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Regional variation in cardiovascular magnetic resonance service delivery across the UK
Niall G Keenan1,2, Gabriella Captur3,4, Gerry P McCann5,6
1Cardiology, West Hertfordshire Hospitals NHS Trust, Watford, Hertfordshire, UK n.keenan@imperial.ac.uk.
Insights
Cardiovascular magnetic resonance (CMR) use in the UK has grown fivefold in 10 years, but access varies significantly by region. Some areas report low CMR scans per capita and long waiting times, indicating potential inequities in diagnostic imaging.
Area of Science:
- Cardiology
- Medical Imaging
- Health Services Research
Background:
- Equitable access to diagnostic imaging is crucial for effective healthcare.
- Cardiovascular Magnetic Resonance (CMR) is a key diagnostic tool, but its availability may differ regionally within the UK.
Purpose of the Study:
- To assess the current provision and regional distribution of Cardiovascular Magnetic Resonance (CMR) services across the UK.
- To identify variations in CMR scan volume, waiting times, and service offerings.
Main Methods:
- A 100% response rate electronic survey was distributed to all UK CMR service leads by the British Society of CMR in 2019.
- Data from 2017 and 2018 were collected and analyzed regionally, correlated with population statistics.
Main Results:
- CMR scans increased fivefold over 10 years, reaching 114,967 in 2018. Significant regional disparities exist, with London performing 4256 scans/million population versus 396 in Wales.
- Waiting times varied widely, with a median of 41 days nationally, but reaching 180 days in Northern Ireland. 30% of units exceeded 6-week waiting times for elective procedures.
Conclusions:
- The national CMR service has seen remarkable growth but exhibits significant heterogeneity in utilization and access across UK regions.
- Persistent regional variations in CMR scan rates and extended waiting times raise concerns about equitable patient access to this vital diagnostic imaging modality.
Objectives:
To examine service provision in cardiovascular magnetic resonance (CMR) in the UK. Equitable access to diagnostic imaging is important in healthcare. CMR is widely available in the UK, but there may be regional variations.
Methods:
An electronic survey was sent by the British Society of CMR to the service leads of all CMR units in the UK in 2019 requesting data from 2017 and 2018. Responses were analysed by region and interpreted alongside population statistics.
Results:
The survey response rate was 100% (82 units). 100 386 clinical scans were performed in 2017 and 114 967 in 2018 (15% 1-year increase; 5-fold 10-year increase compared with 2008 data). In 2018, there were 1731 CMR scans/million population overall, with significant regional variation, for example, 4256 scans/million in London vs 396 scans/million in Wales. Median number of clinical scans per unit was 780, IQR 373-1951, range 98-10 000, with wide variation in mean waiting times (median 41 days, IQR 30-49, range 5-180); median 25 days in London vs 180 days in Northern Ireland). Twenty-five units (30%) reported mean elective waiting times in excess of 6 weeks, and 8 (10%) ≥3 months. There were 351 consultants reporting CMR, of whom 230 (66%) were cardiologists and 121 (34%) radiologists; 81% of units offered a CMR service for patients with pacemakers and defibrillators.
Conclusions:
This survey provides a unique, contemporary insight into national CMR delivery with 100% centre engagement. The 10-year growth in CMR usage at fivefold has been remarkable but heterogeneous across the UK, with some regions still reporting low usage or long waiting times which may be of clinical concern.
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