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Vascular Services

What are vascular services?

Vascular refers to the vessels of the body that circulate or conduct fluids e.g., blood vessels. These vessels can be affected and cause such conditions as varicose veins or potentially life-threatening aneurysms. Therefore, the NHS provides a range of services to diagnose and treat these conditions.

An aneurysm is an area of localised widening of a blood vessel. An aortic aneurysm involves the aorta, one of the large arteries through which blood passes from the heart to the rest of the body. The aorta bulges at the site of the aneurysm like a weak spot on an old worn tyre.

 

The case for change

The latest clinical evidence shows that patients with a vascular condition do better if they are treated by a vascular specialist, but we know that at the moment not everyone in the East Midlands is seen by a specialist.

The latest clinical evidence also shows us that if an aneurysm does rupture the person has a better chance of survival if they are operated on by a vascular specialist, but again we know that at the moment not everyone in the East Midlands in this situation is treated by a specialist. 

We want to improve access for everyone across the region to specialist vascular services to reduce premature death for people with aortic aneurysms and significantly improve the outcomes for patients with other vascular conditions.

In addition to the Vascular Service Review, a national Abdominal Aortic Aneurysm Screening programme is currently being set up, which will identify patients at risk from abdominal aortic aneurysms. This will reduce the likelihood of patients requiring emergency surgery.  People will be monitored and have planned surgery to meet their individual needs. This is important as most abdominal aortic aneurysms do not produce symptoms and are often only discovered when the patient is being scanned for other conditions. Someone can live with the condition unaffected for a number of years, but aneurysms carry a high risk of rupturing which causes profuse bleeding and can send the body into shock. At the moment half of all people with an untreated abdominal aortic aneurysm die from a rupture within five years. However, if detected, aneurysms can be treated.  

 

Our proposals

To begin with we need to understand how and where vascular services are currently being provided in our region. We are working with all of our hospitals and specialist vascular clinicians to map this and agree the minimum standards and protocols which need to be in place.

Vascular surgery requires specialist teams to provide high quality care to patients e.g., repairing aneurysms is a highly specialised procedure and clinicians need to keep up their expertise by treating a minimum number of patients every year. These and other clinical standards are being introduced to ensure that the best possible outcomes for patients are achieved, so we may need to bring some vascular services together to create specialist centres in some of our hospitals.

The new model of care for vascular conditions for the East Midlands is being developed by the very clinical staff who are already looking after patients in our region. We are using their expertise together with research and service models from across the rest of the country and abroad to fine tune our proposals. We are also speaking to patients and their families to find out what their experiences of being treated for vascular conditions are and how this could be improved.

 

The national aortic aneurysm screening programme

A national Abdominal Aortic Aneurysm Screening programme is currently being set up, which will identify patients at risk from abdominal aortic aneurysms. This will reduce the likelihood of patients requiring emergency surgery.  

United Hospitals of Leicester NHS Trust is an “early implementer”.  It commenced screening, as part of the national programme in March 2009. The Trust has considerable experience in providing screening, having started its service to some GP practices in the mid 90s. 

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