was a descriptive pilot/ impact assessment. The methodology used in the project had two key features. Firstly, the specialist cardiology clinic was delivered in a community venue or clinical mobile unit. Secondly, 'opportunistic cardiology assessment' was used. This involved the identification of potential patients through attendance at local events e.g. gala days, bingo halls and mosques.
The primary outcomes of the project was to measure the numbers taking up the service, clinical need identified and numbers attending a subsequent referral appointment.
A number of secondary outcomes were also measured. These were the numbers and socio-demographic distribution of: patients contacted; patients who were contacted and offered follow-up services; patients who attended follow-up services and patients views regarding acceptability.
Key Results
1781 people have engaged with clinical project activity and of this number, 10% are of South Asian ethnicity, a group known to have an increased risk of coronary heart disease. The majority of people who have engaged are from the poorest areas of Tayside. In addition, taking clinical services to places of worship has increased engagement with ethnic groups.
Of the total number engaging with the service, 161 have had a consultation at the specialist cardiology clinic and of this number, 82 had no known CHD but described significant symptoms.
Conclusions
The project successfully improved access to modern cardiology services to those in deprived communities and ethnic minorities. The project has produced a variety of service design and delivery information that can inform future service design related to the feasibility, acceptability and popularity of the service in this format.
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