King’s Health Partners Cardiovascular integrates adult cardiology, cardiac surgery and vascular teams at Guy’s and St Thomas’ and King’s College Hospital NHS Foundation Trusts with the School of Cardiovascular Medicine & Sciences, King’s College London.
We also host a British Heart Foundation Centre of Research Excellence – now in its eleventh year as the highest-funded UK British Heart Foundation Centre.
Our specialist team brings together clinical, research and educational expertise in cardiovascular disease to improve outcomes and patient experience.
Our aims are to:
- deliver the best patient experience and clinical outcomes across a comprehensive range of high quality specialised cardiovascular services, treating the whole person by addressing patients’ physical and mental health needs through our Mind & Body Programme
- create a population health-focused network of care, setting standards for what defines ‘best practice’ in cardiovascular prevention and care
- be global leaders in research and innovation to advance the prevention, early diagnosis and treatment of cardiovascular disease through ground-breaking studies and a MedTech hub
- deliver outstanding education and training programmes
- maximise commercial opportunities for King’s Health Partners, our local economy and ensure financial sustainability of our services
- be the centre of choice in Europe for cardiovascular patients, staff, trainees and students.
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We provide specialist cardiovascular services to an extensive population network spanning south east London and Kent, and in some specialities even further afield, in partnership with other local and regional providers. Our cardiovascular networks (including the South East Vascular Network, South West Vascular Network, and South London Cardiac Operational Delivery Network) serves approximately 4.5m people.
Our services encompass a comprehensive range of sub-specialities including leading-edge programmes in percutaneous and minimally invasive heart valve replacement, emergency services for heart attack, complex electrophysiology, heart failure, inherited heart disease, endovascular interventions and complex imaging.
We are pioneering novel integrated patient care pathways both locally and regionally, to enhance overall quality of care, outcomes, value and sustainability of services. There is also a focus on addressing the mental and physical wellbeing of our patients through our Mind & Body Programme.
Our services include;
- Imaging and diagnostics
- Interventional cardiology including a heart attack service
- Cardiac surgery
- Vascular surgery
- Structural heart disease
- Heart failure and inherited disease
- Adult congenital heart disease
- Clinical pharmacology and prevention.
Integration case studies
Currently, King’s Health Partners Cardiovascular is developing closer collaborative working and clinical-academic integration of our existing teams to strengthen our offer across the network we deliver our services in.
In practice, this means increasingly working as a single clinical and operational team, providing a seamless service to patients, shortening the time it takes to translate research and innovation into patient care, and developing new educational programmes.
This current phase includes a focus on the integration of the two clinical operational cardiovascular services at our acute trusts, Guy’s and St Thomas’ and King’s College Hospital. This focus is driven by a belief that we can do things better – for patients, staff, and the service – by doing them together.
King’s Health Partners Cardiovascular reducing wait times and improving outcomes for patients
King’s Health Partners Cardiovascular has introduced an inter hospital transfer (IHT) system for cardiac patients with the aim of facilitating timely, high quality referrals and transfers. This will support improved outcomes through reduced mortality and readmission rates and fewer cases of patients experiencing complications due to earlier interventions. The system allows referrals to be made, managed and tracked electronically for cardiac patients who need to be transferred from their local hospital for treatment at a specialist hospital.
Across King’s Health Partners Cardiovascular, the electronic referral system has been configured to provide a single point of referral and a joint waiting list for inter-hospital transfers. This enables the most effective use of collective resources across our partners and equity of access to specialist care and treatment for patients across the network.
It has also encouraged much closer working between clinical teams across King’s Health Partners.
Over the past two years, King’s Health Partners Cardiovascular has been focusing on improving outcomes and providing better support to transfer patients in angio/percutaneous coronary intervention (PCI), cardiac surgery, arrhythmia, and TAVI pathways through the IHT system. The pilot has already demonstrated improved outcomes and resulted in better communication between referring clinicians and tertiary centres, with services being delivered within guidance timelines.
Working as One Team across Cardiovascular services ensures that no matter where patients are treated across the partnership, they receive the quickest access to top clinicians who can give them excellent care. A significant benefit of this work has been closer working between the referring hospitals and tertiary centres, working across the network to refine and improve referral processes, for example in the acute coronary syndrome (ACS):
From the data we saw a lot of the delays were at our end and we felt we couldn’t complain about tertiary centre waits if we didn’t have our own house in order. So we changed the role of the ACS nurse entirely and made them responsible for the pathway of the patents….it’s made a huge difference.
Cardiac Matron, Princess Royal University Hospital, King’s College Hospital NHS Foundation Trust.
My job is so much more rewarding now it’s changed and I'm focusing on the ACS inpatients, referring them on the IHT, and then chasing their angios and seeing the outcomes. It’s great to see the improved patient journey and results. I've also formed new relationships with people in the cath labs at St Thomas's and Denmark Hill.
ACS nurse, Princess Royal University Hospital, King’s College Hospital NHS Foundation Trust.
The team are continuing in their efforts to reduce waiting times and variation for patients to ensure an equitable service across a whole network of care. They are also supporting other parts of London to run similar projects so the benefits can spread across a wider geography in South East England.
Reducing inappropriate referrals from primary care into the cardiology service
It is recognised that by improving referrals across King’s Health Partners Cardiovascular, we can provide our patients with better, quicker care using resources in the most effective manner. The primary driver for this work has been improving patient experience – we knew there were patients attending clinics when they did not need to, or without the necessary diagnostics, resulting in multiple appointments and frustrating delays to treatment.
Clinicians across King’s Health Partners Cardiovascular have designed and implemented enhanced clinical triage for GP referrals. This new model means that referrals are vetted by clinicians and either accepted, returned with advice, redirected to another clinic, or referred for diagnostics. Not only will this strengthen our One Team working, but it will ultimately enable the development of a single point of access and one waiting list for patients. This will improve access and reduce inequalities for patients and will support decision making into the appropriate sub-speciality for GP colleagues. Enhanced clinical triage is in place across King’s Health Partners Cardiovascular for heart failure, with arrhythmia and inherited cardiac conditions (ICC) in place at Guy’s and St Thomas’, and soon to follow at King’s College Hospital.
Along with this, we are developing a jointly agreed directory of services (DoS) for King’s Health Partners Cardiovascular for heart failure, arrhythmia, ICC and interventional cardiology, which is replacing general cardiology, as it describes much more accurately what the clinic offers.
Initial results have shown that effective clinical triage is resulting in up to 30% of referrals being rejected or redirected. It has also helped to expose where bottlenecks in the outpatient pathway are and identify where improvements can be made – for example, only requesting diagnostics when absolutely necessary.