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Foreword by the Secretary of State for Health

Seven years ago, cardiac services were in a terrible state. Patients could wait years for diagnosis and then more than two years for surgery.  We had one of the highest heart disease death rates in the developed world and heart services in this country lagged behind health systems in other countries. There were social, ethnic and geographical inequalities in who developed and who died from the disease. Those areas in the country with the highest level of Coronary Heart Disease (CHD) often had the poorest provision of services.

That is why the Government identified heart disease as a top priority and set a target of reducing the death rate by at least 40% by 2010. We worked with key stakeholders to develop a radical and far-reaching programme aimed at transforming the prevention, diagnosis and treatment of CHD.

The National Service Framework (NSF) for CHD, published in March 2000, is a blueprint for action to reduce incidence of coronary heart disease and modernise the NHS by driving up standards and cutting variations in services. It was the product of two years hard work by some of our country's leading clinicians, heart specialists and patient representatives. Therein lies its great strength. It was not cooked up in Whitehall, but based firmly on expert opinion, frontline experience and the patient's perspective.

This report details the progress which has been made in implementing the CHD NSF in the four years since its publication. It makes impressive reading.  There has been excellent progress on helping people to stop smoking and on diet and nutrition. NHS Stop Smoking Services are in place across the country and are helping people to quit. These are supported by national media campaigns and regional and local action.The National School Fruit Scheme and the 5 A DAY work are having a real and direct impact. The forthcoming public health White Paper, informed by Wanless, will build on these strengths and provide further momentum and direction to this vital area.

And progress has been made in the prevention of heart attacks and deaths in people who already have heart disease. More than 1.8 million people - that is over 3% of the population - are now receiving statins and that number is still increasing rapidly. We estimate that this is saving about 6-7,000 lives a year as well as reducing the number and severity of heart attacks. Importantly, we have also seen that this effort can reduce inequalities in health.

Gains in saving lives have also come in improvements in thrombolysis response times. Before the NSF was published less than a quarter of patients received clot-busting drugs within an hour of calling for help. Today almost a half of patients are seen in that time and we are set for further improvement.

This is saving lives.

Excellent progress has been made in cutting waiting times for heart surgery and angioplasty. Today only a very small number of people are waiting over six months. The stain on NHS history of 24 month waits is beginning to fade. Unprecedented investment of revenue combined with the radical reform of choice has brought extraordinarily rapid progress - underpinned by the hard work of dedicated NHS professionals.

The progress we have seen would not have been possible without increased investment in the cardiac workforce and in the capital infrastructure.

Getting the right staff is critical to support our programme of hospital building to provide new or expanded heart surgery hospitals in places where they are most needed so that people have the care they need close to home.

The work that is being done to improve the way that we prevent deaths from heart disease and relieve suffering is an example of what the NHS can do, given the money and given the will to change.

Deaths from cardiovascular disease fell by more than 23% between 1995/97 and 2000/02.

We are winning the war on heart disease but there is still much further to go.

There will be further change, further expansion and further improvement.

For me, my Department and the Government, tackling heart disease remains a top priority. Cardiac services are leading the way in modernising the NHS and they are delivering real improvements for patients.

John Reid
SECRETARY OF STATE FOR HEALTH

• Download The National Service Framework for Coronary Heart Disease: winning the war on heart disease (PDF, 324K)