title: Provision, organization and models of heart valve clinics within The United Kingdom.
abstract: BACKGROUND
  Specialist clinics are recommended for the assessment and follow-up of patients with heart valve disease. We sought to identify the current provision of specialist valve clinics in UK.
  
  
  METHODS
  A database of all UK National Health Service hospitals was created. An online survey was distributed to each hospital to examine the model of heart valve clinic, patient population, provision of advanced imaging modalities and biochemical markers and provision of patient information services.
  
  
  RESULTS
  Valve clinics were run in 48/228 (21%) hospitals, in 27/45 (60%) tertiary centres and 21/183 (11%) district hospitals. The survey was completed by 34 (71%). A consultant cardiologist ran the clinic in 19 (56%), a cardiac sonographer in 8 (24%), a nurse specialist in 3 (9%) and a hybrid model was used in 4 (12%). Patients with native valve disease were seen in 32 (94%), after heart valve surgery in 19 (56%), pre-/post-transcatheter valve intervention in 10 (29%) and with Marfan syndrome in 9(26%). Stress echocardiography, cardiac magnetic resonance imaging, computed tomography and positron emission tomography were available in 21 (62%), 19 (56%), 22 (65%) and 6 (18%) hospitals, respectively.
  
  
  CONCLUSIONS
  There is an underprovision of specialist heart valve clinics within the UK, and there is a 5-fold difference between cardiac centres and district general hospitals.
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Trust, London, UK, Department of Cardiology, Imperial College Healthcare NHS Trust, London, UK, Department of Cardiology, East Sussex Hospitals NHS Trust, Eastbourne, UK and Cardiothoracic Centre, Guy's and St Thomas's NHS Foundation Trust, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Bhattacharyya
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Trust, London, UK, Department of Cardiology, Imperial College Healthcare NHS Trust, London, UK, Department of Cardiology, East Sussex Hospitals NHS Trust, Eastbourne, UK and Cardiothoracic Centre, Guy's and St Thomas's NHS Foundation Trust, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Pavitt
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Trust, London, UK, Department of Cardiology, Imperial College Healthcare NHS Trust, London, UK, Department of Cardiology, East Sussex Hospitals NHS Trust, Eastbourne, UK and Cardiothoracic Centre, Guy's and St Thomas's NHS Foundation Trust, London, UK.
authors.forename: G
authors.initials: G
authors.lastname: Lloyd
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Trust, London, UK, Department of Cardiology, Imperial College Healthcare NHS Trust, London, UK, Department of Cardiology, East Sussex Hospitals NHS Trust, Eastbourne, UK and Cardiothoracic Centre, Guy's and St Thomas's NHS Foundation Trust, London, UK jboydchambers@aol.com.
authors.forename: J B
authors.initials: JB
authors.lastname: Chambers
mesh_terms: D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D006349:Heart Valve Diseases / Q000628:therapy*; D006767:Hospitals, District / Q000458:organization & administration*; D006801:Humans; D017146:Models, Organizational; D009313:National Health Programs / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation; D062606:Tertiary Care Centers / Q000458:organization & administration*; D006113:United Kingdom