The data analysis undertaken as part of this report, although an approximation, highlights how woefully inadequate diagnosis and treatment is for this patient population. The number of patients left untreated is alarming. There is also an unacceptable variation in the provision of services, and part of the reason for this is that the true prevalence of MTV disease is unknown. Currently the severity of disease is not coded within the Hospital Episode Statistics (HES) data so it is impossible to know whether patients have mild, moderate or severe disease. It is essential that disease severity is coded explicitly and to compare who is providing good service.
Cardiology is one of the 14 high-volume elective care specialties that form part of the Elective Care Transformation Programme; changes required include optimising outpatient pathways through triage, and initial diagnostic activity in the community through diagnostic hubs. It is vital that there are explicit referral pathways at a regional level for percuntaneous mitral valve leaflet repair (PMVLR) and percutaneous tricuspid valve repair to address this low-volume highly-specialised intervention. GIRFT recommends that each tertiary centre should have a single point of entry into a pathway for the assessment and consideration for intervention, with rapid triage protocol and specialist heart valve multidisciplinary team (MDT) for consideration of patients for surgery or percutaneous interventions.