Br Heart J. 1985 May;53(5):477-82. doi: 10.1136/hrt.53.5.477.
The principal conclusions of the report are as follows. Cardiology continues to change rapidly. In the five years since the issue of the Second Report of the Joint Cardiology Committee in 1980 the specialty has been affected principally by the increase in coronary artery surgery and the increasing importance of non-invasive techniques of diagnosis, particularly echocardiography. The burden of heart disease in Britain shows some decline recently, but this falls short of that which has occurred in other countries. The vital role of the initial assessment of patients to ensure the efficient use of limited resources falls upon physicians and paediatricians in district general hospitals. Each district general hospital should have at least one physician, practising general medicine but having a special expertise and training in cardiology. He should undertake echocardiography, stress testing, ambulatory monitoring, emergency pacing, rehabilitation, and cardiac intensive care, with the necessary facilities and staff. He will also play an important part in the follow up of patients assessed and treated at cardiac centres. Paediatricians should continue to evaluate children with heart disease and their training should include periods at cardiac centres. Cardiac centres currently undertaking invasive investigations and cardiac surgery need to expand to cope with demand. A target figure of 750-1000 coronary artery bypass operations annually is suggested. This implies three or four surgeons and six cardiologists per centre. Other staffing should be based on these figures. Smaller centres are not necessarily non-viable but should be encouraged to expand or merge. Funding should be clarified so that regional contributions to regional services are identified and not lost in district budgets. Expensive capital equipment should be regionally funded whether sited in cardiac centres of district general hospitals. (7) Supraregional centres for the cardiac problems of infants under the age of one year have been identified ans should receive supraregional funding. Their staffing and equipment should be appropriate to the exceptional demands of this work. If such a centre is sited within an existing cardiac centre the staff will be additional to those needed for the adult work. Facilities for older children should continue to be provided, as at present, at all cardiac centres. (8) Cardiac transplantation should be funded supraregionally. (9) The medical audit of cardiac work should be supported by the Department of Health and Social Security (DHSS). (10) Research remains a high priority, and cardiac centres should be provided with the facilities, and staff with the contracts and time, to undertake it. (11) A revision of this report is recommended within five years.
该报告的主要结论如下。心脏病学仍在迅速发展。自1980年联合心脏病学委员会第二次报告发布后的五年里，该专业主要受到冠状动脉手术增加以及非侵入性诊断技术（尤其是超声心动图）日益重要的影响。英国心脏病的负担最近有所下降，但仍低于其他国家。为确保有限资源的有效利用，对患者进行初步评估的重要职责落在了地区综合医院的内科医生和儿科医生身上。每家地区综合医院应至少有一名内科医生，从事普通内科工作，但在心脏病学方面有专业知识和培训。他应进行超声心动图检查、负荷试验、动态监测、紧急起搏、康复治疗以及心脏重症监护，并配备必要的设施和工作人员。他还将在对在心脏中心接受评估和治疗的患者进行随访方面发挥重要作用。儿科医生应继续对患有心脏病的儿童进行评估，其培训应包括在心脏中心的实习阶段。目前进行侵入性检查和心脏手术的心脏中心需要扩大规模以满足需求。建议每年进行750 - 1000例冠状动脉搭桥手术的目标数字。这意味着每个中心需要三到四名外科医生和六名心脏病专家。其他人员配置应以此为依据。规模较小的中心不一定无法生存，但应鼓励其扩大规模或合并。资金来源应明确，以便确定地区对地区服务的贡献，避免在地区预算中流失。无论位于心脏中心还是地区综合医院，昂贵的大型设备都应由地区提供资金。（7）已确定设立针对一岁以下婴儿心脏问题的超地区中心，并应获得超地区资金。其人员配置和设备应符合此项工作的特殊需求。如果这样的中心位于现有的心脏中心内，工作人员将是成人工作所需人员之外的额外配置。所有心脏中心应继续像目前这样为大龄儿童提供设施。（8）心脏移植应由超地区提供资金。（9）心脏工作的医学审计应由卫生和社会保障部（DHSS）提供支持。（10）研究仍然是高度优先事项，应向心脏中心提供设施，并为工作人员提供合同和时间以便开展研究。（11）建议在五年内对本报告进行修订。
