Skip to main content

Health: Cardiac Arrest

Volume 831: debated on Monday 17 July 2023


Asked by

To ask His Majesty’s Government what steps they are taking to improve outcomes in cases of sudden cardiac arrest.

My Lords, the treatment and prevention of cardiovascular disease are a priority for the Government. We want people to have the best chance of survival from cardiac arrest and rapid intervention is critical to improving outcomes. This is why the Government have agreed to provide funding of £1 million to design a grant scheme for the expansion of AEDs that increases the number of public access defibrillators.

My Lords, I declare that my son is a consultant cardiologist. Around 80,000 cardiac arrests happen each year out of hospital, mostly in the home. Learning from countries such as Norway and Denmark—where survival rates are more than double ours, which is below 10%—will the Government extend cardiac first aid training to primary schools, to part of the driver’s licence, to all public sector workers and to those attending jobcentres? Will defibrillators be carried on every first response police and fire vehicle, with the NHS defibrillator purchasing scheme and registration extended to public places, to greatly increase 24-hour bystander public access to a working defibrillator via 999, with those who attempt CPR signposted to support afterwards?

My Lords, I believe this is the noble Baroness’s 1,000th contribution to your Lordships’ House, so I congratulate her—that is some feat. She asked a very good, topical question. All state-funded schools are required to teach first aid as part of the mandatory relationships, sex and health education curriculum. This involves children aged over 12 being taught CPR and how to use a defibrillator.

To improve survival rates for out-of-hospital cardiac arrest cases, the NHS long-term plan sets out that a national network of community first responders and automated external defibrillators will help save up to 4,000 lives each year by 2028. NHS England are working with St John Ambulance to increase the awareness of the importance of CPR in England. Learning from other countries, as the noble Baroness said, is exactly right and it is very important that the NHS does learn from other countries to continually improve. With regard to first responder vehicles, including in the police and fire service, carrying defibrillators, it is a very good question and I will take this back to my colleagues in the Home Office.

My Lords, I am very glad that the Minister said that this was a priority for the Government, but can I ask him to look at the UK out-of-hospital cardiac arrest outcomes project? The current 2023 figures show that the survival rate after 30 days is 11% in London but 5.3% in the West Midlands. Will he call in the integrated care systems in the West Midlands to see what they are doing to improve? That is a very big discrepancy between those two rates.

The noble Lord is very knowledgeable about the West Midlands. I will certainly take that specific point back to the department.

My Lords, building on the comments made by the noble Baroness, Lady Finlay, about the importance of defibrillators, the Minister may be aware of a database called the Circuit, which has been set up by the British Heart Foundation and its partners so that people can register the defibrillators they have on their premises. The project is far from complete. What might the Government do to encourage registration of defibrillators with that service and encourage the use of the associated consumer service,

I am most grateful to the noble Lord; as always, he asks searching questions on such matters. I have taken the time and trouble to look into the exact app. As for what the Government can do, he has already mentioned the British Heart Foundation, and we are working closely with it. Noble Lords can download the defib app to locate the nearest defib registration on the Circuit; the defibrillators will appear on it. I encourage all organisations—sports clubs, community churches, and so on and so forth—to register to be on the app. That is key. Having the defib is one thing; having it on that app is another.

My Lords, following the successful campaign to ensure all state-funded schools will receive defibrillators—for which many thanks to the Government—will my noble friend the Minister ensure that all public and private sector sport and recreation facilities are also mandated to have defibrillators on site, with personnel trained to use them?

My noble friend raises a very good point. He is exactly right to point out the DfE’s programme, which is backed by £19 million of government support. In June 2021, the then Sports Minister welcomed the Premier League’s announcement of its new defibrillator fund, which will fund AEDs for thousands of football clubs and facilities across the country. Each grant recipient will receive all the training and support that the noble Lord refers to. It is not just about football; cricket clubs and other sports clubs throughout the nation should do this.

My Lords, many survivors of sudden cardiac arrest—unlike survivors of strokes or heart attacks—receive little or no follow-up care, although they may suffer from emotional, psychological and memory difficulties. Will the Minister look at establishing a formal care pathway for cardiac arrest survivors and ensuring that an individualised post-cardiac arrest rehabilitation plan is available across all integrated care boards to everyone who needs it, including families and people who give CPR, many of whom suffer from anxiety, depression and post-traumatic stress?

The noble Lord is exactly right: surviving a heart attack is one thing, but recovery, both of the victim and their family, is another. I will take that point back to the department.

My Lords, it is estimated that 999 call handlers and ambulance services do not have access to data on the whereabouts of tens of thousands of defibrillators, meaning that emergency services cannot direct bystanders to them in the event of a cardiac arrest while they wait for ambulance support. We know that a victim’s chance of survival falls by about 10% with every minute that defibrillation is delayed. What steps are the Government taking to address this, particularly targeting areas of poor health and high OHCA incidence so that the chances of survival in these communities can be significantly increased?

On the noble Baroness’s latter point, NHS England has partnered with St John Ambulance to co-ordinate skills development to significantly increase the use of AEDs by individuals in community settings such as those she has just outlined. The ambulance service has access to the location of defibrillators, but, as I said to the noble Lord earlier, it is important that, if you have a defibrillator, you register it so it ends up on the system.

My Lords, defibrillators are extremely important in helping people who have out-of-hospital cardiac arrests, but research shows that there is significant variation in the treatment that patients receive, depending on where they are from, after a cardiac arrest. What can the Government do to ensure that evidence-based guidance for treatment is embedded in practice consistently across the NHS?

That is a very good point. Treatment does vary from hospital to hospital, which is why it is very important that the NHS establishes best practice so that hospitals which are not performing to a high standard can learn from the best within the NHS.

My Lords, would it be a good idea, if we are dealing with things which have to be used by the general public, for us to have a universal signing system to tell you where you can find something? For instance, something red or yellow could flash in public to say where a defibrillator is—because I managed to walk past one in my office without noticing it for a couple of years.

If the noble Lord refers to the House of Lords or the House of Commons, he raises a very good point. However, in my experience, looking at defibrillators out and about in the community, they are very well signposted—there are signs that clearly indicate them to the public. But it does vary; there is no standard, as indeed communities vary throughout the country. If the noble Lord wants to share with me his case of a specific defibrillator, we can certainly take that up with the House authorities.

My Lords, this important question is part of a wider issue regarding rapid intervention across a range of health emergencies. Stroke victims, for example, who are treated quickly have a much better recovery rate and suffer much less harm, and therefore place much less subsequent pressure on health and social services. What are the Government doing to ensure that rapid intervention is a key element in the health strategy across this country? Our outcomes on a range of medical emergencies are much worse in this country than in many others.

The NHS is doing all that it can to raise awareness. The noble Lord talks about stroke victims, and awareness and looking for the signs of somebody who is suffering from a stroke are far better than they were. However, the noble Lord is right and, as I said in an earlier answer, we can always learn from other countries’ health services. On heart attacks, the survival rate of those who receive CPR is twice that of those who do not receive it.

My Lords, may I ask the Minister to examine one of the causes of cardiovascular disease: the manufacturing of food? Manufacturers add excessive salt, sugar and fat, which then trigger neurological responses leading to cravings for food. This is highly profitable for the industry and leads to very high executive bonuses, but it is disastrous for people. Can the Minister say when the Government will examine the role of food manufacturers in creating cardiovascular disease?

It is well documented that a healthy lifestyle and diet are critical for a long and healthy life. A balanced and healthy lifestyle includes exercise, reduced sugar and fats. That is not the unique responsibility of food manufacturers; it is incumbent on us all to have a healthy, balanced diet.