There have been 470,000 fewer new prescriptions of preventative cardiovascular medications during the pandemic, according to new research by IPPR and the CF healthcare analytics company. This will cause an estimated 12,000 extra cases of heart attack and stroke in England, in the next five years, without bold government intervention.
Fewer prescriptions of preventative medicines are just one of a number of disruptions to cardiovascular care during 2020. The new analysis, Without Skipping a Beat, also shows:
- An estimated 23,000 missed diagnoses of heart failure during the pandemic. Heart failure has a worse five-year survival rate than most cancers and early diagnosis is the key to better outcomes.
- Referrals to cardiovascular and diabetes specialists remain a quarter below expected levels.
- A 44 per cent drop in echocardiograms, a key diagnostic scan for long-term heart disease, compared to 2019.
Each of these threatens to cause more preventable deaths in the years following the pandemic.
These disruptions compound a lost decade of progress in heart disease during 2020. There were 5,600 excess deaths from cardiovascular disease last year. This means cardiovascular deaths reached their highest level seen since 2010. There is a risk this greater-than-expected cardiovascular death toll now remains elevated for years to come.
The authors urge the government to act with bold health policy to ‘build back better’ in England, and avoid these severe consequences. Among the steps the government should take are:
- Find and diagnose patients who have been missed by increasing the number of echocardiogram tests carried out in the community.
- Create a public health cabinet committee, to help sequence and co-ordinate cross-government policies, ensuring they improve health and reduce inequalities.
- Upgrade the NHS’s digital infrastructure to ensure the remote revolution in healthcare can flourish and does not come with a trade-off to quality of care.
The alternative, the researchers say, is a parliamentary term ‘scarred’ by the deadly legacy of the pandemic.
Dr Parth Patel, IPPR Research Fellow and lead author of the paper, said:
“Every year, hundreds of thousands of people are diagnosed with heart disease. The good news is that we have effective medications that can really slow down the deterioration of such disease and prevent future heart attacks and strokes.
“The bad news is the pandemic means almost half a million chances to prevent have been missed. This is really alarming. It pits us in a race against time to avoid thousands of deaths in the coming years that would be entirely attributable to the pandemic’s disruptions to normal healthcare services.
“Crucially, these deaths are not inevitable – but avoiding them relies on bold policy now. It is time for the government to match its ‘build back better’ rhetoric with urgent action.”
Dr Sonya Babu-Narayan, Associate Medical Director and Consultant Cardiologist at the British Heart Foundation said:
“People with heart and circulatory diseases are facing devastating disruption to their care on a scale never seen before, and at every stage of their treatment.
“The steep decline in heart investigations and so many missed diagnoses will have an impact that will be felt for years to come. What’s more, the pandemic’s true toll on cardiovascular care is still unknown. We are already seeing the consequences, with an average of 100 extra heart and stroke deaths in England a week and increasingly stark health inequalities.
“The pressure from Covid-19 may be lessening, but the backlog of cardiovascular care is ever increasing and must be urgently addressed. This is a significant but surmountable challenge that will require a clear plan and enough investment, now and in the long term.”
Juliet Bouverie OBE, Chief Executive of the Stroke Association said:
“IPPR’s ‘Without skipping a beat’ report is consistent with our findings that the Covid-19 pandemic has damaged stroke care in England and now puts the goals of the NHS Long Term Plan at risk.
“Most strokes are preventable, which is why it is vital to achieve the NHS Long Term Plan aims around stroke prevention. It is deeply worrying to hear that NHS Health Checks have dropped during lockdown as these are key opportunities to spot the risk factors for stroke, such as high blood pressure and atrial fibrillation, an irregular heartbeat that makes you five times more likely to have a stroke. When stroke risk is identified it is important that actions are taken, whether these are lifestyle changes or the introduction of medications like anticoagulants, are introduced straight away to prevent those most at risk from having a stroke.
“A stroke is a brain attack. Cardiovascular disease and strokes didn’t stop during the pandemic, in fact, they became more deadly. This is why it’s important that the NHS focuses on finding the hundreds of thousands of people who could be taking action to prevent stroke. This will help save some of the 12,000 extra deaths the report anticipates.”