Outpatients

Cardiac Outpatients
Cardiology consultants and their team run several outpatient clinics a week in the Lancashire Cardiac Centre, some are new referrals from GPs, some are existing patients having follow up appointments having had interventional procedures such as stents, cardioversions etc [see patient journey].

Cardiac Pre-admission Clinic
Patients are seen before their invasive cardiology investigations / procedures in the pre admission clinics. The clinics are fully nurse led by experienced nurse practitioners/ specialists. During an appointment patients are clinically assessed, examined, an ECG is performed and bloods taken. If there are any abnormalities found these can be acted upon prior to the patient’s procedure. During the appointment the nurse will explain the procedure and answer any questions the patients have. The cardiology pre admission team incorporates nurse practitioners/specialist, clinic secretary and health care assistant.

Cardiothoracic Outpatient clinics
Cardiothoracic consultants have a clinic in the Lancashire Cardiac Centre either weekly (if they do clinics at hospitals outside of Blackpool which require a cardiothoracic clinic) or twice weekly. They see all new referrals for cardiac surgery or thoracic surgery and also see patients as follow up after their surgery.

Cardiothoracic Preadmission Clinic
Pre admission clinics open each day Monday – Friday 8 until 4pm. Open to all patients who are due for cardiac or thoracic surgery. Patients are seen by nursing staff and all pre operative checks are completed including blood tests, chest x-ray, ECG, MRSA screen and the paperwork that goes with them. This is to ensure no patients are cancelled at short notice before their operations. Advice and information is also given about smoking cessation and lifestyle advice as well as reassurance about their surgery.

The clinic is led by highly experienced and qualified cardiac physiologists that have chosen to specialise in pacing and cardiac rhythm management.  The physiologists are a constant feature of your device care – they will be present at your device implant and for your subsequent life-long device follow up so you will get to know them well.

They work closely with the medical team, specialist cardiac device and arrhythmia nurses to optimise your care and can advise you and your relatives on all aspects of living with an implanted cardiac device.  

For more information, visit the Pacemaker Clinic page.

The outpatient heart failure service available at the Lancashire Cardiac Centre is ideally suited to meet the needs of clinicians in primary and secondary care looking to work within the new NICE guidelines. We planned the service and launched it in early 2009 with the following guidelines in mind.

The ‘ NICE quick reference guide’ below details the immediate relevance of our Heart failure diagnostic clinic (HFDC) and specialist heart failure clinic (HFC)

HFDC

• Urgent two-week echo AND specialist review seen as essential for all patients with previous MI and HF symptoms
• All new diagnosis made under the care of specialist team – a one stop consultant-led clinic being an ideal approach

The HFDC is intended to be a one stop clinic such that the majority of patients are discharged after only a single visit with a clear management plan.

HFC

Considering the NICE guidance, it is important to have ready access to specialists for those patients who have had their diagnosis confirmed previously.

• Having received a clear management plan after initial diagnosis, we are keen that you feel able to contact us again for support in patient management.
• Indeed we ask that all patients with known HF combined with new AF, angina or LBBB on ECG (QRS>120ms) are referred to us, a very high risk population who we hope will be identified at routine six monthly review if not before.
• We ask that patients with any remaining symptoms despite optimal BB and ACE I are also referred to us.

We have offered a respected regional service to cardiologists in the North West as well as following up our own local admissions. We hope to help you prevent those admissions.There is so often more that we can do to improve symptoms, prognosis and importantly avoid the non elective admissions that are to some extent so predictable.

Referral forms for both HFDC and specialist HFC are available here and through choose and book.The HF team, which includes myself and a team of hospital based nurses, are happy to discuss individual patient needs by telephone too, indeed we look forward to developing a two-way relationship that offers our patients the very best care.

Dr. Alison Seed. Tel: 01253 657865Heart failure Specialist Nurses (Gillian Martin and Kathy McCann) Tel. 01253 303269

C&B Heart Failure Diagnostic Clinic Referral FormC&B Heart Failure Clinic Referral FormC&B Heart Failure Fact Sheet

Our doctors and healthcare professionals have recently developed our adult congenital heart disease clinic. In this clinic patients suspected of having heart disease which may have been present at birth but undiagnosed are referred by their GP to the service.

As the clinic is a “one-stop” clinic patients will receive an appointment as an outpatient clinic, they will see the specialist doctor first, have the full range of investigations required to investigate and diagnose the heart problem and then will see the specialist again. This means the majority of patients will receive a diagnosis on the day of attending the clinic (small numbers of patient may require further test which will mean results may not be given on the day). Investigations patient may undergo range from an ECG, a chest X-ray or an echocardiogram.

The Rapid access chest pain clinic is based in Cardiac Investigations department in the Lancashire Cardiac Centre. Patients are seen in the clinic for early assessment of chest pain to determine if there is any heart disease present.

Referrals are received from general practitioners (GPs) and the Emergency Department (A&E).  Patients are then seen within two weeks of their referral being received. During the appointment, patients are clinically assessed, examined by the doctor or specialist nurse. If appropriate, the patient will then be asked to do an exercise stress test (see Investigations). Following this test the patient will either be discharged back to GPs or referred for further tests/ follow up.

The rapid access chest pain clinic team incorporates a cardiology registrar, nurse practitioner/specialist, cardiac physiologists and a clinic secretary.