Heart disease service improvement

Care for people in Scotland with heart disease requires continuous improvement. The national improvement programme launched in 2007, provides evidence, implementation support and measurement to ensure this improvement is effectiveness.

Our heart disease service improvement focuses on:

In 2011, we published Take Heart, a national review of heart disease services in Scotland. Targeting resources locally and nationally to streamline data collection and analysis, we moved away from a 'measure everyone against everything' approach.

The data, intelligence and knowledge produced as a result of this work has been used to develop a national heart failure care bundle by the Scottish Patient Safety Programme.

We work collaboratively with the managed clinical networks in NHS boards plan and support improvement in heart disease services.

Measuring heart disease services in Scotland

The 2010 Heart Disease Clinical Standards were piloted in NHS Ayrshire & Arran and NHS Western Isles. All NHS boards then had two rounds of measurement or audit to complete. The first round helped NHS boards test local systems and provided us with feedback on how best to measure performance against the standards. Second round measurement data was analysed and used for submission as part of the formal performance assessment exercise.

Collecting improvement evidence

NHS boards were asked to evidence that they were meeting the standards or developing systems of improvement that would lead to the standards being met. Every NHS board completed a self evaluation and gave supporting evidence.

Supporting evidence included:

  • details of current local services and improvement plans
  • local protocols, pathways, care plans and patient information documents
  • data from national and local audits
  • data provided by ISD
  • data from the Quality and Outcomes Framework (QOF)
  • data provided by the Scottish Ambulance Service.

Evaluated by professional, patient and public representatives

Evaluation panels were used to review each NHS board’s overall performance against each standard. The panels consistent of public partners, medical and nursing staff, managers, and representatives from voluntary sector organisations.

Panel members met over a 2-day period in January 2011 and issued a score for each NHS board using this four-point assessment scale:

  • Level 1: The NHS board is developing its policies, strategies, systems and processes to deliver heart disease services in line with national evidence, standards and guidance.
  • Level 2: The NHS board is implementing its policies, strategies, systems and processes to deliver care in line with national evidence, standards and guidance.
  • Level 3: The NHS board is monitoring the effectiveness of its policies, strategies, systems and processes to deliver care in line with national evidence, standards and guidance.
  • Level 4: The NHS board is reviewing and continuously improving its policies, strategies, systems and processes to deliver care in line with national evidence, standards and guidance.

This scale reflects the infrastructure in place to provide person-centred, safe and effective care for people with heart disease. Our National Overview report and local review summaries provide full details on each boards performance.

Share this content