Have their been Atrial Fibrillation targets in the NHS?

[Ivan_the_Terrible]

I was diagnosed with AFib at the end of 2018 and referred to an NHS hospital in London. I didn't hit it off with them, largely I think because I was unsure if I wanted any treatment. I had a consultation today with a consultant at a different NHS hospital and he thought it very sensible just to live with it. Of course he is under pressure to reduce waiting lists but it occurs to me to ask whether in 2019 whether they had targets to hit, a certain percentage of referrals to receive cardioversions and ablation within a certain timeframe. This would explain why my attitude would have been unwelcome to them at that time. I've seen at first hand how targets can corrupt the criminal justice system and heard various, stories about the NHS. Does anyone know if there were targets in force regarding AFib in 2019? It would help me to make sense of what happened.

[mav7]

Hi Ivan

Personal opinion, I would think "targets" would violate the medical code of conduct.

Would encourage you to find a trusted GP, cardiologist/EP, and have your individual circumstances evaluated.

You are correct in stating that there are certain factors in AF we have to live with. But at the same time take action to improve health and quality of life.

Best to You in managing your health !

[Ivan_the_Terrible in reply to mav7]

NHS is full of targets and they conflict with medical code of conduct all the time. Just wondered if they were at play here.

[Singwell in reply to Ivan_the_Terrible]

It's the government that impose the targets, not the NHS. That's what you're thinking of e. g. No waiting lists longer then X months etc. Far more likely that it's the pandemic that's impacted waiting lists and perhaps influenced a changed attitude in that particular hospital.

[Ivan_the_Terrible in reply to Singwell]

No question that what they tell you is good for you is what they can afford. That's a given. But I'm still wondering why they were so keen to push me towards a cardioversion/ablation in the first place when I was reluctant. Perhaps they assumed that my GP had discussed the 'non-intervention' option with me when she hadn't. It can hardly be unusual for a 64 year old who feels perfectly okay except for some tiredness to be wary of invasive treatments.

[Singwell in reply to Ivan_the_Terrible]

Personally I was only too happy at 64 to get on that list! Once I'd endured almost a year of highly symptomatic AF I'd had enough.

[Ivan_the_Terrible in reply to Singwell]

I suspect if I'd been highly symptomatic I'd have been glad too. But I wasn't. Perhaps I should never have been on it, it just caused trouble and expense all round.

[Singwell in reply to Ivan_the_Terrible]

Yup. My brother's had AF for almost 7 years and is now in persistent AF. It's never bothered him much.

[Ivan_the_Terrible in reply to Singwell]

That's interesting and good to hear. Good luck with your treatment.

[BobD Volunteer]

There are no targets, just waiting lists. That said if you go to a carpet salesman he will try to sell you a carpet. Not all cardiologists are electrophysiologists and many are wary of such things (they don't understand you see).

In my experience you need to see the right people and take their advice or you risk missing out on the right treatment.

Ablation is one of those things that people seem scared of so they often put it off till it is too late. Since any treatment for AF is only ever about quality of life (QOL) not cure, in other words for symptom control, the only best treatment is what you decide.

The only time I am aware of what might be called "targets" concerns those people who are obese or maybe have other health limiting factors where a form of treatment is known to be ineffective. Ablation has often been refused pending serious weight loss for example.

[Ivan_the_Terrible in reply to BobD]

There are certainly waiting time targets and there was certainly an atrial fibrillation pathway and they never raised the possibility of not following the cardioversion/ablation route. I raised that question myself with support of my GP. I've submitted an FOI request on this. By the time I understood the purpose of the cardioversion it had become rather late for an ablation. But as life is fine, I just get a bit tired at times, I think I'm better off for not having had the ablation. If that's a form of self-consolation so be it.

[Hidden]

Offered ablations early on presentation this month and 2020. Not sure what that says!

[mark66uk]

Offered an ablation in July 2021 and still waiting so it has worsened any waiting list target

[Afibflipper in reply to mark66uk]

So sorry to hear this, I was fortunate enough to be able to go private as I was told it was quicker - I don’t know if it’s true but, some people say they can go private for initial consultation the go on that cardiologist/EP list by nhs - as I say I’ve heard it but I don’t know for sure

[Ivan_the_Terrible in reply to mark66uk]

Waiting time targets have gone out of the window post COVID.

[Jajarunner]

There are the NICE guidelines for treatment of Afib. They lay out which treatments should be used when ie drugs before electrical cardioversion. However I know from experience that clinicians will ignore them based on their judgement of your case. They might tell you what you are looking for and are available online.

[Ivan_the_Terrible in reply to Jajarunner]

Thanks.

[Janey1955]

I was on a waiting list for an ablation as I cannot take any medication other than anti coagulants down to my naturally low heart rate. The EP tried flecinade but it was altering the p waves of my heart. So an ablation was elected. But then they rang me and as my symptom burden was not great, although I can tell when I am having an attack, it was decided I should live with it for now. They said an ablation is not a cure and only lessens the symptom burden.

I have had lone paroxyl afib for 8 years and the attacks have increased in frequency, now down to every fortnight, but they are shorter In Duration which seems odd. However no one seems to check on me now I suppose it’s left to me to get in touch if I worsen

Jane

[Ivan_the_Terrible in reply to Janey1955]

I think their aim is to cut waiting lists. I think in some cases 'living with it' may in fact be best. Most of the world has no choice other than living with it. I hope it goes well with you however it pans out.

[Janey1955 in reply to Ivan_the_Terrible]

Thank you and you. I do think the waiting lists are significant. Jane