Part II, The next five years

Let me start by describing an average episode of care in 2017. John is in his mid-50’s, a smoker (average 10 cigarettes a day), drinks regularly (around 2 pints of beer or 2 medium glasses of wine on his heaviest drinking day) and does not exercise frequently. He is overweight and has a family history of heart disease. John booked an appointment with his local GP because he had been having worsening chest pains over the previous five weeks. His GP referred him to the local rapid access chest pain clinic, where he had tests such as an ECG. The tests did not show any abnormalities and John was sent back to his GP with a note asking his doctors to continue monitoring him in case his symptoms worsened. His GP received the summary but did not schedule a follow-up appointment with John because the practice was short-staffed that day. (more…)