1. ¹School of Mathematics, University of Southampton, Southampton, UK
2. ²Department of Health, Eastern Region, Cambridge, UK
3. ³College of Medicine, Blantyre, Malawi

Correspondence: P R Harper, E-mail: P.R.Harper@maths.soton.ac.uk

Received June 2003; Accepted September 2003.

Abstract

The National Service Framework (NSF) for Coronary Heart Disease (CHD), recently published by the Department of Health, specifies Government target rates for different cardiac procedures. This paper describes how the Eastern Regional Office of the Department of Health, with current rates approximately half the NSF target levels, designed a strategy to plan rationally for increases in service provision. A bottom-up needs assessment model was used to predict the population requirements for these CHD procedures and accounts for the effects of demographic change, anticipated reduction in the incidence of heart disease due to primary prevention programmes and the expected improvement in cardiology and cardiac surgery technologies. It is predicted that excess procedures would be required across the region over the next 20 years, and so a geographical access model was developed and used to recommend the building and location of a new tertiary cardiac centre to meet the increased demand. These tools have successfully been used in the Eastern Region to plan long-term increases in CHD rates in order to achieve Department of Health targets.