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Annual Report 2008
Annual Report 2008
Our MissionBritish Cardiovascular Society:
• Sets standards of excellence; for individuals,organizations and the care of patients withcardiovascular disease.
• Is committed to training and education, andsupports the practice of professionals workingwithin cardiovascular health, science anddisease management.
• Is the primary source of professional advice andadvocacy in these areas, to government, fundingbodies and industry.
• Will deliver these objectives in collaboration withpatients, the public and partner organisations.
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ContentsOfficers of the Society 4
Staff of the Society 5
Introduction and Report from the President 6
Affiliated Groups 8
Arrhythmia Alliance (A-A) 8
British Association for Cardiac Rehabilitation (BACR) 9
British Association for Nursing in Cardiovascular Care (BANCC) 10
British Atherosclerosis Society (BAS) 12
British Congenital Cardiac Association (BCCA) 12
British Cardiovascular Intervention Society (BCIS) 13
British Junior Cardiologists’ Association (BJCA) 15
British Nuclear Cardiac Society (BNCS) 16
British Society of Cardiovascular Imaging (BSCI) 18
British Society of Cardiovascular Magnetic Resonance (BSCMR) 19
British Society for Cardiovascular Research (BSCR) 20
British Society of Echocardiography (BSE) 21
British Society for Heart Failure (BSH) 22
Heart Care Partnership (UK) (HCP UK) 24
Primary Care Cardiovascular Society (PCCS) 26
Society for Cardiological Science and Technology (SCST) 27
Working Groups and Other Reports 29
Working Group on Trainee Education 29
Working Group on Practitioners with a Special Interest in Cardiology (PwSI) 30
Working Group on Women’s Heart Health 30
Women in UK Cardiology 31
Regional Variations in Cardiac Services 32
Heart 32
Membership 33
Annual Scientific Conference 35
Divisional Reports 37
Clinical Standards Division 37
Corporate and Financial Affairs Division 39
Education and Research Division 40
Training Division 42
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From left to right: David Hackett, Charles Knight, David Crossman, Carol Black, Kevin Jennings, Nicholas Boon, Stephen Holmberg, Stuart Cobbe, Iain Simpson, Steven Yeats Officers of the Society
President Dr Nicholas Boon2007-2009
Honorary SecretaryDr Stephen Holmberg2006-2008
Honorary Secretary ElectDr Charles Knight2007-2008
VP Clinical StandardsDr David Hackett2007-2010
VP Corporate and Financial AffairsDr Kevin Jennings2006-2009
VP Education and ResearchProf David Crossman2003-2008
VP Education andResearch ElectDr Iain Simpson2007-2008
VP TrainingProf Stuart Cobbe2007-2009
Non-executive TrusteeProf Dame Carol Black2007-2011
Non-executive TrusteeMr Graham Meek2007-2011
Mr Graham Meek
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Staff of the SocietyHead of InformationServices (Acting CEO)Steven Yeats Appointed 1998 [email protected]
Affiliate CoordinatorAzeem Ahmad Appointed [email protected]
IT Support SpecialistJasdeep Bhamber Appointed [email protected]
Head of DevelopmentKirsten Bradbury Appointed [email protected]
Web DeveloperDilowar Hussain Appointed [email protected]
Affiliate CoordinatorLulu HoAppointed [email protected]
Project CoordinatorAnna Kassai Appointed [email protected]
Office AssistantCatherine MullinAppointed [email protected]
Resources ManagerMary-Lou Pitts Appointed [email protected]
Finance and Membership CoordinatorWojtek Trzcinski Appointed [email protected]
From left to right: Back Row: Anna Kassai, Kirsten Bradbury, Wojtek TrzcinksiMiddle Row: Jasdeep Bhamber, Dilowar Hussain, Azeem AhmadFront Row: Mary-Lou Pitts, Steven Yeats, Lulu Ho
Annual Report 2008
Introduction and Report from the PresidentThis report is intended to
provide a brief summaryof the wide range ofwork that the BritishCardiovascularSociety hasundertaken thisyear. Our activitiesfall into threecategories.
Firstly, there arenumerous routine
but desperatelyimportant tasks such
as maintaining andimproving the website,
responding to consultationdocuments from the
Department of Health, NICE, the Royal Colleges
and others, and most notablyrunning the Annual Scientific
Conference. Secondly, we must react appropriately and sometimes
very rapidly to unexpected developments
and set backs. There have been morethan our fair share of such challenges inthe last 12 months, not least, the fall-outfrom the MTAS/MMC debacle and NICE’scontroversial appraisal of drug elutingstents. Finally, there are new initiativesand developments, which in the past havenot always attracted the attention theydeserve because of the pressing need totend to matters in the first two categories.
The changes in the way we govern ouraffairs brought about by “Strategy forChange” are now in place and there is every indication that they will make it easier to pursue new developments.Indeed, I am pleased to report that theBoard has set itself five immediate andexciting new objectives. These are therelocation of our offices, the developmentof a cardiovascular plan to follow theNational Service Framework (a jointproject supported by the British HeartFoundation and other cardiovascularcharities), a comprehensive review ofBCS membership, benefits and charges,
the launch of an accreditation system fortraining courses aimed at practitionerswith a special interest in cardiology, and a major review of the way we seek sponsorship for our education and training initiatives.
The many achievements listed in thisreport are really quiet remarkableconsidering that, for much of the year, wehave been operating without three seniormembers of staff, in offices overrun bybuilders and decorators. The fact that we have made so much progress istestimony to the commitment and hardwork of the Society’s active members,Officers and permanent staff, particularlySteven Yeats who has done anexceptionally good job as Acting ChiefExecutive since Finola McNicoll left the Society last June. The last round of elections has introduced even moretalent. Iain Simpson is now Vice PresidentElect for Education and Research andCharles Knight has become our HonorarySecretary Elect. They are all bursting
Dr Nicholas Boon
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with ideas and I know that they willcontinue to serve the Society well.
The dedication and skills of our staff, the Officers and the Board have made my duties as President both enjoyableand relatively easy. My principleresponsibility is to maintain an overviewof all the Society’s activities, ensure that each fits with our overall strategicobjectives, and foster good relations withkey organisations such as the AffiliatedGroups, the Royal Colleges, the ESC and the ACC. I am delighted that theArrhythmia Alliance is now affiliated to the BCS and am pleased to say thatrelations with the Royal Colleges, the ESCand ACC are better than ever.
Alan Fraser, who sits on the Board of the ESC, has helped to keep us abreast of European developments and we havebenefited from the fact that Kim Fox, thecurrent President of the ESC, and RobertoFerrari, the President Elect of the ESCboth have strong links with UK cardiology
and the BCS. Moreover John Martin, a senior member of the BCS, has taken a leading role in promoting the EU HeartHealth Charter, a major ESC initiativeaimed at improving cardiovascular healththrough European legislation. The UK’scontribution to European affairs has alsobeen bolstered by the appointment ofPeter Mills, our last Vice President forTraining, to the Co-Chair of the EuropeanBoard for the Specialty of Cardiology(EBSC). Peter has been given specialresponsibility for developing the ESC’splans for a major e-learning project thatwill support training programmes ingeneral cardiology and sub-specialtycardiology and provide tools forassessment that can be used as aplatform for revalidation andrecertification. English will be the chosenlanguage for this initiative and the BCSwill be closely involved.
Members of the BCS now benefit fromaccess to JACC on-line and Cardiosource,the ACC’s on-line portal for cardiovascular
news, information and education. Thesesuperb facilities have not been used asmuch as we had expected and Irecommend that you explore themthrough our website if you have not doneso already. Our links to the ACC have alsobeen strengthened by the activities of twoof our Past Presidents. John Camm isnow a member of the ACC’s Board andHuon Gray has become a member oftheir international committee.
I do hope that you will find this report bothinteresting and stimulating. The Societyexists solely for the benefit of its membersand will only thrive if it properly representsyour views and aspirations. Please do nothesitate to contact me if you would like toparticipate in any of the projects describedin this report or have any ideas orsuggestions that you would like to discuss.
Annual Report 2008
Dr Nicholas Brooks the outgoing BCS President welcomes Dr Nicholas Boon the new BCS President, at the Annual Dinner, June 2007
Annual Report 2008
Affiliated Groups
ARRHYTHMIA ALLIANCE (A-A)Founder and Trustee: MMrrss TTrruuddiiee LLoobbbbaann
Arrhythmia Alliance is a coalition ofcharities, patient groups, patients, carers,medical groups and allied professionalswho work together to promote timely and effective diagnosis and treatment of arrhythmia. A-A is delighted to beaffiliated with BCS and looks forward to a continued working relationship withall affiliates built around a framework of integrity and co-operation.
During its first yearas an affiliate to the BCS,ArrhythmiaAlliance (A-A)has achievedanother series ofgreat milestones
including staging:
• The fourth Arrhythmia Awareness Week
• The second Heart Rhythm Congress
• Our first ever World Heart Rhythm Day
• Our first ‘Shine A Light’ educationcampaign
The Arrhythmia Awareness Week 2007(AAAW) targeted greater awareness of cardiac arrhythmia at Primary Carelevel and the continued implementation of National Service Framework Chapter 8.Such was the success of AAAW that 260events were held countrywide in hospitalsand other organisations; that figure isexpected to rise as more events areplanned for 2008.
A-A aims to build on the success of lastyear by organising its fifth ArrhythmiaAwareness Week from 9-15 June 2008,with a World Heart Rhythm Day falling on13th June, more details are available on www.aaaw.org.uk
The 2007 Heart Rhythm congress wasstaged in Birmingham and over 800 UKand international delegates attended.Primary care and arrhythmia nursingwere two items on the congress agenda.Plans for the 2008 Heart RhythmCongress – Birmingham 20-22 October –are well advanced and more informationis available on www.heartrhythm.org.uk
One of the big A-A success stories of last year saw a number of AutomatedExternal Defibrillators installed in certainparts of the country. The campaign –‘Where’s the AED?’ – proved to be a remarkable example of community,ambulance service and local businessworking together to provide external lifesaving equipment which can be operatedin conjunction with CPR until theemergency services arrive.
As part of raising awareness amongparents, children and teachers the‘Shine a Light on Education’ website
campaign was launched by STARS – theSyncope Trust And Reflex anoxic Seizurescharity – which is part of the A-A. STARS also launched the highlysuccessful Blackouts Checklist which is designed to help patients and doctorsreach the correct diagnosis in the event of blackouts – unexplained loss of consciousness – and to determinewhether blackouts are ‘head’ or ‘heart’related when presenting to primary care.
A-A also forged stronger ties withEuropean counterparts in 2007. Ten European countries attended an A-Aorganised conference in June to endorse
the A-A message of awareness,diagnosis, early treatmentand after care support.
Another AED is installed in a local community
Mrs Trudie Lobban
A-A UK has provided the start-up model forsome of these countries with the emphasison the three Cs – Communication, Co-operation, Collaboration – furtherEuropean conferences are planned for2008. For more information please visitwww.arrhythmia-europe.eu
A-A played a fundamental role in theextension of the National ServiceFramework (NSF) for Coronary HeartDisease to include the chapter onArrhythmias and Sudden Cardiac Death.The next five years will hopefully seesignificant progress for the A-A in thefollowing areas: a massive increase inpublic awareness of cardiac arrhythmias,clear, early and correct diagnosis of thecondition and the establishment of rapidaccess support clinics for sufferers.
In such a short period of time – andthanks to the enthusiasm and motivationof patients, carers, champions, medicalprofessionals and all connected with
A-A the public’s awareness of cardiacarrhythmia has increased but the workcontinues in order to ensure that cardiacdisorders are regarded with the level of care and concern that they deserve.(www.heartrhythmcharity.org.uk)
BRITISH ASSOCIATION FORCARDIAC REHABILITATION (BACR)President: Prof. Patrick Doherty
BACR continues to make progress in termsof representing its membership and raising the profile of cardiac rehabilitation.The association has released a majordocument in the form of the BACRMinimum Standards and Core Components(2007) which has helped clarify what isexpected of a modern rehabilitation servicethat enables patients to achieve sustainedbenefits. The release of this document hasled to positive dialogue between BACR, theNational Institute for Health and ClinicalExcellence (NICE) and health carecommissioners, all of whom are workingon the imminent NICE commissioning guidefor cardiac rehabilitation.
BACR acknowledges that funding is a major challenge for many services and is working hard in collaboration with
colleagues to develop a tariff for cardiacrehabilitation. With the help of theDepartment of Health and the Care andEducation Research Group of the BritishHeart Foundation, we have recentlymanaged to set up a tariff pilot studywhich aims to develop accurate costs for cardiac rehabilitation across urbanand rural communities.
The success of the National Audit forCardiac Rehabilitation (NACR) isparamount to the future of cardiacrehabilitation because it gives accuracy to our demands for moreappropriate funding.Almost two-thirdsof programmesare registeredand the BACRis determinedto make this100%. Theinequality of the
Prof. Patrick Doherty
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service in some regions is something that professionalsneed to challenge and weshould all aim to ensure thatpatients, no matter where they live, receive the bestservice possible. The CardiacRehabilitation Campaign, led bythe British Heart Foundation,has brought professional andpatient groups together andincreased media awareness ofthe problems faced by patientsaccessing and practitionersdelivering rehabilitation.
Year-on-year the business ofBACR is increasing and it hasbecome more important thanever not only to use the skills of the BACR Council, but also the wider BACR membership.BACR has set up foursub-committees with their own chair person: Professional
Affairs; Conference; Education andTraining; and Communications. BACR hasopened up these committees to a selectgroup of non-Council members and weenvisage that these groups will alter their membership in response to thechallenges ahead. In this tough financialclimate where clinicians are struggling togain funding and time for courses and conferences we will, with the help of our members, optimise the BACR Annual Conference.
It is a great time to be with BACR and we see 2008-2009 as being pivotal in shaping the service over the next tenyears. BACR calls on all its members,allied associations and societies to rallyto the cause, and together we will be able to say that in 2008 we changedcardiac rehabilitation for the better.
For more information on BACR contact [email protected]
BRITISH ASSOCIATION FORNURSING IN CARDIOVASCULARCARE (BANCC)President: Mrs Jenny Tagney
Since last year’s annual report, BANCChas had quite a change in terms ofCouncil members as several reached theend of their elected time and newlyelected members joined. We have alsowelcomed Jan Proctor-King and ProfessorDavid Thompson as non-voting Councilmembers. Both have already madesignificant contributions to the working ofthe Council – Jan in terms of her dual DHand primary care roles providing usefulinformation and links, and David who hasagreed to act as the lead for the recentlystructured research network.
We have been working to strengthen linkswith the Cardiovascular Nurses’ Networkof the Royal College of Nursing and planto host a joint conference with them early next year. Links have also beenIm
ages
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maintained and strengthened with theEuropean Society of Cardiology Council on Cardiovascular Nursing and AlliedProfessions following last year’ssuccessful joint conference.
We have always enjoyed a close workingrelationship with the British HeartFoundation Nursing colleagues and thishas been taken to a new level with thecommencement of a new level 3 cardiacnursing course. This initiative has been
led by our past president, Dr Ian Jonesand Cynthia Curtis on behalf of the BHF.Applicants are required to be members of BANCC and may benefit from BHFfunding to cover course fees. The firstcohort began in January this year and we look forward to reviewing the evaluation.
The joint BANCC and British Journal ofCardiac Nursing ‘Cardiac Nursing Awards’were so successful last year that it wasdecided to repeat them this year. Nationaland international entries for each of the11 categories were received and winnerswere presented with a commemorativeplaque at a wonderful ceremony amongsttheir peers.
BANCC aspires to be the ‘umbrellaorganisation’ for nurses involved incardiovascular care and has alreadynegotiated some key links as outlinedabove but will continue to nurture othersin the coming year. BANCC members have
again contributed to the development ofNICE guidelines and technology appraisalsover the past year.
In this time of changing practice aroundtreatment of patients with MI leading toclosure of some coronary care units, BCShave asked BANCC to lead a review of thecurrent situation and identify implications.Dr Ian Jones is leading this initiative andour links with other organisations will beinvaluable in accessing information.
For more information on BANCC contact [email protected]
BANCC Cardiac Nursing Awards (Jayne Mudd pictured)
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BRITISH ATHEROSCLEROSISSOCIETY (BAS)President: Prof Keith Channon
The British Atherosclerosis Society (BAS)holds two meetings each year in Springand Autumn. These meetings, held over 2 days and attended by 100-150delegates, have programmes thatincorporate clinical and basic scienceresearch in vascular disease. The BASalso organises and hosts sessions at the BCS Annual Scientific Conference.
In 2007, the BAS Spring meeting inOxford, on role of macrophages inatherosclerosis, included abstractpresentations, posters, the John FrenchLecture (delivered by Professor MarkKearney, Leeds), and the Michael DaviesYoung Investigator competition(sponsored by the BHF). The BAS Autumnmeeting, held in Bristol in September, was organised jointly with the EuropeanVascular Biology Organisation, giving
the BAS direct involvement in a largerinternational meeting. The meetingincluded a number of internationallyrenowned speakers, including ProfessorGoran Hansson (Karolinska Institute,Stockholm) who gave the Hugh Sinclairlecture.
At the BCS Annual Scientific Conference inGlasgow, the BAS co-hosted a symposiumentitled ‘Endothelial dysfunction andrepair after stenting’ with BCIS and BSCR,and a teach-in session on anti-plateletdrugs. The next BAS Spring meeting willbe held in Oxford in April 2008 with thetopic ‘Angiogenesis and Atherosclerosis’.In Autumn 2008 the BAS meeting willcelebrate the 100th meeting of theSociety and will incorporate contributionsfrom founder members and emeritusfigures from the UK atherosclerosis andvascular biology fields.
For further details please seewww.britathsoc.ac.uk
BRITISH CONGENITAL CARDIAC ASSOCIATION (BCCA)President: Mr William J Brawn
The BCCA now has over 350 memberswith an expanding membership includingadult cardiologists and paediatricians with a sub-speciality interest in congenitalheart disease, as well as nurses andclinical physiologists. The rapid expansionand involvement of different specialitiesprovides for very interesting debates at our meetings.
In 2007, the BCCA component of the BCSAnnual Scientific Conference in Glasgow,and our annual meeting in November inLeeds were both a great success. At theBCS Annual Scientific Conference inGlasgow there was an opportunity tocombine with other groups to have a morecomprehensive view of the problems ofmanaging patients with congenital heartdisease, such as management of aorticvalve lesions, pacing in congenital heart
disease and lifestyle issues related tocongenital heart disease. In November,we discussed workforce planning and the recent exciting developments inhybrid transcatheter surgical treatment of hypoplastic left heart syndrome.
In June 2008, the BCS will have itsannual conference in Manchester andBCCA component of this will include topicsof imaging in congenital heart disease,interventional catheterisation, technicalissues and assessment of competenceand the follow up of patients withcongenital heart disease both surgicallyand medically. In November 2008,the BCCA annual meeting is to be held in Birmingham; two exciting overseas speakers have already been invited, Dr Frank Hanley from Stanford and Dr Gary Webb from Philadelphia. A wide variety of
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topics will be discussed from neonataland foetal surgery through to themanagement of patients in adult life.
The congenital CCAD project under theenthusiastic guidance of Dr John Gibbshas progressed so that in June 2007 thedata became public for the first time onthe internet. There were some problemswith accuracy of the data which did notcome to light immediately but these arebeing rectified and over time this publicportal for the CCAD will become a majorsource of information for colleagues andfor patients and their families. Havinggone public, however, every centreinvolved now realises how important it isto check on the data to make sure that itis accurate and reflects truly the workgoing on in individual units.
The core curriculum project has had greatdifficulties over the last few years but atlast a new programme is being developedand led by Dr Andrew Cook in the Institute
of Child Health, UCL. This programmefunded by the British Heart Foundation willhopefully develop a national congenitalheart disease education programme. The SAC and BCCA are supporting fivetraining days per year for SpRs to be held in different locations throughout the country with a travelling morphologistand local faculty providing the clinicalcomponent of the day.
Following on from the Bristol report, theMonro committee suggested a review ofprogress of the reorganisation of cardiacsurgical services for children and adultswith congenital heart disease; some fiveyears after the report it is apparent that there has been no change. There ismuch discussion now among members of the BCCA as to where we stand onthese recommendations and a survey of centres will take place to ascertaincolleagues’ views about the reorganisationand restructuring, in particular of surgicalservices. However, it is also important
that we discover administrators’ andpoliticians’ views about possible changes.It is apparent that whatever the outcome,the reorganisation will require a largeamount of planning and financing.
For more information on BCCA contact [email protected]
BRITISH CARDIOVASCULARINTERVENTION SOCIETY (BCIS)President: Dr Mark De Belder
BCIS maintains a key role in thedevelopment of interventional practice in the UK through its sustainedmultidisciplinary membership of over1,000 people. Major developments in the past year include the continued rise in rates of revascularisation to approachEuropean norms, the increasingexpansion of percutaneous coronaryintervention (PCI) into non-surgicalcentres, improved access to timelytreatment for patients with acutecoronary syndromes, the progressiveadoption of primary angioplasty fortreatment of acute myocardial infarctionand availability of the new technique ofpercutaneous aortic valve replacement.
BCIS has encouraged and supported thedevelopment of 9 new PCI programmes innon-surgical centres during 2007/2008
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by means of its collaborative scheme of peer review in partnership with The Department of Health to ensure the highest standards of patient care. The overall expansion in activity has been carefully monitored by annual BCIS PCI audit and increasing linkage with the Central Cardiac Audit Database.Expansion of this audit activity into fields of non-coronary intervention(percutaneous atrial septal closure, septalablation for HOCM, and percutaneousvalve intervention) and linkage with newlyestablished European databases is nowanticipated.
BCIS is instrumental in the maintenanceof training programmes for PCI in the UK and its sub-speciality curriculum,developed in collaboration with thecardiology SAC, has now been largelyadopted as the template for Europeantraining in conjunction with the newlyestablished European Association forPercutaneous Intervention (EAPCI).
BCIS sub-committees have also maderepresentations to NICE in relation to the newly established technique ofpercutaneous aortic valve replacementand successfully challenged and reversedthe original NICE decision to withdrawapproval for the use of drug eluting stentsin the UK. Major British interventionalmulti-centre randomised trials haveincluded BCIS-1, examining the role of the intra-aortic balloon pump in high riskPCI, and BBC-ONE investigating optimalstrategies for the treatment of coronarybifurcation disease. Both trials have been strongly supported by BCIS andpresentation of their findings isanticipated at the TCT meeting inWashington later this year.
In addition to its mainstreamcontribution to the BCS AnnualScientific Conference, BCIS hoststwo popular national meetingseach year. The 2007 AutumnMeeting held in Dublin attracted
200 delegates with a varied programme.More recently, the expanded format of theJanuary Advanced Angioplasty Meetingadopted in 2006 continued successfullyin 2008 with an opening day of live casetransmissions (Left Main Stem 6 Plus)
hosted by Dr Simon Redwood atSt Thomas’ Hospital, London, followed by two days of didactic presentations,debate and the ever popular interactiveangioplasty review sessions. Outstandingkeynote presentations from the invitedinternational faculty, Dr William Wijns(President of EAPCI) and Martyn Leon(USA), were greatly appreciated by therecord 780 delegates. The increasingstanding of BCIS on the world stage was
also recognised in its continuingcontribution to internationalcollaborative research and itsgrowing educational presence at key global events, notablyEuroPCR and TCT, the premierEuropean and US interventionalmeetings. Led by the new
President, Dr Mark De Belder,BCIS looks forward to the nextexciting 12 months of itsdevelopment.
For more information on BCIScontact [email protected]
Dr Martyn Thomas and Dr Mark De Belder
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BRITISH JUNIOR CARDIOLOGISTS’ ASSOCIATION (BJCA)President: Dr Chris Gale
This year, training and education havebeen at the forefront of trainees’ minds.There has been a significant restructuringof higher specialist training in the UK and Cardiology faces unique challenges in both selecting and training doctors witha wide array of sub-specialist interests.Another major change has been theimplementation of the new specialtytraining Curriculum in Cardiology fromAugust 2007; the format, delivery andevaluation of cardiology training are now somewhat different as the newcurriculum not only builds on the previousone but also aims for a competency-based approach to assessment.
The emphasis on some disciplines haschanged; for example, there is lessemphasis on pacing numbers and moreon echocardiography experience, more
structured training in adult congenitalheart disease and the introduction of new areas such as cardiovascularmagnetic resonance. Notably, thesechanges are relevant to both existing and newly appointed trainees and willcreate challenges for existing trainees. In addition to workplace-basedassessments, trainee evaluation will also include a knowledge-basedassessment. The format (timing and costto trainees) of this has created concernamongst trainees.
To achieve effective engagement oftrainees, the BJCA aims to establish the views of cardiology trainees and ensure they are represented at a national level. Information obtainedby deanery representatives throughformal surveys, local discussion or personal communications informs the opinions that are taken forward by BJCA representatives
who sit on many key committees such asthe BCS, BCIS, BSE, Heart Rhythm UK,SAC, the BMA, and the Trainee EducationWorking Group.
Through regular feedback between BJCAregional representatives and trainees wecan put forward the views of the traineesand disseminate those of policy-makers. In 2007, the BJCA published an overviewof the 2007 Curriculum in Cardiology fortrainees and trainers (Br J Cardiol2007;14:286-8). The BJCA conductsannual surveys of trainees and in 2007
we conducted the fourth annual survey.We had responses from over 200 trainees.The findings have been disseminated tothe British Cardiovascular Society andhave also been accepted for publication in the British Journal of Cardiology.
Additionally, in 2007, we conducted asurvey to ascertain views of trainees onspecific aspects of training. We found thatthere was overwhelming opposition bytrainees to the proposal of non-selective“run-through” training for cardiology.Trainees felt strongly that competitiveselection into cardiology specialisttraining was fundamental to maintaininghigh standards in clinical training and thatit should occur at a local level.
The BJCA hold a database of trainees incardiology which now contains over 500 members. This includes researchfellows in addition to those with trainingnumbers. It is regularly up-dated by BJCAregional representatives and proves to be
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extremely valuable in allowing effectivecommunication between trainees.Undeniably, it allows us to undertakesurveys, canvas opinions and todisseminate news and information on training courses and other trainingopportunities.
The third BJCA Research Awards wereheld at the end of 2007 in Birminghamand there were some exceptionally highquality presentations. Abstracts wereseparated into basic science and clinicalareas and each section presented to a panel of judges. The winner from eachsection was awarded the prize of a travelfellowship to the BCS Annual ScientificConference and the overall winner a travelfellowship to an international conference.The Awards will continue in 2008.Unfortunately, the BJCA annual conferencewas cancelled in 2007. Historically, it hasproven to be a great success amongtrainees. As such, plans have been madefor a 2008 BJCA conference. We are in
the process of developing the BJCA webpages on the BCS website. Together, weintend to provide a first port of call forcardiology trainees for all resourcesrelated to cardiology and training,including news, courses, conferences,training issues, fellowship schemes,guidelines and education.
Finally, cardiology trainees are fortunateto benefit from the efforts of the BCS infostering equitable access to high-qualitytraining opportunities throughout the UK.In concert, we can continue this processand safeguard the future of cardiologytraining in the UK.
For more information on BJCA contact [email protected]
BRITISH NUCLEAR CARDIACSOCIETY (BNCS)President: Dr Simon Woldman
2007 has been a year of consolidationand growth for the British NuclearCardiology Society. NICE TechnologyAppraisal 73 was reviewed andreaffirmed with no major changes. NICE therefore continues to suggest thatSPECT perfusion imaging should be thefirst diagnostic tool used for patients inthe following categories: women, patientswith conduction system abnormalities(e.g. LBBB), patients with diabetes andthose unable to exercise. This excellentnews is tempered by the inability of NICEto indicate uptake of this guidance.
There were a large number of scientificmeetings last year in which NuclearCardiology was discussed. In particularthe 8th International Conference onNuclear Cardiology was held in Pragueand was attended by over 1000 people.
There was also a large Nuclear Cardiologyinterest in the British CardiovascularSociety Annual Scientific Conference andin the British Nuclear Medicine SocietyMeeting. In our own annual meeting, we reviewed the role of risk stratificationusing Nuclear and other techniques in assessment of acute coronarysyndromes, but noted that the currentfunding of the NHS in England mitigatedagainst the use of perfusion imaging in this field. We also discussed excitingnew technologies, such as the D-SPECTgamma camera which will reduceimaging times and radiation dosimetry.
The combination of Cardiac CT andmyocardial perfusion scintigraphycontinues to excite. Whilst we havealways known that functional imaging(e.g. Myocardial Perfusion Scintigraphy)gives complimentary information toanatomical imaging (e.g. CoronaryAngiography), we can now do this non-invasively. The radiation dose of
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Cardiac CT is falling rapidly with dosemodulation techniques. The combinationof the two techniques undoubtedly has thecapacity to unlock the problem ofun-interpretable segments on cardiac CT images, although much work needs to be done here.
Personnel ChangesThe AGM in December represented thelast meeting for the old Council. Dr SimonWoldman (Heart Hospital) was electedPresident, Catherine Dickinson (Leeds),Treasurer and Parthiban Arumugam(Manchester), Secretary. The Societyowes a huge debt to Mark Harbinson,outgoing President, for his outstandingleadership in the last two years. We haveexpanded the Council in the last fewyears and we now have special Councilmembers representing Nuclear Medicine(Dr Liz Prvulovich) and Nuclear Medicinetechnologists (Ms Maureen Gardner). Dr Mark Harbinson has kindly agreed to stay on and lead on training issues.
NICE appraisalsThe BNCS is a registered stakeholder in a number of forthcoming NICE guidelinesand technology appraisals, including acute coronary syndromes, acute chestpain, stable angina and CT coronaryangiography. This promises to keep the honorary officers from idleness!
Education and TrainingA document on non-medical stress testing was published in Nuclear MedicineCommunications in July of 2007. This document, published on behalf of the BNCS, identifies alternative groups of people who might be able to stress test patients for Myocardial PerfusionScintigraphy and the training they might need. Guidance on performingRadionuclide Ventriculography (alsoknown as MUGA) is currently inproduction and at the time of writing has just been submitted to the Councils of the BNMS and BCS.
The BNCS remains heavilyinvolved with discussions ontraining junior doctors, not onlycardiologists but also radiologistsand nuclear medicine physicians.
Plans for 2008We plan to continue to highlightthe role of Nuclear Cardiology inthe assessment of patients withchest pain, myocardial infarctionand heart failure. We are againlooking into accreditation. We are(under auspices of the ESC WorkingGroup of Nuclear Cardiology and CardiacCT) now performing annual surveys ofNuclear Cardiology Practice in the UK. It is anticipated that this will inform us as to the current practice in the UKand the extent to which NICE TechnologyAppraisal 73 is being followed.
Visit our website for further informationon BNCS, www.bncs.org.uk
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BRITISH SOCIETY OFCARDIOVASCULAR IMAGING(BSCI)President: Dr Charles Peebles
The Society was founded in March 2004and was an evolution from the previouscardiovascular radiology group of theRoyal College of Radiologists, which had been in existence for 25 years. The Society was initially set up to promotecardiac imaging covering all modalities,predominantly for radiologists. Since2004, however, we have been open to all those involved with cardiac imagingincluding cardiologists, radiologists,cardiac technicians and radiographers.Our numbers have grown swiftlyparticularly with the rapid growth ofinterest in Cardiac CT and CMR. Webecame affiliated with the BCS in 2006.
The objectives of the Society are to:
• Promote the highest standards ofpractice of cardiac imaging in theUnited Kingdom.
• To promote the exchange ofinformation, education and training in all aspects of cardiac imaging.
• To advise the Royal College ofRadiologists and British CardiovascularSociety regarding cardiac imaging.
A main aim of the Society is to nurtureand evolve the links between thecardiology and radiology communities and we were particularly pleased tobecome an affiliate group of the BCS.
Our annual meeting in 2007 was held inApril at the Royal College of Physicians in Glasgow and entitled “Imaging of ChestPain”. With an international faculty, themeeting was extremely well attended and feedback was excellent. Our secondmeeting was hosted jointly with the RoyalCollege of Radiologists in October 2007at the Royal Institution of British Architectsin London. This was also very successfulwith a wide-ranging selection of topicsfrom dual source CT through to MRIperfusion and the basics of congenital
heart disease. In addition, we co-hostedpopular sessions at the 2007 ASC andthe UKRC.
In addition to our programme of meetingswe have been actively involved in trainingissues. We have provided an updatedsub-specialty curriculum for the RCR incardiac imaging and continue to workclosely with the BCS to draw up theirguidelines on sub-specialty training forimaging. More work remains to be donein these areas, specifically in identifyingand providing good training opportunitiesfor cardiac MR and CT.
We are currently undertaking abenchmarking exercise for cardiac cross-sectional imaging to support ourmembers and offer realistic guidelines for job planning – an issue we areregularly asked about by our members.We have contributed heavily to the sixth ‘Making the best use of clinicalradiology services’ (MBUR6) document of the RCR, and provided expert advice
on cardiac CT and MRI to several NICEguideline groups.
The Society has recently changed itssecretarial support and is about to updateits website via a new host. This will resultin smoother running of the administration,much better communication with ourmembership and enhanced facilities forour members on the website.
Plans for 2008 include lookingat accreditation for cardiacimaging, starting with cardiacCT (working with the SCCT).Following consultation withour members we will look atthe need and mechanismsfor providing formalaccreditation in cardiac CT.Depending on progress we may be able to offeraccreditation services to ourmembers during 2009.
Visit our website for furtherinformation on BSCI.www.bsci.org.uk
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BRITISH SOCIETY OFCARDIOVASCULAR MAGNETICRESONANCE (BSCMR)Chairman: Prof Dudley Pennell
The BSCMR continues to grow and nowhas 80 members. We hold an AnnualSociety Meeting, and also contributescientific and educational sessions to theBCS Annual Scientific Conference (ASC).
The 2nd BSCMR Annual Meeting in March2007 was a great success, with nearly100 attendees and several exhibitors. We also introduced the CMRInvestigators’ Prize at the meeting,which was of great interest, and the
Society will continue with this initiative for future meetings.
Four abstracts wereselected for
presentation
and judged by Prof Stephen Ball (Leeds),Dr Gerry McCann (Leicester) and Dr Charles Peebles (Southampton):
• Dr Stuart Watkins (Glasgow) presenteddata on the relationship between CMRmyocardial perfusion defects and thefractional flow reserve, which is basedon coronary pressure measurementproximal and distal to coronary stenosis(1st prize).
• Dr Chen (Oxford) compared myocardialperfusion imaging between the twofield strengths of 1.5T and 3T.
• Dr Chalil (Birmingham) presentedoutcome data in patients with heartfailure related to CMR measures ofdys-synchrony.
• Dr He (London) presented experiencein the design and implementation of a T2 quantification technique for themeasurement of cardiac iron in betathalassaemia major.
The 3rd BSCMR Annual Meeting will take place in Leeds on 2 April 2008, and will include an extended ‘Read caseswith the experts’ session, following the popularity of this type of session at the 2007 meeting.
At the BCS ASC in June 2007, BSCMRcontributed to three sessions:
• Optimising the use of multimodalityimaging in cardiac patients. A case-based approach.
• Should CMR be used routinely in heartfailure?
• When cardiovascular magneticresonance (CMR) makes the difference– cases in heart failure: read with the experts’.
The BSCMR continues to be involved withseveral projects focusing on educationand training including:
• The core curriculum in CMR as part ofthe cardiology SpR training scheme; theSociety has identified first and secondtier CM centres suitable for training andhas agreed criteria for the inclusion ofa unit as a training centre.
• Survey of CMR activity for 2006 and2007 in order to gain a clear nationalperspective of CMR activity in the UK.
In 2008, we will be holding elections for Board membership.
Please watch for details and visit ourwebsite, www.bscmr.org for more aboutthe Society and its projects.
BSCMR
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BRITISH SOCIETY FORCARDIOVASCULAR RESEARCH(BSCR)President: Prof David A Eisner
BSCR Main MeetingsOur Autumn 2007 meeting was held on24-25 September at St Thomas’ Hospital,London during which we held our AGM.Organized by Dr Michael Curtis, themeeting focused on ‘The QT Interval and Drug-Induced Torsades de Pointes’and was made up of three symposia each asking a provocative question: ‘Is QT prolongation always intrinsicallyarrhythmogenic, or intrinsicallyantiarrhythmic?’; ‘How validated arecurrent models and biomarkers for testingdrug-induced torsades de pointes liability?’;and ‘Drug-induced torsades de pointes –now what?’. A report of this meeting waspublished in the BSCR Quarterly Bulletin(Vol. 21, No. 1) and abstracts are found athttp://heart.bmj.com/cgi/content/full/94/2/e1
British Cardiovascular Society SymposiaAt the 2007 Annual Scientific Conferenceof the BCS held in Glasgow during 4-7 June, the BSCR was involved inorganising four sessions: a teach-inentitled ‘Is the failing heart in need ofmore energy?’ with the British Society for Heart Failure (BSH); a symposiumentitled ‘Molecular and clinical aspects of vascular calcification: prognostic andtherapeutic implications’; a symposium on‘Endothelial dysfunction and thrombosisfollowing stenting: scientific and clinicalissues’ with the British AtherosclerosisSociety (BAS) and the BritishCardiovascular Intervention Society(BCIS); and a symposium on ‘Cytotoxicchemotherapy and the heart’ with theBSH and the British Society forEchocardiography (BSE).
Committee, Officers and ElectionsAt the end of 2007, there was a change ofSecretary and several changes in generalcommittee membership. Dr Michael Curtis
Chairman: Professor David Eisner
(01/06 – Present)University of Manchester
Secretary: Dr Christopher Jackson
(01/08 – Present)University of Bristol
Treasurer: Dr Michael Curtis
(01/08 – Present)King’s College, London
BAS Rep: Dr CMH Newman
(01/06 – Present)University of Sheffield
Committee Members:Dr Yvonne Alexander Dr Andrew Grace(01/08 – Present) (01/06 – Present)University of Manchester University of Cambridge
Dr Katrina Bicknell Dr David Grieve(01/08 – Present) (01/08)University of Reading Queen’s University, Belfast
Professor Barbara Casadei Dr Cathy Holt(01/06 – Present) (01/06 – Present)University of Oxford University of Manchester
Dr Alison Cave Dr Nicola King(01/08 – Present) (01/06 – Present)King’s College, London Universiti Brunei Darussalam
Bulletin Editors:Dr Nicola Smart Dr Helen Maddock(09/99 – Present) (09/01 – Present)University College London Coventry University
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was re-elected as Treasurer. Prof BarbaraMcDermott stood down as Secretary after6 years of excellent service to the Societyand was replaced by Dr ChristopherJackson (University of Bristol). The newcomposition of the Committee is shown in the box on page 20.
SponsorshipGlaxo SmithKline gave a generouseducational grant of £5,000. Dr MichaelCurtis obtained additional funding for theAutumn 2007 meeting and we aregrateful to the British Heart Foundation,Abbott, AstraZeneca USA, JanssenPharmaceuticals, QTest Labs, Servier,Data Sciences International and Roche UKfor generous support. The journal, ClinicalScience, continued to sponsor a YoungInvestigator Award of £250, given ateach meeting for a best presentation.
Visit our website for further informationon BSCR, www.bscr.org
BRITISH SOCIETY OF ECHOCARDIOGRAPHY (BSE)President: Dr Simon Ray
Membership and AccreditationThe British Society of Echocardiographyhas had another successful year.Membership stands at over 2300,representing almost every acute hospitalin the UK. The annual meeting in Edinburghattracted over 500 delegates and 425candidates sat accreditation exams in2007. One hundred and ninety threecandidates achieved transthoracicaccreditation, two obtained communityaccreditation, and 18 TOE accreditation.
Website DevelopmentsWork has begun on a major redesign of the BSE website (www.bsecho.org) to improve communications with ourmembers. In parallel with this, theSociety’s database is being redesigned tostreamline our administration and allowon-line registration and payment formeetings, exams and other events.
Review of the ConstitutionA review of the BSE constitution isunderway. The Society has grown rapidlyover the last few years and we areaiming to ensure that it becomes moreresponsive to the needs and aspirationsof its members.
Workforce IssuesWe continue to engage with theDepartment of Health and other bodies toensure that sonographers are appropriatelybanded under Agenda for Change andthat echocardiography is performed bysuitably qualified and experienced staff.Staff recruitment and retention remainmajor problems nationally and we areactively involved in seeking solutions tothese issues.
Departmental AccreditationThe Departmental Accreditation processhas been extensively revamped and thenew version will be available on the BSEwebsite from March 2008. We are aimingfor a major expansion in the number of
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accredited departments over the next two years. Our procedures have beenadopted to form the basis for theLaboratory Accreditation currently beingpiloted by the European Association ofEchocardiography.
Echocardiography in Intensive Care and Emergency SettingsWe recognise that limited resources meanthat it is impossible for many cardiologydepartments to provide a continuousechocardiography service for acutelyunwell patients. The BSE has been
working closely with representatives from intensive care, acute medicine andemergency medicine to develop trainingprograms and an assessment structurefor clinicians working in these areas whowish to gain skills in echocardiography. It is likely that there will be a basic test of competence in the assessment of theshocked or ‘peri-arrest’ patient that willbe applicable to emergency medicine and the majority of acute medicinepractitioners, while some intensive carephysicians will require a more advancedlevel of training leading to a modifiedversion of full BSE accreditation.
Education, Training and GuidelinesThe BSE continues to develop itsinvolvement in education and training. Thefirst core training day in echocardiographywas held in conjunction with the autumnmeeting in Edinburgh and attracted 70 delegates. Several successful jointsessions were held during the BCSAnnual Scientific Conference in Glasgow
and the BSE also contributed to Euroecho10 in Lisbon.
BSE representatives have jointly led the development of proposed clinicalstandards for the management of mitralregurgitation. Minimum datasets for theimaging of Marfan’s syndrome andHypertrophic Cardiomyopathy are underdevelopment and we will publish jointlywith the British Heart Foundation a posterof normal values for transthoracicechocardiography. The BSE Journal ‘Echo’ is published four times per yearand is sent to all members.
In conjunction with the BCS and the SACfor Cardiology, the BSE has developed a curriculum for the training of SpRs inechocardiography. We have also planned a national training day in advancedimaging to be held in March 2008.
Visit our website for further informationon BSE, www.bsecho.org
BRITISH SOCIETY FOR HEARTFAILURE (BSH)Chair: Prof Martin Cowie
In 2007, the election of the new BSHBoard took place and the new Chair forthe period June 2007–May 2009 isProfessor Martin Cowie.
The highlight of the year was the 10th BSHAnnual Autumn Meeting entitled ‘Bridgingthe divide in heart failure’ and ‘Advancedheart failure management challenges’.This day and a half meeting was attendedby a large multi-disciplinary audience ofover 300 participants, and evoked somelively and thought-provoking discussion.
The Society was also involved with eightsuccessful sessions at the BritishCardiovascular Society (BCS) AnnualScientific Conference 2007, incollaboration with other BCS-affiliatedgroups. The programme titles included:
1. Diabetes mellitus and heart failure(joint session BSH/Diabetes UK)
22
2. Is the failing heart in need of moreenergy? (joint session BSH/BCS/BSCR)
3. Should CMR be used routinely in heartfailure? (joint session BSH/BSCMR)
4. Atrial fibrillation in heart failure (jointsession BSH/HRUK)
5. The right stuff (joint sessionBSH/BCCA)
6. Workshop: When cardiovascularmagnetic resonance (CMR) makes thedifference – cases in heart failure:read with the experts (joint sessionBSH/BSCMR)
7. Cytotoxic chemotherapy and the heart(joint session BSH/BSE/BSCR)
8. Audit session including heart failure
We have also been involved in a number of other important initiatives and collaborations during the past year, including:
• The National Heart Failure Audit, runjointly by The Information Centre forHealth and Social Care (The IC) and
the BSH, and funded by the HealthcareCommission, was rolled-out in July2007. By the end of year, 33% of Trusts had registered or weresubmitting data, and 5256 cases had been submitted. Early findings of the Audit are included in a report by The IC posted on the BSH website(www.bsh.org.uk).
• Results from the HealthcareCommission survey on heart failureconducted during 2005/06 werereported in July 2007 in a publicationtitled ‘Pushing the boundaries –improving services for people withheart failure’. The survey assessed 303 healthcare communities in Englandon the basis of four key criteria:diagnosis; treatment; care and support;and outcomes. The BSH provided advice to the Healthcare Commissionon the design and analysis of thisimportant audit, a summary of whichwas published in Heart (Nicols ED et al. Heart 2008; 94: 172-7).
• Further input to the National KnowledgeService Heart Failure Project, aimed atfacilitating access to information aboutheart failure.
• Advice to the National Institute forClinical Excellence on its heart failureguideline implementation tool forcommissioners.
• Further input to PMETB on thedevelopment of a training curriculumfor registrars specialising in heartfailure.
• Continuing nurse education inpartnership with Glasgow CaledonianUniversity and the British HeartFoundation, now also franchised to theUniversity of the West of England inaddition to the University of Leicester.
• Continued engagement with the HeartFailure Association of the EuropeanSociety of Cardiology to provideinformation on relevant services in theUK, and to share good practice.
• Collaboration with publishers to enableBSH members to receive discounts onheart failure-related books.
• The 3rd BSH Charity Ball, which furtherincreased the profile of the Society andproved to be an extremely enjoyableevening.
For more information on the aboveprojects and future plans, please see the BSH website www.bsh.org.uk.
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Annual Report 2008
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24
HEART CARE PARTNERSHIP (UK)(HCP UK) President: Mr David H Geldard
Towards the end of the year we askedour Trustees to list the organisations and committees and groups on whichthey serve. The result has been an awe-inspiring catalogue of involvement of cardiovascular representation, interestand often leadership at local, regional and national level and beyond.
As the patient arm of the BCS, wecontinue to act as the Society’s mainsounding board and contact for matters relating to patient and public participation. Similarly, because of our broad ranging clinical interests, our involvement with the affiliated specialist clinical groups is also blossoming. Our relationship with BACR and BANCC is well established and proves to be mutually beneficial. During the year we have been welcomed to their national
and international conventions and awardceremonies, we have cooperated incourse and programme planning and inother areas. Our involvement with otheraffiliated groups, especially PCCS, BCIS,HR(UK), SCST and the researchers in basicscience is increasing. As a consequenceof progress and development in recentyears, we have witnessed a rise in end-of-life issues as heart patients, whoused to die young or suddenly, are nowenabled to live out their lives morefruitfully and usefully. Thus we have beenworking more closely with BSH and with
BCCA. We can, therefore, be relied on tohave a meaningful view on most issuesaffecting patients and their clinicalpathways and we are keen to engagewith others in all aspects of thecardiovascular patient journey.
All levels of service provision know that more needs to be done to improvethe quantity and quality of cardiacrehabilitation. At the launch of theNational Campaign for CardiacRehabilitation in April at York University,three of our Trustees were speakers on
the programme, Dr Jane Flint, TrudieLobban and our President.
The Campaign has gone well. Right fromthe start HCP (UK) were involved in theplanning process alongside BACR, buthuge credit must go to BHF who havebacked the campaign with theirformidable expertise and resources whichno one could have done better.
At the BCS Annual Scientific Conference in Glasgow in June, at a joint symposiumwith BACR and BANCC, Dr Jane Flint
HCP (UK) Trustees, from left to right: Azeem Ahmad, Anne Jolly, David Geldard,
Ken Timmis, Carol Reilly, Peter Diamond
formally launched the strategy for a freshand comprehensive approach to Womens’Heart Health. In October Dr Flint gave asimilar presentation to the UK launch ofthe European Heart Health Charter whereher group’s recommendations wererecognised and prioritised as the BCScontribution to implementation. Thestrategy was also presented to the
Department of Health’s CardiovascularProgramme Board in November, where itwas recognised as a significant pillar ofevidence and intent in the wider aspect ofinconsistencies in provision for womengenerally. Unexpectedly we had delivereda fresh chapter of evidence on genderinequality to an important mainstreamWestminster review.
On another memorable day in Whitehall in December our President and President Elect, together with the BCSHon. Secretary, gave presentations to apacked room at an All Party ParliamentaryGroup on Medical Technology supportingthe provision of drug eluting stents. We must have been the final straw onsome one’s back, as NICE issued anapproval report a short while later, albeit with financial restrictions.
The Arrhythmia Awareness Week Partnerscontinued to raise interest around NSFChapter 8 arrhythmias and sudden cardiac
death; most recently targeting the primarycare sector.
Early Day Motion 395 “cardiac arrest inschools”, urging Government to bringforward a strategy to include AEDs in allschools to help save lives, was tabled onbehalf of SADS UK and gainedconsiderable parliamentary backing.
Judging by very recent DoH good newsthat the target to cut cardiac deaths inpeople under 75 has been met five yearsearly, we can all take a deserved bow.But epidemiologists are today reportingconcern of significant increases in heartdisease in younger people. We are wellplaced to participate in that too, and werewe not right to support SUSTRANS andthe like, I can feel the “Age of Prevention”coming on.
The process of involving and engagingpatients is now regarded as acornerstone of sound clinical practice.
The BCS took an early lead in what wasthen a novel practice and we still have a way to go, but our HCP (UK) team havebeen warmly received and acceptedamongst the professional ranks and werelish the prospect of further engagement.
For more informaation on HCPUK, [email protected]
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Annual Report 2008
David H Geldard, President, Heart Care Partnership (UK)
Annual Report 2008
PRIMARY CARE CARDIOVASCULARSOCIETY (PCCS)Chair: Dr Terry McCormack
2007 saw the tenth anniversary of thePrimary Care Cardiovascular Society, and the Society celebrated this auspiciousoccasion by holding its Annual ScientificMeeting and AGM in London for the firsttime. The theme ‘Looking to the Future’included a review of where we havetravelled since the creation of the Society,where we are now and where we mightgo in the future. It featured several highprofile speakers including the Rt Hon
William Hague MPand AdrianSanders MP,as well asmany otherleadingmembers ofour clinicalprofessions.
The PCCS Special Interest Groupscontinue to thrive, each holding theirseparate meetings throughout the year,as well as participating in the AnnualScientific meeting. In fact both the GPSI(GPs with a Special Interest) Forum inCardiology and the CVNL (CardiovascularNurse Leaders) Forum had a dedicatedday at the annual meeting. In addition,having attended meetings with theDepartment of Health to discuss thevascular risk assessment programme, theCVNLs were invited to attend a receptionat the House of Commons on the daypreceding the PCCS conference to launcha new vascular risk initiative.
Throughout the year, the PCCS maintainedand developed its contact with externalorganisations. It continued its strongaffiliation with the British CardiovascularSociety with membership of Council aswell as participation in its AnnualScientific Conference. This year the PCCS
was involved in three symposia at the BCS conference in Glasgow which werejointly organised with the BritishHypertension Society, the British Societyfor Heart Failure and Heart Rhythm UK.
The restructuring of the British HeartFoundation administration saw thecreation of the Care and PreventionCommittee to which the PCCS was invitedto provide representation. Another activityinvolving the BHF was the establishmentof the Cardio & Vascular Coalition (CVC).This is a voluntary organisation of some29 cardiovascular charities, including thePCCS, whose remit is to developrecommendations for a CVD strategy forEngland to replace the NSF for CHD whichcomes to an end in 2010.
We are currently planning joint meetings for2008 with the General Practice AirwaysGroup and the British Hypertension Society.We are also in discussion over joint
ventures with HEART UK, the NationalObesity Forum and the Association ofPrimary Care Societies within the RCGP.
The Society has continued its programmeof Parliamentary activities to campaignfor a targeted, comprehensive vascularrisk screening programme, meeting withkey ministers of health and oppositionhealth spokespeople at the Labour and Conservative conferences andattending follow up meetings with healthspokespeople from all political parties.
Finally, a tribute to Gill Brown who died of a brain tumour early in 2008. Gill played a key role in the success of the Society over recent years and will be sadly missed.
For more information on the work ofPCCS visit our website, www.pccs.org.uk
Dr Terry McCormack
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SOCIETY FOR CARDIOLOGICALSCIENCE AND TECHNOLOGY(SCST)Chairman: Dr Chris Eggett
The Society for Cardiological Science andTechnology is celebrating its DiamondJubilee during 2008. For the past 60 years the Society has successfullyimproved standards in terms of educationand training for all staff involved incardiac investigations. How things havechanged from those early days wherestaff were responsible for the use of a string galvanometer. Certainly verydifferent from today’s highly specialistpractitioners with the skills andknowledge to programme compleximplantable devices, run advancedelectrophysiological mapping systems and produce the detailed echo reportsthat are required for the diagnosis and effective treatment of patients withheart disease.
The current membership of the Society is at an all time high. However, thereremains a national shortfall in the cardiacphysiology workforce, particularly in thespecialist areas of echocardiography andcardiac rhythm management. Fortunately,the current focus on waiting times meansthat diagnostic procedures are definitelyvery high on the agenda. CardiacPhysiologists and the roles we undertakeare, at last, beginning to be considered by health service planners. During 2007there were numerous meetings at anational level specifically relating tocardiac diagnostics and SCST membershave worked closely with the Departmentof Health to produce good practice guidesrelating to cardiac investigations.
The Cardiac Physiologist workforce hasalso been independently reviewed onbehalf of the British Heart Foundation(BHF). As a result of work that theycommissioned, the BHF has made a significant investment by funding ten
clinical trainers across the UK with a specific remit to develop the cardiacphysiologist workforce.
In recognition of the shortage of skilledprofessionals, the Welsh Assembly hasestablished a second degree course inWales. It is also very encouraging to seethat Cardiac Physiologists featureprominently in a strategy document fromthe Scottish Executive. Funding has beenidentified and SCST hope to see progresswith the first degree programme inScotland during 2008. The Northern Irelandbranch of the Society has been proactivelocally as well as making significantcontributions to the work of SCST Counciland Education Committees. Their membershave developed the programme for thisyear’s scientific meeting and designed thenew website that will be launched as partof the Diamond Jubilee celebrations.
A major disappointment for the professionduring 2007 was the news of yet another
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delay to statutory regulation. Publicprotection must be paramount, particularlyat a time when policy dictates thatservices are moved out of the relativelywell controlled hospital environment and new providers are enticed into thearena. The primary purpose of statutoryregulation is to assure patients that theprofessionals they come across in ahealthcare setting have successfullycompleted a recognised training pathwayand continue to undertake professionaldevelopment in order to maintaincompetency. With the recognised trainingpathways firmly established, bureaucracyis all that is preventing statutoryregulation from being introduced. The further delay looks likely to last some years, SCST find this completelyunacceptable and will continue to workwith partner organisations to try andmove forward on this critical issue.
SCST education experts, busy as alwaysduring 2007, produced updated guidance
on the management of bradycardiapacemaker follow-up clinics that has beenendorsed by the British CardiovascularSociety. They also successfully ran thelargest national examinations to-date atthe NEC in Birmingham. Planning theseevents is a huge logistical feat and theirsmooth running bear testament to theexaminations team meticulous attention to detail.
Details are beginning to emerge regardingplans for a significant overhaul of the way scientific staff are trained for theirwork in the health service. The specificeffect upon Cardiac Physiologists has yet to become clear but there is likely tobe change on the way and SCST will beresponding appropriately to any proposals,thereby continuing the work that beganway back in 1948.
Visit our website for further informationon SCST, www.scst.org.uk
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Working Groups and other ReportsWORKING GROUP ON TRAINEEEDUCATIONChair: Dr Alun Harcombe
The Working Group on Trainee Educationwas set up in June 2007 under the aegisof David Crossman as VP for Educationand Research. The group was assembledto make a broad review of cardiologyeducation for trainees; aiming to scopepresent activity, define any shortfalls in relation to the new curriculum, andrecommend ways that the BCS couldenhance future educational provision.Membership includes representativesfrom the major specialty sub-groups, the Specialist Advisory Committee forCardiology, the President of the BritishJunior Cardiologists Association, theCommunication and Education committee(formerly known as Information andSurveys committee), the KnowledgeBased Assessment examination incardiology and key personnel from theBCS itself.
There are many drivers for change incardiology education, not least the majorupheavals related to the ModernisingMedical Careers process, but includingincreased fragmentation of training as the working hours directive altersprevious patterns of work-based learning.Responding to these challenges poses a number of problems in maintainingstandards and allowing equal access tokey resources. In addition opportunitiespresent themselves to make best use of technology in providing education,particularly in niche subjects and difficultconcepts. There is also an opportunity forthe Society to capitalise on the excellenteducational provision already available in many areas, most of it provided bymembers of the BCS, in enabling betterco-ordination between these events andfuture plans, particularly at regional level.
Over the past year the group has draftedand circulated two surveys, one targetedat the consultant membership of the BCS that is complete and another aimed
specifically at Training ProgrammeDirectors that is ongoing. In addition we have benefited greatly from input andaccess to the British Junior CardiologistAssociation’s own survey of its members.The insights gained from these threeactivities are helping to shape the directionof travel of the group and inform decisionsabout future educational activities. All members of the Society are invited to contribute any thoughts they have tothe chair of the Trainee Education Group.
During a series of meetings andworkshops the group has identified keyissues, begun to plan a future strategy andto assess the best use of resources intraining the cardiologist of the future. A keyrelationship is with the Communicationand Education committee, who arerepresented on the working group and it is clear that one of the main themes is increased use of the BCS website as a repository for information, includinga planned searchable database of allcardiology educational programmes as
permitted or supported by the relevanttraining programme directors. A numberof other initiatives are proposed, includinga core web-based programme ofeducational packages designed toaddress the problems of topics that areotherwise difficult to access and areasthat specialty groups feel are overlooked.There are no plans for a new textbook,on-line or otherwise, but a coherenteducational programme linked with realworld events and co-ordinated centrally to ensure all trainees are able to accessas much education as possible is indevelopment. In addition the group isexamining whether new courses, atnational or regional level, should becommissioned to address the needs of new training patterns, for examplebased around the requirement to sit the Knowledge Based Assessment.
The Working Group on Trainee Educationaims to complete its review and producea draft report by the time of the AnnualScientific Conference in June 2008.
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WORKING GROUP ONPRACTITIONERS WITH A SPECIALINTEREST IN CARDIOLOGY (PwSI)Chair: Dr Mark Dancy
This group reported to Council on theproposal that the British CardiovascularSociety should become the accreditingbody for all Practitioners with a SpecialInterest in Cardiology (PwSI) in March2007. Council accepted therecommendations of the working partyand the Chair is now working toimplement them.
A meeting was held with a group oforganisers of courses for training PwSI in October 2007 to explore their attitudestowards BCS accrediting their courses.The majority were in favour of the idea of visiting BCS-appointed examiners whowould accredit their courses using anaccreditation process based on the Heart Improvement Programme’s Skills-Based Framework for Training PwSI in Cardiology
(http://www.heart.nhs.uk/heart/Resources/DocumentsforSharing/tabid/68/Default.aspx). On the basis of thatmeeting it was agreed to pilot anaccreditation process with two existingcourses and one in development.
The accreditation process is now beingdesigned by members of the Society and will then be piloted with the threecourses before being refined andoffered to all the remainingcourses in England.
In parallel with this work,DH has developed a generic set ofproposals in the samearea. There are somepotentially importantdifferences betweenBCS and DH ideaswhich will need to berationalised. The maindifference is that theDH definition of a PwSI
excludes nurses, and that is clearly notappropriate for Cardiology.
The Chair is working with DH on theseissues, and as he and Kathryn Griffith(GPwSI, and Chair of GPwSI group ofPCCS) have been asked to write the first
draft, we believe that these issuescan be ironed out. The DH
Framework is likely to bepublished electronically in
late spring.
WORKING GROUP ON WOMEN’SHEART HEALTHChair BCS Working Group for Women’s Heart Health: Dr Jane Flint
The BCS Joint Working GroupRecommendations for Women’s HeartHealth were launched at the 2007 ASC inGlasgow, and their context in the EuropeanHeart Health Charter (EHHC) wasrecognised at its launch in Brussels. Therewas immediate media interest and this hascontinued during the year, contributionsvarying from interview on Woman’s Hourin June to copy in ‘Take a Break’ January2008. The full report is being finalised forpublication with hopefully joint sponsorshipfrom industry and the ESC.
Professional dissemination continued withpresentation to the Cardiac Networks’Clinical Leads’ meeting in July 2007, BHFNurses in October, and I was also invitedto report to the CHD Programme Board atthe DoH in November. The ‘Her at Heart’Symposium II in September followed on
Annual Report 2008
well from our joint BANCC/BACR/HCP (UK)session at the ASC and useful discussionregarding research recommendationswith the National Director ProfessorRoger Boyle has further informed ourdocument, as have policy statements fromBHF with regard to Gender Equality Duty.The challenge to raise awareness and theneed for appropriate risk assessmentmust tackle both health professionals andthe community. Our affiliated group HCP(UK) has been very active in promotingjoint working with other affiliated groupsas we approach this year’s ASC inManchester. For the first time there willbe two sessions specifically addressingthe issue from different aspects,and wehave brought on board BSH and BCCA.A ‘Women’s Track’ will also be identifiedwithin the meeting. Teaching our medicalstudents and MDTs Cardiology shouldinclude the opportunity to study women’scases, and our junior doctors should bemade aware of the issues in their trainingso that future medical practice in alldisciplines understand women’scardiovascular risk.
WOMEN IN UK CARDIOLOGY BCS Council Representative for Women in Cardiology: Dr Jane Flint
The Royal College of Physicians’ 2006Census published in December 2007finds almost half of all consultantphysicians under the age of 35 to bewomen. The 6.4% increase in femaleconsultants during the last year wasexceeded by Cardiology at 12%, with 8 of 17 new consultant appointmentsbeing female, bringing us to 9.1% overallin the specialty compared with 25%overall in medicine. The RCP census foundmore than 20% of our SpRs in Cardiologyare now women, and congratulations goto four more Higher Specialist TrainingCommittees (HSTC) – Oxford, SW London,Northern Ireland and NE Scotland – whohave achieved the 25% goal set for thisyear. Professor Jennifer Adgey hasretired this year, but there are two newwomen Chairs of STCs – Alison Calver inWessex, and Justein Sim in Dundee. Thenumber of trainee appointments’committees always including a woman
has doubled to 50% this year, and wouldbe higher still if there were more womenconsultants available in some regions,and holding their Equal Opportunities’training certificate.
Our Women’s Network and progress in recruitment have been shared with the Medical Schools’ Career database,European and Global Networks forwomen in Cardiology. Medical studentsand junior doctors have made most useof it to date. I am looking forward tosharing our progress at the AmericanCollege of Cardiology March/April 2008in Chicago. Professor Catherine Ottoattended our Network meeting at the2007 ASC in Glasgow and shared womentrainees’ experiences from the USA. An important appointment this year is that of Jean McEwan to ‘ImprovingWorking Lives’ Officer for the RoyalCollege of Physicians – look out forarticles in Clinical Medicine!
The Gender Equality Duty for England,Wales and Scotland requires public
bodies to eliminate unlawful discriminationor harassment against either women or men and ensure that policies do notmaintain or lead to gender inequality. The NHS was asked to implement this2006 legislation from April 2007. TheWomen in Academic Medicine summaryand recommendations were published inJuly 2007 concentrating on appointmentsand promotions processes, structures,systems and activities in place regardingcareer progression, organisationalarrangements and culture, and flexibilityin working life. They reflect and amplifyour 2005 recommendations and Councilin October 2007 accepted them andsupported their sharing across theCardiology community. Theywill be available with ourother documents onthe BCS website this year.
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REGIONAL VARIATIONS INCARDIAC SERVICESChair: Dr Nick Boon
A working party to examine NationalVariations in Cardiac Services was set up in 2003 to examine concerns that the devolved nations had been disadvantaged by exclusion from theNational Service Framework. Its first report(Br J Cardiology 2005; 12 : 192-198)identified clear evidence of importantvariations between the four home nationsin the provision, delivery and planning of cardiac services that were not relatedto differences in need. A second report(Heart 2006; 92 : 873-878) extendedthese findings by providing 5-year trendanalyses and additional data on services,such as echocardiography, that were notevaluated first time around.
These findings prompted Council torequest an annual update and the groupsubmitted a third (unpublished) report
with additional data on rehabilitationservices in 2007. While collecting datafor these reports the members of theworking group became aware of similarvariations in service across the Englishregions. Council has therefore requesteda more comprehensive review of servicesbroken down by country and region.
This constitutes a major task and willoverlap, to some extent, with the BritishHeart Foundation’s and Cardio & VascularCoalition’s plans to model the futureburden of cardiovascular disease in UK.Although the project is still in its infancywe intend to produce a draft report in theSpring of 2009.
HEARTEditor: Dr Adam Timmis
1. The journal honoured the memory ofRaphael Balcon (former President BCS)with a full page obituary in the May2008 issue.
2. We started the New Year with a newlydesigned journal cover – moreminimalist and hopefully more eyecatching than previously.
3. Submission rates remain high with theinevitable corollary of high (c 85%)reject rates and unacceptable waitingtimes for paper publication althoughelectronic publication is rapid byOnlineFirst. Solutions to these signalsof success are being actioned orconsidered and, in addition to items4 and 5 below, include:a. Electronic-only publication of papers
to clear backlog (actioned).b. Managing the waiting list of papers,
with a fast-track for the most highlyranked (actioned).
4. The Management Committee hasconsidered and now sanctioned movingto twice monthly publication. This will beactioned in 2009, when 24 editions ofHeart will be published. The purpose ismore towards production of a smallermore focused journal than a vehicle forincreasing volume, although the changewill, of course, give us more flexibility inthat direction. It will also bring us intoline with other major cardiac journals.
5. We also have plans to develop a stable of specialist sister journals. The first stepin that direction is to develop a HeartInterventional Journal. This will beaugmented with the development of additional specialist journals over the next few years to extend ourpublication portfolio and keep track with similar developments in othercardiovascular journals (Circulation,JACC, EHJ).
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Annual Report 2008
MembershipThe British Cardiovascular Societycurrently has over 1,650 members andwe are actively recruiting to increasemembership numbers further. Ourmembers are healthcare professionals,working in the field of cardiovascularhealth. A large majority of our membersare Cardiologists and we are particularlykeen to encourage Specialist Registrars in training to apply for BCS membership.
Membership BenefitsOne of the key areas of the Society’swork that President Nicholas Boon haschosen to focus on is the membershippackage that we offer. Currently, BCSmembership gives the following offers:
• Free access to Heart Online.
• A discounted subscription for themonthly journal Heart, a peer reviewjournal for health professionals andresearchers in all areas of cardiology.
• Free access to Cardiosource and JACC online in collaboration with the ACC,
which offers research, information,ongoing clinical trials, and newsregarding cardiovascular health.
• Free registration at our AnnualScientific Conference (if you register in time for the early-bird fees).
As the voice for those working incardiovascular health, science and diseasemanagement in the UK, BCS aims topromote and support both the healthcareprofessionals who work in cardiology.BCS membership gives our memberssignificant professional support, including:
• Professional representation with theRoyal College of Physicians.
• Representation at the Department of Health.
• Support for ACCEA Awards.
BCS members help to run the Societythrough their involvement in variousCommittees and Working Groups and of course, through our Executive.
Membership of the BCS enables you to have:
• All notices and electroniccommunications of the Society.
• Full participation in business meetingsand voting rights.
• The option to stand for nominated BCS positions or to become part of the ASC faculty.
• Access to the facilities of the Society’soffices.
Becoming a member of the BCS will alsogive you the ability to access the whole ofthe website including the members-onlyarea, which enables members to:
• Discuss issues of interest in thediscussion section.
• Make contact with other members in the members directory.
• Access restricted library documents.
Members ViewsDiscussions with Council, Affiliated Groupsand members have been taking placeover the Winter period to gather views on BCS membership. Taking on boardcomments on the lengthy applicationprocess for BCS membership, thefollowing changes are being implemented:
• New members will be given access tomembership benefits once the Boardhas approved individual applications,(rather than waiting till the AGM in Juneof each year).
• Payment and details will be collected on the application form to speed up the process further.
The application form still contains thecurrent criteria for election to ordinarymembership. For more details aboutmembership, the form can be downloadedfor new members from our website(http://www.bcs.com/pages/join.asp).
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We are keen to listen to the views of ourmembers. If you have a comment orquery on your BCS membership you canemail us at [email protected]
Membership CostsCurrent Membership Fees are:
• £258.50 for ordinary membership.
• £164.50 for the first two years ofmembership if you have an NTN.
• £164.50 if you do not hold clinics, e.g. you are a nurse, technician, basicscientist.
Our membership fee had to increase in2007 to take into account VAT, however,we believe that BCS membership remainsgreat value for our members. We continueto negotiate with our membership serviceproviders to ensure that our costs arekept as low as possible.
International BCS MembershipBCS is currently offering InternationalMembership to those working incardiovascular health, science anddisease management outside of the UK.International Membership is at a reducedfee of £75 + VAT and the benefits include:
• A free subscription of e-Heart
• All notices of the Society.
• A reduced subscription for attending the Annual Scientific Conference.
• All electronic communications of the Society.
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Annual Report 2008
Annual Scientific ConferenceThe 2007 BCS Annual ScientificConference was held in Glasgow, at theSECC. The conference was opened with a launch party on the Monday night in the Exhibition Hall; the event was a greatsuccess and will be repeated at futureBCS conferences. Also on the Mondaynight a BCS lecture was given, the topicbeing ‘Sixty years of UK contribution toCardiovascular Medicine’. The lectureincluded presentations from key figures
in the Cardiovascular field: ‘CardiacSurgery’ by Prof Sir Bruce Keogh; ‘Clinical Translation of Basic Science’ by Prof Peter Weissberg; ‘Arrhythmia’ by Prof John Camm; ‘Population’ by Prof Rory Collins; ‘Myocardial infarction’by Prof Keith Fox and ‘Heart failure’ by Prof Philip Poole-Wilson.
As has come to be expected, the 2007conference contained a wide selection of varied and informative sessions fromthe four main areas in CardiovascularMedicine: Heart Failure,Electrophysiology/Pacing, Interventionand Imaging. Monday was again theTrainee day and this year also includedan interactive session from the SAC. OnWednesday our affiliated group BritishAssociation for Nursing in CardiovascularCare (BANCC) held their national annualmeeting. Several of our affiliated groupsmake use of the ASC for their Council orAGM meetings as the ASC offers a rareopportunity for a large number of membersto be in the same place at the same time!
Some of the other highlights from the2007 conference included sponsoredsymposiums from top pharmaceuticalcompanies, the annual Young ResearchWorkers’ Prize (YRWP) and a variety ofTeach-ins and How To sessions onsubjects such as:
• Diabetes UK Teach In Session
• How To Select Patients For CardiacResynchronisation Therapy:Echocardiographic Criteria
• How To Set Up A Primary AngioplastyService
Many of the BSC affiliated groups ransessions and workshops on key areas in their sub-specialty, such as:
• Promoting physical activity in thesedentary cardiac patient (BACR)
• Multimodality Monitoring of ValveDisease (BSE)
• Is the Failing Heart in Need of MoreEnergy? (BSCR/BSH)
• Challenges and Complications in DeviceTherapy (HRUK).
Continuing with the educational theme,the 2007 exhibition contained interactivestands as well as informative stands andcafé areas. In addition, there were also279 abstracts presented over the fourdays of the Conference. This year theSociety hosted an internet café open to all delegates.
Over the 4 days that the conference ran,there were almost 3,000 visitors. 77% ofdelegates gave positive feedback that theconference fully met with their expectations. Sixty Years of Cardiology lecture at ASC 2007 Educational stand at the ASC Exhibition 2007
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The 2008 Annual Scientific Conference This year’s British Cardiovascular SocietyAnnual Scientific Conference will be inManchester from 2nd to 4th June 2008.The Programme Committee of the BCShave made a number of changes inresponse to feedback received from bothmembers and industry.
The first and perhaps most obvious is thatthe conference has been put into three fulldays, Monday, Tuesday and Wednesday –there are no half days at the beginningand the end. The committee hope that thiswill help those wishing to attend a goodproportion of the conference.
This year will see the return of theposters with the majority of abstractspresented in this format. Poster sessions
will occur at the end of Monday andTuesday. Those attending will be able toget a free glass of wine which it is hopedwill stimulate discussion of the posters!Moderated posters will continue. Wherethere are abstracts that can be groupedtogether, by virtue of a common theme,this will be done and these will be oralpresentations with an introductoryoverview talk on the subject.
Another new innovation is that there is ameeting within a meeting. BSCR will holdtheir Annual Conference on Monday andTuesday. We hope this continues in futureyears with different affiliated groups.
Interactive voting systems were viewedas a success last year and these will beextended to two rooms in the conferencecentre. This year we are going to trialweb casting of the major plenaries.
We hope that you will be able to attend.The reduced fees for early registrationfollow:
Internet Café ASC 2007
Registration Fees
Categories Early-bird Pre- On-site On-sitefees registration registration Day
On/before fees Ticket14/03/08 On/before
16/05/08£ £ £ £
BCS Full Members (including New Members)* 0 100 200 100
Full Member of Affiliated Group co-hosted at meeting – 2008 (BSCR Member) 0 100 200 100
Nurse/ Cardiac Physiologist/ Echocardiographer/Other Healthcare Professional/Scientist/Researcher 60 60 200 100
BJCA 60 60 200 100
Non-member Consultants , Staff or Associate Specialists 300 350 400 180
Non Members (including Industry) 300 350 400 180
Presenters/Chairmen 0 0 0 0
Annual Dinner Ticket 60 60 N/A N/A
* BCS members who are in arrears with their membership subscription will be charged the non-member rate.
Lecture at BCS Conference 2007
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Annual Report 2008
Divisional ReportsCLINICAL STANDARDS DIVISIONThe Clinical Standards Division wasformally established in 2006, and hasgrown up quickly since then! Dr DavidHackett was elected Vice PresidentClinical Standards for 2007-10. The Division has brought together the activities of the Clinical PracticeCommittee and various predecessorcommittees, the Cardiac WorkforceWorking Groups and Committees, and the Professional Standards and Peer Review Committee.
As reported last year, theBCS Executive decided in2007 to disband theProfessional Standardsand Peer ReviewCommittee, and theCardiac WorkforceCommittee. ProfessorMartin Cowie resignedas Chairman of the ClinicalPractice Committee in2007. Dr Adrian Brady
has been appointed as Chairman of the renamed Guidelines and PracticeCommittee. The Committee is meetingearly in 2008. A new committee, theClinical Standards Committee, has beenformed, and will take over the work of the Professional Standards and PeerReview Committee and the CardiacWorkforce Committee. Also, the newClinical Standards Committee will take the responsibility for discussing anddeveloping plans for recertification of cardiologists. The Clinical StandardsCommittee is also meeting early in 2008.
The main work of the ClinicalStandards Division during
2007-08 has included:• Divisional strategy review
meeting in early 2007;• Reviewing the roles and
responsibilities of BCSregional advisors;
• Divisional strategy reviewwith the British HeartFoundation (BHF) in early 2007;
• Representing BCS on BHF Prevention and Care Committee (specific areas ofresponsibility include cardiac workforceand training);
• Developing ways to establish trainingand provision of the appropriateprofessional cardiac workforce in UKwith the BHF;
• Developing the actions recommendedfrom the BCS Non-medical catheterlaboratory staffing working group reportwith the BHF;
• Developing a model of BCSaccreditation for Practitioners with aSpecial Interest, led by Dr Mark Dancy;
• Working with the Cardio-VascularCoalition, specifically on inequalities ofprovision of cardiac services, andmodelling the burden of cardio-vasculardisease in the UK, both now and in the future;
• Establishing a BCS Working Group onFitness for Air Travel withCardiovascular Conditions asrecommended by the House of LordsScience and Technology Committee
report on Air Travel and Health: anUpdate published in December 2007;
• Developing a structure forrecertification of cardiologists as part of revalidation for the General MedicalCouncil;
• Developing a Code of Practice formembers of BCS on the ethics ofinteracting with medical devicecompanies;
• Facilitating the setting of standards for mitral valve repair surgery (led byDr Simon Ray);
• Responding to consultations with the Royal College of Physicians onConsultant Physicians working forpatients (4th edition); Acute MedicalAdmission Proforma; Draft HandoverRecord v2; Draft Discharge Record v2;
• Responding to consultations on theDefinition of Specialised Services for Specialised Services NationalDefinition Set (SSNDS) forCommissioning of Specialised Services by the National SpecialisedCommissioning Group (NSCG);
Vice President: Dr David Hackett
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Guidelines and Practice Committee
The areas of responsibility of thiscommittee include:• Issues of principle affecting the practice
of cardiovascular healthcare;• Changes in clinical practice which could
affect cardiovascular healthcare;• Advice to the BCS on professional
matters which could affect the practiceof cardiovascular healthcare;
• Advice to BCS on matters ofprofessional practice referred to it byits ordinary members;
• Review of guidelines produced by theEuropean Society of Cardiology andother relevant professional groups, andto make recommendations on theirendorsement to BCS;
• Development of guidelines for clinicalpractice, as and when so instructed bythe BCS.
Guidelines reviewed by G&PC for BCS in 2007-08:
European Society of Cardiologyguidelines:• Management of Arterial Hypertension• Cardiac Pacing and Cardiac
resynchronisation therapy• Stable Angina Pectoris• Diagnosis and Treatment of Non-ST
Elevation Acute Coronary Syndromes• Atrial fibrillation• Ventricular arrhythmias and sudden
death• Diabetes, pre-diabetes and CVD• Valvular Heart Disease• Cardiovascular Disease Prevention in
clinical practice• Universal Definition of Myocardial
Infarction• The role of endomyocardial biopsy in the
management of cardiovascular disease
NICE Appraisals and guidelines• Drugs for the treatment of smoking
cessation (varenicline) • Guidance Preventing the Uptake of
Smoking by Children
• Drugs for the treatment ofhypercholesterolemia (ezetimibe)
• Development of a clinical practiceguideline on familial hypercholesterolemia
• Prevention of Venous thromboembolism(VTE) in medical patients
• Assessment and management of acutecoronary syndromes
• Clinical practice assessment inHypertension in pregnancy
• Drugs for the treatment of pulmonaryarterial hypertension
• Computed tomography (CT) angiographyfor the diagnosis and management ofcoronary artery disease
• Health Technology Appraisal of aliskirenfor hypertension.
• Antimicrobial prophylaxis againstinfective endocarditis
• Prasugrel for the treatment of acutecoronary artery syndromes withpercutaneous coronary intervention
• Lipid modification• Investigation, assessment and
management of acute chest pain ofsuspected cardiac origin
• Drug-eluting stents for the treatment ofcoronary artery disease (part review ofNICE technology appraisal guidance 71)
• Cardiac resynchronisation therapy forthe treatment of heart failure
• Secondary prevention in primary andsecondary care for patients following amyocardial infarction
Other guidelines reviewed:• Oxygen therapy in adult patients (British
Thoracic Society)• 18 Week Pathways on Atrial Fibrillation,
Chest pain and Shortness of Breath(NHS, Department of Health)
• Physiological Measurement – Standardsand Guidelines – TransthoracicEchocardiography (BSE)
• Consensus for Clinical ElectrocardiographyExercise Tolerance Testing (SCST)
• Guidance Information for ManagingBradycardia Pacemaker Follow-UpClinics (SCST)
• Supplemental Technical Information forrelating to Bradycardia Pacemakers(SCST)
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Annual Report 2008
CORPORATE AND FINANCIALAFFAIRS DIVISIONIn the last year, the Society has facedsome financial challenges. Revenue fromthe Annual Scientific Conference hascontinued to decline. Although interest in and attendance at the conference is maintained, Industry are persuadedthat they wish to invest less in theexhibition, traditionally an importantsource of revenue. Additionally, it hasbeen a volatile year for the stock marketwhere the Society has significant fundsinvested. Finally, it has proven necessaryto upgrade our headquarters at FitzroySquare to prevent the fabric of thisvaluable resource deteriorating.
Notwithstanding these issues, the Societyhas a surplus of £244,017 for the yearending 31st December 2007.
The Finance CommitteeThe Society’s financial health is overseen by a committee chaired by
the Vice President for Financial andCorporate Affairs, assisted by four Societymembers, Professor Martin Rothman,Professor John Deanfield, ProfessorDerek Yellon and Dr Paul Oldershaw. The Committee is grateful to receive sageadvice from two lay members with cityexperience Graham Meek and Tony Salter.Our accountants, Alexander Edward Leeare represented by Nicholas Kaye and we receive investment advice from theSociety’s brokers, Rensburg Sheppards.
The Annual Scientific Conference.The meeting in 2007 saw a further fall in revenue of £120,000. The officershave held severalmeetings with industryto develop ways ofworking better inpartnership. It isapparent that thefootfall of members in the exhibition hasdecreased greatly in
recent years such that Industry nowconsiders investing in a large stand to beeconomically unfavourable. However, weare gratified to learn from Industry thatthere is a desire to support the Society inwhat it is attempting to achieve, but thereis a clear signal that companies wish this investment to be increasingly directed towards educational opportunities and fellowships where the major financial beneficiary will be the Society.The President is actively pursuing theseopportunities.
HeartThis has been another excellent
year for the Journal which isco-owned with BMJ Publishing.This collaboration has netted£250,000 in 2007 and hasensured that the Society iscushioned from the loss ofrevenue from the Conference.As previously, we provide freeon-line access to the Journal
(normal subscription £95.00)
and members may elect to receive thepaper copy of the journal at a greatlyreduced subscription of £70.00 per year(normal subscription £172.00), held atthis attractive price for a further yeardespite rising costs. Members who preferto receive the paper version of Heart may arrange to do so by contactingFitzroy Square ([email protected]).
FellowshipsThe Society supports three fellowshipswith the welcome support of the Swire Trust, Astra Zeneca and BMS. This support includes salary for up tothree years and a contribution towardsequipment costs. These fellowships areadvertised annually. We also offer travel awards to allow the attendance oftrainees at courses, meetings or topresent scientific papers. Application for these travel awards may be made to Fitzroy Square.
Vice President: Dr Kevin Jennings
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MembershipCurrently, we have 1600 members and itis reassuring that, in 2007, 36% of thenew members were SpRs suggesting thatmembership of the Society is consideredrelevant to trainees. Nonetheless, manytrainees and newly appointed consultantsare not members and the Executivewould encourage members to bring to theattention of those training or working inCardiology the benefits of membership.The less overt roles of the Society includeeducation and training, setting standards,assessment and accreditation andlobbying of Government in the interest ofpatients and cardiologists. Additionally theSociety provides support for Cardiologistswho are under threat and for thoseseeking promotion through one of thesystems of NHS awards. Trainees enjoy areduced membership subscription. We alsoprovide free access to Cardiosource, theeducational on-line resource of theAmerican College of Cardiology (normalsubscription $190.00).
SummaryThe Society remains sound financially butthe reduction in revenue from the ASC isa continuing concern. Income fromalternative sources such as throughsubscriptions with enhanced membershipnumbers and our investment in Heart, willsecure the financial future of the Societyand allow us to develop our activities onbehalf of the membership. Finally, theSociety will need to look at a move tolarger premises more fit for purpose ifwe are to assume a greater role onbehalf of affiliated groups and to developnew activities to include assessment andaccreditation.
EDUCATION AND RESEARCHDIVISIONProgramme Committee for the AnnualScientific ConferenceThe Programme Committee has developedthe ASC in an environment of industrialcontraction in the Exhibition. Interest inthe ASC from members remains strongwith 461 abstracts submitted and over20 submissions of high quality forconsideration of the Young ResearchWorkers Prize. Against this backgroundthe Programme committee have made anumber of changes and built on existingplans for the development of the ASCas well as responding to feedbackfrom the 2007 meeting.
Meeting within a meeting.This year’s ASC will host oneof BSCRs annual meetings.The Programme Committeeare most grateful to theCommittee of the BSCR forsupporting this development,
which it is anticipated will be mutuallybeneficial. The concept of a small meetingwithin a larger one is not new but one thatespecially suits the BCS with its strongAffiliated Groups. A strategic direction forthe ASC is to develop Affiliated Groupmeetings at the ASC over the comingyears. This year the integration of basicscience with BSCR’s meeting gives a newtheme to the meeting with a clear basicscience track through the first two days.This development will be extended furtherby the British Atherosclerosis Societyhaving one of its meetings embedded
within the 2009 ASC in London. It is hoped that in 2010 BSCR
will return, and thus in thisalternating manner, abasic science track isassured. The ProgrammeCommittee and theExecutive are exploringincorporating otherAffiliated Groups in a similar manner.
Vice President: Prof David Crossman
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Annual Report 2008
Industrial Support for the ASC.There is some concern arising from the downturn in the amount of Exhibitionspace that has been sold. At the time of writing revenue from the selling ofExhibition space is approximately £460K,compared with a total last year of £630K.This mainly arises from companies taking smaller amounts of space butthere will be some companies that are absent this year. The ProgrammeCommittee believes the reasons for thisare multiple, and only some of these arein our control. Possible factors are; poorattendance at the Exhibition by attendeesat the Glasgow meeting, a feeling that the Exhibition stand is a mediumrepresenting poor value for money to the companies (the set-up fees areconsiderable and this money goes tocontractors), the turn down in the globaleconomy, the failure of a number of new CV drugs in phase 3 developmentand the alteration in the pattern ofpurchasing of drugs in the UK.
The Programme Committee seesdevelopment of the Exhibition Hall as anovertly educational venue as one solutionto some of the above. To support this,posters will be presented in the ExhibitionHall with free wine to those attending.There will be two lecture theatre areasbuilt up in the Exhibition Hall for lunchtime“how to” sessions and moderated posterpresentations. The meeting is now goingto be concentrated over three whole dayswhich it is hoped will increase the densityof delegate attendance.
The Programme Committee agreed anincreased flexibility of models for industrialfunding. Previously industrial funding through sponsorship of satellite symposiahas required that exhibition space is taken. This eligibility criterion has been removed and now support solely through satellitesponsorship is allowed, at an increased rate.This appears to have been sucessful andapplications for satellite sessions has beenpreserved, even at the increased rates.
In connection with these industrialsponsorship issues the BCS hasappointed a part time business consultant(George Barnes) to help liaise with industry.George has a background in industry andhas been very helpful in developing themarketing strategy of BCS with industry in connection with the ASC.
Academic and Research CommitteeThe role of the Academic and ResearchCommittee (chaired by Hugh Watkins) hasbeen expanded. This year the Committeehas undertaken the selection of the BCSFellowships. In addition, the shortlisting of the 6 finalists for the Young ResearchWorkers’ Prize has been performed bymembers of this committee. This hasallowed the selection of a judging panelthat is selected on the basis of expertisethat fits the topic of the shortlistedabstracts. The Academic and ResearchCommittee has also undertaken to form aworking group to investigate the possiblerole of the BCS in commissioning research.
Trainee Education working groupA working group established under theChairmanship of Alun Harcombe has been established to examine the creationand co-ordination of education forspecialty registrars in cardiovascularmedicine. This group is now drafting its report which will advise the BCS on co-ordination of existing educationalopportunities, the development ofweb-based education and the creation of a specific taught course to cover the curriculum of the knowledge basedassessment. The first draft will beavailable to the Executive and Council in June 2008.
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TRAINING DIVISIONThe principal activities of the TrainingDivision relate to the work of theSpecialist Advisory Committee inCardiology, which is chaired by ProfessorStuart Cobbe with Dr Jim Hall asSecretary. It has been a busy year!
New Cardiology CurriculumAll medical specialties were required toupdate their training curricula to conformwith PMETB standards. Since thecurriculum was radically overhauled in2005, the changes this time have beenrelatively modest. However, theintroduction of the advancedsub-specialty curricula andthe “mapping” of themethods of assessmenton to the curriculum haverequired considerableeffort. Thanks go to JimHall and Ian Wilson inparticular for their sterlingefforts on this. The newcurriculum and the
assessment techniques have receivedfinal approval by PMETB.
Knowledge Based Assessment As part of the new assessmentprocedures for the curriculum, Cardiologyand other medical specialties arerequired to introduce a Knowledge Based Assessment (KBA). Cardiologyparticipated in a pilot study run by theJoint Committee for Higher MedicalTraining, which was successful. Howeverthis “light touch” examination has beenpassed on to the MRCP UK office forfurther development. We have had
serious misgivings about thedirection of travel of theMRCP UK office in thedevelopment of thisproject. As well as offeringthe assessment for UKCCT trainees, leading tothe award of MRCP(Cardiology) at the end of
training, the Royal Collegeswish to market this
examination overseas. Cardiology, andother medical specialties, are concernedthat this will cause confusion, and allowforeign medical graduates to claim thatthey have a UK cardiology training whenthey have simply taken the KnowledgeBased Assessment. Another stumblingblock has been the proposed costs of theKBA, both to trainees and to the Society.The Society continues in negotiation withthe Federation of Medical Royal Collegesin order to resolve these difficulties. Onepossible solution may be the involvementof the European Society of Cardiology,which is keen to develop postgraduateexaminations for cardiology trainees.
Modernising Medical CareersAs part of the fall-out from the MMC/MTASdebacle, the SAC and the Society made a joint submission to the Tooke Enquiry. In this, we strongly emphasised theprinciples of excellence, and in particularargued strongly for restoration of the“uncoupling” between ST2 and ST3. We were delighted that the interim andfinal reports of Sir John Tooke’s enquiry
have supported this proposal and no new“run-through” training posts will beappointed in England and Wales in 2008.Unfortunately, trainees awarded“run-through” posts at ST1 and ST2 levelin 2007 have a legally binding promisethat their contract will be honoured. The SAC has lobbied hard to try to minimisethe extent to which run-through traineeswill be allowed to enter Cardiologyautomatically at the expense of others suchas research fellows, FTSTAs, LAT and LASholders. As a result of representations by various individuals and organisations,approximately one third of the eightyCardiology ST3 posts in England in 2008have been reserved for open competition,and two thirds of those in Scotland. The SAChas been asked to organise a nationalrecruitment process for the appointmentof these ST3 posts, and this will take placein April 2008. By developing nationalperson specifications, application forms,shortlisting and interview standards, wewill be well placed to appoint the mostdeserving candidates into Cardiology inthis year and in the future.
Vice President: Prof Stuart Cobbe
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Annual Report 2008
British Cardiovascular Society9 Fitzroy Square, London W1T 5HWTel: + 44 (0)20 7383 3887 Fax: + 44 (0)20 7388 0903 email: [email protected] Limited by guarantee.Registered in England No: 3005604. Registered Charity No: 1093321www.bcs.com
Annual Report 2008
