56K angina patients in UK denied CTs in 2017 due to radiologist shortage

Last year, more than 56,000 angina patients across the U.K. were denied life-saving CT heart scans due to the continuing shortage of radiologists and scanners, according to data released Nov. 8 by the Royal College of Radiologists (RCR) and the British Society of Cardiovascular Imaging (BSCI), published in The BMJ.  

The British Heart Foundation estimates that coronary heart disease kills 180 people in the U.K. every day. Angina is caused by reduced blood flow to the heart and is a common symptom of coronary heart disease and can increase the risk of other serious cardiovascular issues, according to the Mayo Clinic.  

Cardiac experts believe exercise tests are not accurate enough to determine the underlying causes of angina, however the U.K.’s current radiologist shortage has only reduced the amount of scans and care administered, according to an RCR news release published Nov. 8. 

Since 2016, the National Institute for Health and Care Excellence (NICE), which offers treatment guidelines for the English NHS, recommends all patients with angina-type symptoms receive a computed tomography coronary angiography (CTCA) scan. However, fatal heart conditions continue to go undetected in the U.K. with just nine CT scanner per 100,000 people, according to a recent report by The Independent.  

“It is beyond frustrating that we do not have the capacity to provide what should be a routine frontline test for everyone presenting with chest pain,” Roditi said in a prepared statement. “Deadly cases of heart disease are being missed because we can’t deliver these scans properly across the U.K.” 

According to the study, only 75,791 CTCAs were performed in the U.K. last year, equating to a shortfall of 43 percent or at least 56,289 angina patients who did not receive scans. Instead, if angina patients were automatically given scans, as recommended by NICE, at least 132,080 NHS patients should have received a CTCA test in 2017, according to the findings.  

Overall, England had a 37 percent shortfall with 69,865 CTCA scans performed in 2017, instead of the estimated 111,239 if all relevant angina cases in the country were scanned early.  

Wales had the highest number of patients missing out on scans in 2017 at 4,854 patients. Scotland had 7,900 missed scans (73 percent shortfall) and Nothern Ireland had 2,162 missed scans (58 percent shortfall).

An anonymous poll of BSCI consultants also revealed waiting times for CTCAs were as high as six months at some hospitals due to lack of capacity, according to the release.  

"It is remarkably sad that the CTCA technology exists to diagnose life-threatening heart disease before it kills people, but patients are being denied access because the U.K. government and devolved administrations are failing to invest in training the radiologist doctors needed to report these scans, as well as the state-of-the-art CT scanners needed to perform them,” said Nicola Strickland, MD, president of the RCR.