Echotech Key Messages

• Hand held echocardiography systems are an accurate and reproducible screening technique for the assessment of LVSD in the community[1]

• Community echocardiography gives comparable results to traditional hospital echocardiography for left ventricular dysfunction and for significant valvular disease detection[9]

• Community echocardiography will secure the local, early and accurate diagnosis of cardiac abnormalities

• Community echocardiography will allow risk stratification - early identification of those patients requiring specialist assessment

• Improved access to echocardiography may result in higher rates of optimal pharmacological intervention[2]

• Improved pharmacological intervention (with ACE inhibitors and Beta blockers) will result in decreases in morbidity, mortality and hospital admissions[3,4]

• Community echocardiography has a significant sparing effect on specialist referrals (increase NHS capacity)[5,6]

• Community echocardiography provides a more efficient 'lean' method of working (confirm a patient is normal without resorting to more expensive cart based systems and utilising the specialist skills of the Consultant Cardiologist for only the required patients)

• Open access echocardiography allows avoidance of inappropriate treatment[7]

• Echotech delivers a pathway of care designed around patient needs (reduced waiting time to diagnosis, closer to patient's home)

• All Echotech Clinical Governance is overseen by our Clinical Lead - Consultant Cardiologist Echocardiography Specialist

• Echotech will support healthcare professionals deliver CHD NSF standard 11 and the PPF target (heart failure) and to help implement the NICE guideline for heart failure

• Echotech will support new GMS contract 'the percentage of patients with a diagnosis of CHD and LV dysfunction which has been confirmed by an echocardiogram (90%)'

• Our service is highly responsive to the evolving NHS and reflects several recent Department of Health policy developments. For example, Payment by Results, Practice Based Commissioning and support the delivery of the 18 Week Target

• Echotech provides an integrated, flexible and quality assured echocardiography service to wherever and whenever a PCT requires at a cost effective / highly competitive rate

• The most cost effective strategy to screen for LVSD in community subjects is natriuretic peptide or ECG pre screening prior to hand held echocardiography prior to traditional echocardiography[8]

• Echotech's service reflects several of the themes in the NHS Next Stage Review. For example, 'All the visions emphasised the importance of rapid access to diagnostics in convenient locations' [10]

1. R Senior, G Galasko, J V McMurray, J Mayet. Heart 2003;89(Suppl III):iii24-iii28
2. S Lillis, J Vickers. Assessment and treatment of heart failure in general practice. http:www.priory.com/fam/heart.htm
3. CIBIS II. The cardiac insufficiency bisoprolol study II: a randomised trial. Lancet 1999;353:9-13
4. SOLVD investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fraction and congestive heart failure. NEng J Med 1991;325:293-302
5. Echocardiography in primary care: evaluating an open access service. Vanessa Catterall. www.somerset-health.org.uk/pdf/ha_reports/ echocardiography.pdf
6. E Southall. Mayfield Medical Centre, Paignton. Cardiac diagnostic service in general practice.
7. Francis CM, et al. Open access echocardiography in management of heart failure in the community. BMJ 1995;310:634-636
8. Senior, R et al. What is the most cost effective strategy to screen for left ventricular systolic dysfunction: natriuretic peptides, the electrocardiogram, hand held echocardiography, traditional echocardiography, or their combination? European Heart Journal (2006) 27,193-200
9. Jeyaseelan, S et al. Postgraduate Medical Journal 2005; 81:777-779
10. High quality care for all. NHS next stage review final report. DH June 2008