Short descriptions and download links to BCIS guidance documents

In 2001 an ad hoc Advisory Group of the Coronary Heart Disease Taskforce of the Department of Health, chaired by the National Director for Heart Disease, reported on the development of percutaneous coronary intervention (PCI) services.1 The Group concluded that:

• the development of new PCI services should be planned within Networks of Cardiac Care and agreed between all relevant parties

• facilities for PCI in tertiary centres should be fully utilized

• all PCI services should adhere to agreed technical, professional and practical standards

• all sites considering setting up a PCI service should undergo BCIS peer review prior to starting such a service.

Since then the number of hospitals carrying out percutaneous coronary intervention procedures has increased rapidly, and there has been a commensurate increase in the total number of PCI procedures done in the United Kingdom. There has, however, been concern that the development of new PCI services has not always been compliant with the 2001 Advisory Group recommendations. At the Angioplasty Consensus Meeting, hosted by the National Heart Improvement Programme in September 2008, the importance of British Cardiovascular Intervention Society (BCIS) Peer Review for new PCI Services was emphasized and there was broad agreement that this process should be re-invigorated.

Technical, professional, and practical standards for PCI services are currently defined in several documents. 1-5 All PCI services in the United Kingdom are expected to comply with these standards, which are intended to support provision of high quality patient-centred care. BCIS will review the full PCI Guidance documents during 2010, but in the interim this document summarizes and updates BCIS recommendations on the development of new PCI services. The guidance in this document is also relevant to all PCI services in the United Kingdom.

NHS England announced the creation of 23 Urgent and Emergency Care Networks in the Spring of 2016. As part of the NHS Planning Guidance, Commissioners and Providers are required to compose ‘Sustainability and Transformation plans’ to describe how patients will access emergency specialist services. Emergency care for STEMI heart attack and quality standards for 7 day services concerning Consultant input and access to diagnostics are prioritised. Simultaneously the British Cardiovascular Society is preparing a report on Out of Hours Cardiovascular Care for Hospital In-patients. This document is a statement prepared by Officers of the British Cardiovascular Intervention Society (BCIS) to inform these discussions. It has been approved by BCIS Council on July 7th 2016.

Structure and functioning of a Multidisciplinary “Heart Team” in patients with coronary artery disease

Rationale and Recommendations from a Joint BCS/BCIS/SCTS Working Group

Executive Summary

1.1 International Guidelines from both the Cardiology and Cardiac Surgery Societies have recommended the utilisation of a Multidisciplinary Team (MDT) approach to assist in guiding the management of patients with coronary artery disease (CAD). Whilst such a process is well recognised as beneficial in other areas of medicine, and also incorporated into some elements of current cardiological practice, its routine use in the context of CAD is less established. The functioning of such a “Heart Team” varies across the UK as does its composition, frequency and the type of cases discussed.

1.2 It is the intention of this document to provide guidance as to the essential components of a Heart Team in terms of how it should be structured and how it should function. This includes its attendance, scheduling and frequency as well as the type of cases to be discussed and the minimum data to be presented. Importantly, it also addresses the required managerial, administrative and technological support, systems of documentation, feedback and audit, and the degree and timing of patient/carer involvement.

1.3 It is acknowledged that working environments will differ; surgical as opposed to non-surgical cardiology centres is one such example. It is envisaged therefore that the fundamental components of this document will form a foundation upon which MDT policy for individual units may then be developed. Similarly it is anticipated that it can be used in order to identify any shortfalls in current practices, prompt those initiatives that will deliver improvement and assist to secure the necessary resources that will then allow a robust MDT process to be established.

Percutaneous coronary intervention (PCI) has a considerable evidence base and it is firmly established as the most common procedure used in the invasive treatment of patients with coronary heart disease in the UK. This set of guidelines aims to address specifically issues relating to PCI and is not intended to provide a review of the entire evidence base for coronary intervention. The guidelines focus on issues pertinent to practice within the UK and set out a recommended template to ensure optimal delivery of patient care. BCIS is grateful to the members whose contributions made the publication possible.

View Open Access article.

BCIS members have a responsibility to represent the speciality with professionalism, both in terms of their care and consideration for patients, and in terms of their interactions with other BCIS members. This responsibility is particularly pertinent in the context of BCIS activities – professional, educational, and social.

BCIS would like to have guidelines for the professional standards expected of its members. These apply to the content and conduct of educational activities, including lectures and debates, angiogram review sessions, case-based discussions and live or taped case demonstrations. They also apply to behaviour in general, and most specifically to interaction with other BCIS members and non-BCIS individuals, especially those who may be considered ‘junior’ in professional status.