Screening for unrecognised heart valve disease

Booking the appointment and getting there

Recent improvements in scanning equipment have made it possible to get high quality pictures of the heart using mobile equipment. This means heart valve screening can now be done in local GP surgeries, and the research study is looking at the advantages and disadvantages of this.
 
Some people we talked to remembered being asked to ring their local surgery to book their first screening appointment. This was generally easy to do and there was a choice of appointment slots. Others remembered being sent an appointment time but being able to change the date if it did not suit them. In some cases people were asked when they rang if anyone else in the household was in the right age group and would also like to attend (see ‘Being invited for screening).
 
All the participants in the study are over 65, so fixing a day time appointment did not present many problems. As George said, “Any time nowadays can be virtually convenient, because, let’s face it, time is now my own.” Fraser and Cathy rang to get two appointments together and said, “We just wrapped it up with a trip to the supermarket or something like that. It was easily done.”
 
We asked people how they felt about having something like this in their local surgery. For some this just seemed normal or routine.

The local health centre is very good so Carolyn was not surprised to be screened there. It was...

The local health centre is very good so Carolyn was not surprised to be screened there. It was...

Age at interview: 69
Sex: Female
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And were you surprised that something like this was happening in your local Health Centre?
 
No, I don’t think so. I mean, it’s not just doctors. It’s a very comprehensive set-up for various departments, so I didn’t sort of think it unusual.
 
If it had said you had to go into town to have the...
 
That would have made a difference because I don’t drive, and it would have meant a long bus or train journey into [city]. I mean, numerically it’s only 11 miles, but in travelling time it’s a couple of hours. And it’s no fun.
 
Do you think you might have done it anyway or?
 
Well, I did, some years ago they were doing a bowel cancer screening, and my husband and I both went by public transport, because there again my grandmother had bowel cancer so I thought it was a good opportunity to get cleared, and everything was fine. But I think it would depend on how serious I thought the condition was. If it was something frivolous then I certainly wouldn’t bother.
 
With this one possibly, with family history, you might have.....
 
Yes, that was definitely a good idea, and as I say, I’ve been on hypertension tablets for 25 years.
 
But having it locally was a bonus?
 

Yes, ideal, yes. 

George assumed it was normal to have this kind of screening in the local surgery, and it was easy...

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George assumed it was normal to have this kind of screening in the local surgery, and it was easy...

Age at interview: 86
Sex: Male
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And what did you think about this screening research being done at your local surgery?
 
Well I assumed it was normal, and it certainly didn’t worry me in any shape or form.
 
And did you think it was a good thing that you didn’t have to go a hospital to have this done that it was just..?
 
Oh yeah. Yeah. Not that that would have worried me, you know, if you know what you’re going for, but.
 
You wouldn't have been worried if you’d had to go to your hospital first?
 
No, no, no, why should you? Why should you be?
 
And is your surgery convenient to you, is it near you?
 
It's the other end of town actually.
 
Right.
 

It is convenient because I can get in the car and it's a big enough surgery car park to get the car in. 

When he first got the invitation Hugh thought it must be something everyone was invited to, until...

When he first got the invitation Hugh thought it must be something everyone was invited to, until...

Age at interview: 68
Sex: Male
Age at diagnosis: 68
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So you got the information. You decided to go along. Were you surprised that it was going to be at the local health centre?
 
Well, I was. I didn’t, they hadn’t said anything there, and , but I thought it was just one of these surveys that was going round to every health centre, because you get these things that go round all - like screening - go off to different health centres and all that. I thought it was, just this was it. It was going to happen in most health centres. But I found out since that it isn’t that, is it?
 
No.
 
No.
 
This is the only place. That’s right.
 
That’s it, yeah.
 
Yeah, yeah. So was that, when you found out that it was the only place, what did you feel?
 

I thought it was a bonus, really, to be there and to be involved, and hence I’ve gone on further to this. 

Often people were pleasantly surprised to hear that a specialist service like this was happening locally. This made it much easier for them to get to than a hospital appointment, and some could even walk to their surgery. Having to get to hospital might have put some people off, particularly if they had to use public transport, though others said they would probably have gone wherever it was. However, some people who decided not to take part in the study have told the research team that it was because they did not want to travel to and from appointments.
 

Pamela and Anthony thought it was wonderful that the screening could be done in their local...

Pamela and Anthony thought it was wonderful that the screening could be done in their local...

Age at interview: 78
Sex: Male
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Were you quite surprised that this was happening sort of with this level of equipment actually in the--?
 
Pamela' Yes, I thought it was wonderful that we, you know, that they’ve got things like that, that they can bring out and use. You know, but medical science has changed so much, hasn’t it? There’s so many wonderful things now that, if you had things 50 years ago you would have just been left, but not now. It’s great.
 
I think one of the things that they’re interested in, in setting up this research programme and testing it here, is how feasible it is to have it in local Health Centres?
 
Pamela' Yes, yes.
 
Does it seem to be fine?
 
Pamela' Yes that would be good because then, you know, everyone could be dealt with and there are a lot of people that would be frightened to go to [city] or somewhere else but if they could go into their own Health Centre they’d think, “Oh well, I might as well have it done,” wouldn’t they?
 
Anthony' Yes I agree with that. I think it’s nicer to be in your own environment or somewhere that you know rather than - to be quite honest, going into the [hospital] always sort of you know, there’s always this sort of fear about it a little bit, anyway but.
 
Yes.
 
Anthony' Although it’s very pleasant in there, of course.
 
Pamela' But I think it will, you know, it would be much better for people if they could just go in there, because there are a lot of very shy people that don’t really like to do anything.
 
And also in terms of access, I guess, it’s closer and easier to get to.
 
Pamela' Oh yes. It doesn’t take us a minute in the car. Well, ten minutes and we’re there, aren’t we?
 

Anthony' Mm. 

Susie would still have taken part if the first appointment was in hospital, but others might have...

Susie would still have taken part if the first appointment was in hospital, but others might have...

Age at interview: 74
Sex: Female
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It was held at our health centre a couple of yards down the road so, you know, there’s no problem getting there. If it had been up to the [hospital] I’d have still gone. I wouldn’t have seen any problem there.

 
No. I suppose, I mean, one of the things I think the staff are quite interested in is whether it’s a good idea to have this kind of screening programme in local health centres, and what people think about having it in their own health centre.
 
I think it’s a brilliant idea, it really is, you know. Because there’s a lot of people no doubt wouldn’t bother to go up to the [hospital], you know, because of perhaps a problem getting there and, you know, depends on their age or how active they are. But no, I think it’s a great idea at your own health centre, it is.
 

Anne could walk to the local health centre for the appointment. If it had been in hospital she...

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Anne could walk to the local health centre for the appointment. If it had been in hospital she...

Age at interview: 67
Sex: Female
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You mentioned that it was quite important for you that it was local.
 
Yes.
 
Were you surprised that they were able to do something like that locally?
 
I was. Because I thought, “Oh, no, that means I might have to go into the city.” And I thought, “No.” Because my husband, he’s just in hospital at the moment, he had a hip operation. And I thought, “I don’t want him to drive far away if I’ve got to go away. I shall say, ‘No, don’t bother’.” I wouldn’t have gone. But being at the local town, I could walk. So it was lovely.
 
So you really wouldn’t have gone?
 
No, I wouldn’t have, no.
 
That’s interesting. Because again, one of the things they’re quite keen to find out is whether it improves people’s willingness to come if it’s done locally.
 
That’s right. Yes, I think it did.
 
If they’d found anything, you would have had to go for a follow-up appointment in the city.
 
That’s right. Then my daughter would have driven me. My husband would drive me anyway, but not with his leg. No, he was suffering, pushing the pedal, with his leg.
 
So if it had been at another time, if he’d been well?
 

Yes, that would have been different, yes, that would have, yes, definitely. Yes, he would have took me anywhere. 



Last reviewed August 2016.

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