Streamlining Cardiac Care at Manchester University

HeartFlow would like to take a moment to recognise sites that are going above and beyond to deliver an outstanding CT service to patients, especially during this COVID pandemic.

We are excited and proud to recognise Manchester University NHS Foundation Trust (MFT) for their Outstanding CT Service!

Overview of Manchester University NHS Foundation Trust’s CT service

• Extensive high-volume cardiac CT service at MFT, performing ~4000 scans per year
• Highly skilled CT radiographers with specialist cardiac training
• As well as serving the local community, the service acts as a regional hub for Greater Manchester, extending the service to surrounding hospitals without cardiac CT capabilities
• Great learning centre for fellows, registrars, and radiographers on cardiac CT due to the high volumes performed at MFT

Changes to CT service due to COVID

• Guidance to referrers encouraging prescription of oral beta-blockers as pre-medication
  • Shorter scan appointment with less time spent in hospital
  • Lower requirement for intravenous beta-blockade and shorter post-scan observation time
  • Higher quality imaging & increased suitability for combined FFR_CT assessment
• Increased number of lists per week to exceed a pre-COVID level of capacity, even with more stringent cleaning procedures
• Increased access to in-patient slots for low-probability ACS to facilitate rapid discharge
• Increased staff flexibility with daily tasks based on the unpredictability of the environment
  • Due to the constantly changing environment, MFT staff are comfortable changing their routine and stepping into roles that aren’t traditionally theirs
  • Depending on scheduling rotations, the staff can jump in to perform tasks with higher exposure to patients if other colleagues on staff need to shield to ensure cardiac services run without interruptions
  • For example, a colleague required to shield will focus on reporting while another consultant will jump in to prescribe any intravenous beta blockers as necessary between working on other admin tasks

Their CT departments have been at the forefront of the fight against the COVID-19 pandemic driven by the surge in diagnostic chest imaging requirements. Accordingly, the CT units and staff had to rapidly adapt to social distancing and Personal Protective Equipment protocols; however, this provided the foundation to continue an uninterrupted coronary CT service which was fundamental in maintaining a rapid access chest pain clinic (RACPC) service throughout the pandemic, and in particular took some of the burden away from exercise stress imaging modalities limited by aerosol-generating procedure restrictions.

One additional impact has been that the spectrum of patients with chest pain assessed by a CT-first strategy in accordance with the latest NICE guidelines has increased. It’s a trend MFT expects to continue in a post-COVID environment particularly as tools such as HeartFlow further increase the diagnostic value of coronary CT by adding a physiologic element to the anatomical stenosis and plaque burden assessment.

In summary, Manchester University NHS Foundation Trust has adapted their CT protocols and day to day tasks to ensure they are able to continue to offer their patients uninterrupted access to the best standard of cardiac care, even during this COVID pandemic. We, at HeartFlow, are proud to be working with them to enhance heart care for their patients.