This is a personal opinion and might be controversial, but I am wondering out loud, if there is an argument for not allowing some of the smaller hospitals and units in the UK to perform ablations and even in some cases treatment for specialisms such as AF.
Reading here, I see time and again, people having some challenges after either having ablations, or being referred to units for treatment without (it would seem) the experience of some of the larger units. Of course those challenges can occur within any treatment unit, but they do seem to be more prevalent in the smaller units, and certainly we hear often that some of the smaller cardiology units Poo..Hoo EPs in general and their specialism.
I am not here going to mention anywhere by name, but there are maybe (guessing) 10 to 20 places in the UK where there are "say" more than 3 or 4 EPs and where they carry out more than "say" 15 - 20 ablations a week.
Now of course there can be an excellent EP working at a smaller units or even working alone within a larger cardiac unit, but surely ablation is a procedure where you want experience experience experience in the person performing it.
Plus the equipment for a Cath Lab must be hugely expensive, and you would want the best possible equipment which surely cannot be in all of the units.
And similarly those smaller units are much less likely to have specialist arrythmia nurses, and/or specialist pharmacists and other ancillary services.
Local to me there is a large specialist unit, one of the largest in the country for arrythmias in general, AF and all heart conditions, and yet literally 6 miles away is another hospital with it's own unit and own EP perfoming ablations.
I agree that everyone should have a choice about where they are treated, but is it really in the best interests of the patient or even the NHS for those services to be available at every hospital and not just specialist units?