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Heart attack

Patient satisfaction and heart attack management

Different sources are looking into patient/public satisfaction with the National Health Service (e.g. Patient Voices, King’s Fund). In this summary we report on what recently interviewed heart attack patients said about their experiences of current NHS management of heart attack. The heart attack site was updated with more interviews in 2013 from people who had had a heart attack in the last three years to include experiences of modern cardiac management including pre-hospital care and primary angioplasty.

All those we talked to praised the care received and described it as a fast and effective service that includes paramedics, surgical team and cardiac care team (see ‘Pre-hospital care in the ambulance, ‘Initial treatment for a heart attack and ‘Angioplasty and stents).
 

His hospital notes show that John's primary angioplasty and the fitting of a stent was done in...

His hospital notes show that John's primary angioplasty and the fitting of a stent was done in...

Age at interview: 67
Sex: Male
Age at diagnosis: 67
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As we got to the [Hospital name] they pulled up and as the doors opened a registrar got in, introduced himself to me and said, ‘Do you mind if I ask you a few questions as we are making our way to the Cath lab?’ And so he was running alongside the trolley. At the time it seemed like it was only seconds but in fact their log which I had a copy of, they sent me a copy of their log, showed it was 3 minutes to get me from the ambulance to the Cath lab [catherisation laboratory]. We went into the Cath lab which is like a really 21st Century, almost 22nd Century lot of robotic equipment in there, massive amount of people. I think there were probably 8 people in there or something like that' radiographers, surgeons and so on. I noticed this one guy who was already capped and gowned and he said, ‘Oh Mr. [Name] you’ve had a heart attack, my name is Professor [Name] which filled me full of confidence at being dealt with by a professor and he said, ‘We are going to go in through your groin and stent you.’ He said, ‘There are three arteries which are suspect but only one of them is, you know, urgent.’ He said, ‘So we are going to do that one which is the really urgent one and then you will have the option of either while you are here having them done or you could come back as an outpatient because they’re not urgent that we deal with the other two. They are mild in comparison.

 
So you had the angioplasty and the stent?
 
Yes
 
At the same time?
 
Yes, yes. So he went in and they blew up the artery with the balloon and then they put a stent in. The next thing, I mean it was slightly uncomfortable because I was still in my working clothes and they had sort of not even taken my shirt off. They’d sort of ripped open some of the button and I ended up being told, you know, ‘Keep your hands away from there because this is a sterile area but it was amazing. I have nothing but praise for the team.
 
There was no time to do anything.
 
No [laugh]. But anyway with, and again their log shows that within fourteen minutes of entering the Cath lab I was out again with a stent fitted which is phenomenal.
 

 

It is the view of all those we talked to recently that the NHS “got it right” when it comes to the treatment of heart attack patients. People talked about the dedication of nursing staff and doctors and felt reassured by the way they had their heart attack and its treatment (primary angioplasty and stenting) had been explained to them. Alan remembers that the surgeon used pictures to tell him about his surgery. Alan rated the quality of care received in hospital as ‘very good’, but he and his wife wanted more information and advice on what to do when going home.
 

James feels part of the cardiac team that is looking after him and thinks that the quality of...

James feels part of the cardiac team that is looking after him and thinks that the quality of...

Age at interview: 63
Sex: Male
Age at diagnosis: 62
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Can you tell me what has been good about the care you received from the hospital and from the GP?
 
The good part …
 
The good and the bad if they are any bads.
 
Well the good has got to be the friendliness of the nurses and the people involved, the doctors, everybody. They, they were there for me and that's what mattered at the time that I needed them. I think everybody's followed on as well, has done an excellent job of looking after me I feel I'm part of a team now which is the team of looking after me [laughs] which is quite important. Bad things I don't think there were. I can't really think of a; probably at times when you're laid in the bed in the hospital, you'll think to yourself, well why's nobody interested in me but then again they've got a lot of other patients to look after not just me and I probably like anybody else would think, 'Well why are they dealing with all these other people instead of coming and helping me?' But I don't need any help I'm recovering. Strange, strange sort of feelings you get.
 

 

 

Stanley talks about the support and information he and his partner received when in hospital and...

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Stanley talks about the support and information he and his partner received when in hospital and...

Age at interview: 59
Sex: Male
Age at diagnosis: 59
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How was the care like when you were in the cardiac unit?
 
It was very good yeah.
 
In which sense, in which way?
 
Well they, you know, they never left you very long, they were always coming back to check to see if you were alright. They were all pleasant, you know, did as much as they could for me I think. They were very good with my partner explaining everything to her and they let her stop the night.
 
So she stayed in hospital?
 
Yeah, yeah she stayed the night with me yeah.
 
Anything that you would like to know but you haven't been given it?
 
No I don't think so.
 
No? OK.
 
No, no I think it's been fine. Everything, you know, I had an hour’s meeting with the cardiac rehab nurse and she was very thorough. You know any questions that I wanted to ask I could and she explained everything that had happened to me and you know, yeah it was very good.
 
That was when you were in hospital?
 
No that was when I came out and I had an appointment at [Hospital name] with the rehab nurse yeah. Yeah that was very good.
 
What is in that manual?
 
Well it [the Manual] explains, it explains what a heart attack is, what causes it, what, you know, what's happened to you, what you can expect. It explains all about the stent, how it was done and everything like that. What to expect afterwards, how to feel and how other people feel.

 

 

Alan’s wife felt ‘abandoned’ after Alan was discharged from hospital and started feeling unwell....

Alan’s wife felt ‘abandoned’ after Alan was discharged from hospital and started feeling unwell....

Age at interview: 62
Sex: Male
Age at diagnosis: 62
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Alan’s wife' There just didn’t seem to be anybody you could call on. I mean obviously, you know, the doctor is there but my first port of call when I was worried about him I rang the number at the ACU [Acute Cardiac Unit] to ask some advice. Was it normal that he was getting all the pains he was getting. And then shortly afterwards, after I had spoken to that lady, a lady rang from [City name] because Alan had put down for the rehabilitation to be at our local hospital and they are not [City name]. They are [County name] and a lady rang from [City name] who was very nice and said, ‘If you’ve got any worries or concerns you could ring her any time’. And a couple, well I don’t know how many days, two maybe three days later I tried to ring her. She wasn’t there and I left a message and it went on from the Friday. I tried Friday morning and it was actually Wednesday before I got to speak to anybody. In the meantime we had been back to the GP and he said, ‘Take your medication. That’s what it is for.’ So I didn’t know whether we were worrying unnecessarily or whether. You know, there wasn’t really anybody you could talk to about it who knew about it. There didn’t seem a professional person if you like who we could chat to about it.
 
So how did you feel about it?
 
Alan’s wife' Felt a bit abandoned. As though he had been in and monitored and, you know, they’d unplugged all the monitors and put his things in his bag and we’d come home and that was it sort of thing. Would have been nice if we’d have had a contact number where you could have spoken for reassurance or whatever.

 

Waiting time for a follow-up appointment was a concern for some, particularly those who reported having to wait up to six months.
 

When discharged from hospital, Alan was disappointed to hear that his cardiology follow-up...

When discharged from hospital, Alan was disappointed to hear that his cardiology follow-up...

Age at interview: 62
Sex: Male
Age at diagnosis: 62
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So when is your next appointment in hospital?
 
Alan' July
 
Alan’s wife' Not until July
 
July so that will be?
 
Alan’s wife' Six months after.That’s what I thought was. I realise they are busy don’t get me wrong or anything like that but it seems like a long time to me when you think what you’ve had. I know there are probably thousands of heart attacks, I realise that like, but when they were actually talking to me I am sure they said to me, ‘It would be 5 to 6 weeks they’d be getting in touch with you to come back just to make sure that you are getting along alright’. But obviously, you know, it was 6 months.
 
Have you phoned them and asked why July?
 
Alan' No I mean when I spoke to the lady about going for my rehabilitation thing as well they seemed to think it was quite normal.
 
Alan’s wife' I mentioned it to the lady who I spoke to when I rang [Hospital name] and she said, ‘Oh yeah that’s probably quite normal’. Then I said we were expecting a check up in 6 weeks, that’s what they told us and she said, ‘Oh well I don’t think that happens very often’. That was that.

 

 

 

Levels of satisfaction with GP’s care were less apparent. Stanley felt that his GP did not provide enough feedback after his yearly review, particularly about his annual blood test results. His GP used to phone him and discuss the annual test results but he was recently told by the receptionist that ‘it wasn’t necessary’. Stanley said that knowing how he is doing is important to improve his self-care. James described his follow-up care with his GP as a ‘little bit difficult’. Others were still in the care of their cardiac team.
 

Mervyn wonders if his GP’s attitude regarding communication of personal data is a widespread...

Mervyn wonders if his GP’s attitude regarding communication of personal data is a widespread...

Age at interview: 76
Sex: Male
Age at diagnosis: 73
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And if you have any kind of concern who do you talk to about it? Do you go to your GP and discuss it or?
 
Mervyn' Well I get, I have a yearly review with my GP.
 
And what does that consist of?
 
Mervyn' Well he, he weighs me and he reviews my medication and I have a blood test and that’s about it.
 
Ok.
 
Mervyn' The only thing I, I have a blood test but I don’t get the results and I usually have to wait until the next year to find out the results of the blood test.
 
So can you not phone the surgery before and ask?
 
Mervyn’s wife' You asked if you could didn’t you?
 
Mervyn' Yeah I asked
 
Mervyn’s wife' And he said, ‘It’s not necessary’.
 
Ok would you like to have those results?
 
Mervyn' I would yeah. I think that they when I’ve had a blood test as soon as I, well as soon as I’ve had the blood test I think I ought to get the results either through the post or whatever. Just to reassure me. I don’t know if that’s general practice or not but I’d certainly like to know.
 
So you think it’s something that could be improved.
 
Mervyn' Yeah that’s about the only thing I can think of just for peace of mind.
 
I know I got one lot of results because I’ve got them written down but that’s the only time isn’t it, once? But I’d just like to know.
 
Have you talked to your GP about it?
 
Mervyn' Well not really, no.
 
You haven’t mentioned it to him that it would be good for you. I mean for your piece of mind to have these results and have them explained to you.
 
Mervyn' Yeah I think I’ve got a right to know really but I don’t know. I said, ‘Could I have a telephone appointment this time to get the results’. And he said, ‘Oh that won’t be necessary’. But I say that’s the only thing. I’d like to know.
 
But it might be different with other people. They might get their results in another area, I don’t know. I don’t know what their procedure is.
 

 


Last reviewed June 2017.
Last updated June 2017.
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