An evaluation of two Rapid Access Chest Pain Clinics in central Lancashire, UK

The aim of the project was to assess critically, using Maxwell's six dimensions, the quality of the services provided by the two Rapid Access Chest Pain Clinics (RACPCs) in Central Lancashire.

Data on the actual use of the clinic was obtained from the two RACPCs. A record linkage exercise between the database of patients from the RACPC and HES/mortality data was performed. Expected use of the clinic was established from the performance of other RACPCs and from published angina incidence figures. Patient and general practitioner views were obtained by conducting questionnaire surveys.

(1) Clinic is providing a valuable service and should be continued. (2) A standardized database should be created which includes ethnicity and final diagnosis. (3) Alternative methods for rapid diagnosis and management of chest pain need to be provided for patients who are not suitable for the exercise electrocardiogram. (4) Referral criteria should be redrafted in order to remove the exclusion criteria for patients with chest pain of longer duration than 3 months. (5) Further resources need to be targeted at cardiology outpatients and revascularizations, as waiting times for patients with a positive test are felt to be too long.