Lothian sets the standard on Heart attack care


The Lothian Optimal Reperfusion programme, which is the first of its kind in Scotland, is run in partnership between NHS Lothian and the Scottish Ambulance Service.
The programme aims to give patients suffering from the type of heart attack where a blood clot blocks a heart artery the most effective treatment based on the likely travel time to hospital.
It means that suitable patients in Lothian who can be delivered to a Cardiac Catheterisation laboratory in Edinburgh and have treatment within 90 minutes of diagnosis will be treated using balloon angioplasty.
This involves threading a long, thin balloon through the artery and inflating it to clear the obstruction.
The programme was initially conducted over a 12-month trial period through £500,000 of Scottish Government funding, but has now received £300,000 funding from NHS Lothian to be offered on a permanent basis.
Balloon angioplasty, also known as Primary PCI, is thought to be the most effective treatment for heart attack patients, provided it is administered within a short period of time. Paramedics carry out ECG tests and then consult coronary care experts by mobile phone to decide the best course of action.
A dedicated entrance at the front of the Royal Infirmary of Edinburgh allows ambulances to deliver patients directly to the Catheterisation lab for treatment, bypassing the need to visit A&E, and reducing the time taken for patients to receive treatment.
Those who cannot reach the Cardiac Catheterisation lab within 90 minutes will be given vital clot-busting drugs by paramedics as recommended by Scottish guideline committees.
During the 12 month trial, over two-thirds of patients were treated using balloon angioplasty.A team of five specialists are on call 24 hours a day to man the Catheterisation lab if needed.
Dr Charles Winstanley, Chairman, NHS Lothian, said:
“NHS Lothian is leading the way in providing the best possible care for heart attack patients.
“This pioneering programme enables us to work closely with the Scottish Ambulance Service, to make sure patients receive the best treatment within the shortest possible period of time.
“The time saved in making immediate decisions about the best course of treatment could potentially be the difference between life and death.”
Dr Andrew Flapan, Head of Cardiology Services, NHS Lothian, said:


“We are delighted that NHS Lothian has provided funding for the continuation of this programme. Our team are overwhelmed by the obvious improvement in patients who have undergone this procedure.
“We have demonstrated that ambulance paramedics and coronary care experts can make live decisions on the best option for heart attack patients across Lothian, including both clot-busting drugs and primary angioplasty.
“We are now working with colleagues nationwide in striving for optimal reperfusion therapy for all heart attack patients across Scotland.”


Cabinet Secretary for Health and Wellbeing Nicola Sturgeon said: “The Scottish Government is committed to providing the best possible care for heart attack patients.
“By supporting frontline staff with modern healthcare techniques and specialist cardiac centres, we can help to save lives and improve the daily lives of heart attack patients in Scotland.
“That is why we were pleased to provide funding of £500,000 to pilot this pioneering project and welcome the joint commitment of NHS Lothian and the Scottish Ambulance Service to continue to provide this treatment programme.”
Shirley Rogers, Director of HR and Clinical Development, Scottish Ambulance Service, added:
“This initiative is an excellent example of partnership working in the NHS that has achieved significant clinical benefit for patients. The continued investment in extending the skills of paramedics is delivering measurable improvement to patient care in Scotland.”