New research has revealed significant disparities in the treatment of aortic valve disease between different ethnic groups in England, prompting calls for a nationwide expansion of community-based diagnostic clinics.
Stark Treatment Inequalities Uncovered
A comprehensive study conducted by researchers from the University of Leicester has found that black patients were forty-eight percent less likely to undergo a procedure to replace their aortic valve than white patients. The research further indicated that south Asian patients were twenty-seven percent less likely to receive this crucial treatment.
Aortic stenosis, a condition where the aortic valve becomes narrow and restricts blood flow from the heart to the body, affects approximately three hundred thousand people across England. This narrowing leads to symptoms including shortness of breath and chest pain, yet evidence suggests that individuals from ethnic minority backgrounds face substantial barriers to receiving treatment following diagnosis.
Community Clinics Addressing the Gap
In response to these concerning disparities, two rapid access valve assessment clinics have been established in south London through a collaboration between Guy's and St Thomas' NHS Foundation Trust and King's College Hospital. These clinics were strategically located in areas with high populations of people from ethnic minority backgrounds, where treatment rates for valve disease were known to be particularly low.
The innovative approach involves patients being identified as having a heart murmur either by their general practitioner or at community screening events. They are then referred to one of these specialised clinics where they receive appropriate assessment and treatment.
Professor Ronak Rajani, consultant cardiologist and professor of cardiovascular imaging at Guy's and St Thomas' NHS Foundation Trust and King's College London, emphasised the persistent challenges in detection. "Despite significant advancements in valve disease treatments over the last two decades, a substantial amount of heart valve disease still goes undetected," he stated. "This is particularly true for people from the global majority and those living in economically deprived areas, where there is inequity of diagnosis and treatment."
Promising Results from the Pilot Programme
The ongoing pilot, which has been operational for six months, has already screened one hundred and sixty-eight patients. Remarkably, over half of those screened, fifty-five percent, were from minority ethnic backgrounds. Among the screened individuals, fifty-seven percent were found to have valve disease or other clinically significant findings, while over a third, thirty-five percent, were diagnosed with at least moderate valve disease requiring further treatment or surveillance.
Professor Rajani explained the rationale behind the community-focused approach. "We launched the community rapid access valve clinics to close this healthcare gap by situating the clinics in areas where treatment for valve disease is lower than expected. By bringing these clinics into the community, we are reaching people who might otherwise remain unaware of their heart valve disease. We are diagnosing them more quickly and offering them treatment when necessary, which reduces health complications and generates cost savings for the NHS."
Calls for Nationwide Expansion
Given the encouraging outcomes observed thus far, Professor Rajani and his team have urged for the scheme to be expanded across NHS England. "I would advocate for these community rapid access valve clinics to be replicated across the country, where we know the same issues exist, to close the healthcare inequality gap," he asserted. "This would represent a pioneering approach to delivering heart valve care and addressing a problem that affects not only the United Kingdom but also has global implications."
Dr Sonya Babu-Narayan, clinical director at the British Heart Foundation, endorsed the initiative. "Projects like these are helping to break down barriers, giving people easier access to the heart valve treatment and care they need, when they need it," she commented.
She further highlighted the broader context of health inequalities. "Cardiovascular disease remains a major driver of inequalities in life expectancy across the United Kingdom. It is unacceptable that in 2026, a person's chance of living a long, healthy life continues to be shaped by factors such as their postcode or ethnicity."
Dr Babu-Narayan added, "Research we have supported has also identified stark disparities in access to lifesaving aortic valve treatment, with women, South Asian and Black individuals, and people living in more deprived communities being less likely to receive the diagnosis and care they require."
NHS England has been approached for comment regarding the potential expansion of this community-based approach to heart valve disease diagnosis and treatment.
