Improving the referral pathway
Increasing numbers of patients with AS are waiting for TAVI in the UK and this situation will have worsened after the Covid-19 pandemic. A number of these patients will require pacing, but different centres across the UK have different approaches in terms of patient management and technology choices, and there is significant variation in the rate of post-TAVI PPI across centres. A unified strategy is required to ensure that patients receive a consistent level of care, with the aim of reducing waiting times to access TAVI, reducing PPI where possible and optimising patient outcomes.
PPI post-TAVI increases the hospital mean length of stay (LOS), which presents a capacity issue, especially in light of the Covid-19 pandemic, so it is important that a clearly defined and integrated ‘best practice TAVI pathway’ is developed with a standardised protocol for PPI embedded within it.
This advisory board meeting highlighted that there is much scope to increase the capacity for TAVI procedures within the NHS by the introduction of true integrated care, which could improve the referral pathway for patients and increase the efficiency of tertiary centre multidisciplinary teams.
Download the white paper reports on the right of this page, or view our interview with consultant cardiologist Dr Clare Appleby.
Costed integrated patient scenario: chronic kidney disease
NHS nephrology services are responsible for managing people with kidney failure which may occur as a result of chronic kidney disease (CKD) or acute kidney injury (AKI). Around 3 million people in the UK today have CKD with uncontrolled diabetes and high blood pressure the biggest causes of CKD.
This report (on the right of this page) provides clarity on the issues faced in managing CKD when dialysis has to be the modality of choice by bringing the scenarios to life in a very realistic way.