NHS at 70: What can we do next?

As we mark the 70th anniversary of the NHS, there’s much to reflect on the huge impact it’s had in improving the nation’s health. Medical breakthroughs, pioneering surgeries, and outstanding care are all parts of a service that the nation has grown to treasure.

Nowhere is this truer than in the field of cardiovascular care.

When the NHS was formed, heart and circulatory disease caused more than half of all deaths in the UK. We didn’t understand the causes of a heart attack, and the best treatment doctors could offer was pain relief and bed rest. But since then, medical research, combined with the NHS’s commitment to new innovations, has transformed care.

The progress we’ve made was simply unimaginable in 1948.

For example, one of the world’s first coronary care units was established within the NHS, revolutionising how patients are cared for worldwide. The introduction of clot-busting drugs and stents has transformed heart attack and stroke survival rates, while the prescription of statins prevents thousands more every year. Surgical techniques pioneered on the NHS mean 8 in ten babies born with a congenital heart defect now survive. And research we’ve funded in partnership with the health service has identified many of the faulty genes behind deadly inherited heart conditions, helping to diagnose and treat thousands of people living with these silent killers.

A different challenge, just as urgent

But the battle isn’t won. Heart and circulatory diseases are still responsible for a quarter of all deaths in the UK and we’re lagging behind other countries in how we prevent, diagnose and treat them.

Last week a report showed that a higher proportion of people die in England from heart and circulatory diseases than in nine European countries, including Ireland and Portugal. Indeed in recent years progress in disease management has stalled, with the rise in risk factors like diabetes and undiagnosed high blood pressure threatening to reverse historically improving trends.

Part of the reason for this is the unprecedented pressure the NHS is under from an ageing population, with growing numbers of people living with multiple long-term conditions. Cardiovascular diseases like heart failure, stroke and vascular dementia are perhaps the biggest contributor to this.

All of these factors present a huge challenge for the future of the NHS — a challenge that is different, but no less urgent to tackle than the one faced by the NHS’s founders 70 years ago.

A reinvigorated approach

For the NHS to maintain its status as one of the best health systems in the world, it must transform its approach to heart and circulatory diseases; that encompasses and connects prevention, diagnosis, treatment and recovery, and takes full advantage of emerging technologies and information data.

This should include prioritising innovations that reduce the risk of heart attacks and strokes, including high blood pressure, high cholesterol and diabetes. For example, over 13.5 million adults in England have high blood pressure, but 40% are not diagnosed. Treating those who are diagnosed effectively could prevent 14,500 strokes, 9,710 heart attacks and save £274 million over three years.

Focus should also be given to accelerating medical research using health data and artificial intelligence, which has the potential to revolutionise the way we diagnose and treat many heart and circulatory diseases. Our research has already shown that using artificial intelligence to analyse CT scans could potentially spot early signs of heart disease that are missed by current techniques. This could lead to a quicker diagnosis with more personalised treatment that could ultimately save lives.

Finally, we need to urgently invigorate the care offered to patients after a heart attack or stroke. Currently, just half of patients receive cardiac rehabilitation after a heart attack, despite it significantly improving long-term survival chances and quality of life. If the uptake rate for cardiac rehab was even marginally increased, it would improve thousands of lives and simultaneously reduce hospital admissions.

Working together

We should take pride in what the efforts of so many people have achieved in the last 70 years. But the changes that are with us now show the NHS must embrace innovation, work more closely together in partnerships that work for patients and citizens, and continue to adapt to ensure that we can tackle significant challenges effectively.

And just as in 1948, we need a bold new vision and approach — one that aims to reduce early deaths and disability from conditions including heart disease, stroke and vascular dementia by 2030. Only this will ensure the UK is continuing to offer the world-leading care the UK public deserves.

NHS at 70: What can we do next? was originally published in British Heart Foundation on Medium, where people are continuing the conversation by highlighting and responding to this story.

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