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The latest edition of CONNECT - Express' sister publication - looks at the ambitious redevelopment of the primary care centre at L’Aumone. Dr Robbie Hanna speaks of an accelerating shift towards preventative health care. "Medicine is changing. Patients are being supported to manage and improve their own health," he says. "Traditionally, we have often been looking at the wrong end of the telescope, treating the effects of ill health, and the need in the future is to do more work at the other end to prevent ill health."
Guernsey’s Chest and Heart Clinic is at the centre of preventative care, reducing the incidence of heart disease by identifying risk factors and taking remedial action. Since opening in 1974, the Clinic has carried out more than 85,000 screenings and blood pressure checks.
In a feature also originally published in CONNECT and now reproduced here, Matt Fallaize visited the Clinic to learn more about its critically important work over the past half century and what it offers today.
A full screening, which takes approximately 30 minutes, includes capturing information about lifestyle, an electrocardiogram, breathing tests, blood pressure tests, height and weight measurements, and various readings taken from a single blood sample, such as for cholesterol and diabetes.
A client can access his or her screening report anytime online and GPs are alerted if there is a need for ongoing monitoring. Clients are recalled for a fresh screening every five years, allowing long-term changes to be tracked.
There are, however, some misconceptions about the Clinic – in particular about its status, screening costs and who can be screened.
"We are on the site of the Princess Elizabeth Hospital, but we are not funded by the States in any way. We are a charity solely funded by donations," said Julie Jones, Centre Manager.
"Our screening service is completely free to clients – there is no charge. The obvious advantage of being free is that it helps to prevent health inequality by making us accessible to everyone.
"The free screenings are available to anyone aged between 25 and 75. We feel that a lot of younger people don’t know that they can be screened from 25. Young people can get hypertension and the sooner you treat it the better. You can get your numbers and understand your health and whether you need to make any changes. This is what preventative care is all about."
The Clinic can screen around 2,800 people a year. Typically, around one-third have risk factors for heart disease for which action can be taken to help prevent disease. But the Clinic is not an emergency service. People who have chest pain should go to hospital or a GP. Julie sums up the Clinic’s purpose as "screening and preventing".
"People will sometimes come with concerns and often we’re able to alleviate them. Or they come because of family risk factors and we can reassure them about coming back every five years and the thoroughness of our screening and how we can track any changes over time. Our recall rate is very high. Once people have had a screening, a high percentage return for future screenings every five years.
"We look at everything: what you eat and drink, whether you smoke, exercise, stress, mental wellbeing – all of these things contribute to your health now and in the future. We also do a lot of signposting. We don’t profess to be dieticians or mental health experts – a big part of our role is signposting to specialist services."
As well as offering screenings on the campus of the Princess Elizabeth Hospital, the Clinic takes its services out to public venues and events, and visits workplaces of conscientious employers who want to encourage and facilitate public health and health promotion. Offices, building sites...the Clinic will set up wherever is most convenient for people to have their screening.
"External screenings are a reduced version of a full screening. We take the equipment out in suitcases. We take an accurate height measurement and then provide body composition analysis, blood pressure tests and lifestyle advice. We’ll support and see anyone – we’ve started at half past six in the morning if that suits the clients. One nurse can see 12 people in a morning with 15-minute slots."
Screenings are carried out by a small team of nurses with decades of experience locally and nationally across a wide range of services – midwifery, health visiting, coronary care, cardiothoracic intensive care, high dependency, hospice care, nurse teaching, emergency nursing and resuscitation.
Julie took over as Centre Manager only last year. Her background is in acute nursing and teaching. "I was often doing a lot of adrenaline-fuelled critical care. This opportunity at the Clinic came along and it doesn’t come up very often. I had visited and thought what a fantastic service and role and I was attracted to working in preventative health care. I’m enjoying it very much."
It costs more than £100,000 a year to run the Clinic. Raising this money from donations is no mean task. But from the wider perspective of health services, it is a fraction of the cost of treating acute heart disease once long-standing problems have become critical – indicating again the financial as well as health benefits of preventative care.
A screening at the Clinic led Matt Collas, a Director at design and marketing agency Rock and Small, not only into a major lifestyle change but also to become a significant fundraiser for local good causes.
"My cycling story started seven years ago with a routine check-up at Guernsey Chest and Heart when they suggested cycling to lose a bit of weight," said Matt.
"The cycling bug soon bit and it is fair to say that it has dominated my spare time since. In 2021, I raised over £20,000 for local charities by writing a cycling book and organising two mass participation rides."
"During the second of these rides – The Only Way is UP, in October last year – a rider suffered a cardiac arrest. Thankfully, people were on hand to give life-saving CPR and this rider survived and is able to have a full, active life again.
"It really brought home to me the vital work of Guernsey Chest and Heart in providing regular health checks to islanders. It, therefore, seemed fitting to end the year raising money for the charity where my cycling journey began.
"Between Christmas Eve and New Year’s Eve, I cycled 500km – or 311 miles – in eight days as part of Rapha Festive 500. This is an annual event on Strava to challenge cyclists to get out during the Christmas break. The weather on the whole was relatively kind for the time of year and, with the help of a group of friends, I had different riding partners each day."
To arrange a screening with Julie and her team, call the clinic on 01481 237261 or email info@chestandheart.org.gg
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