The UK has been ranked ninth in the Euro Consumer Heart Index, a survey of how consumer-friendly cardiovascular care systems are in 29 European countries.

The Index, which has been compiled by Swedish health “do-tank” the Health Consumer Powerhouse, provides a ranking of European national cardiovascular healthcare systems across five key areas: information, consumer rights and choice, access, prevention, procedures and outcomes. Overall, Luxembourg comes out on top, with a score of 836 points from a possible 1,000, followed by France, Norway and Switzerland. The UK scored 719 points.

Behind the four leaders, by a substantial gap, are Austria (769 points), Netherlands (761) and Sweden, Denmark, UK, Finland, Italy and Slovenia, all above 700 points.

These findings reveal that European consumers face a wide postcode lottery in healthcare, say the researchers. Generally speaking, there is a correlation between the amount invested in healthcare and the quality of outcome – three of the top four places are high-spenders Luxembourg, Norway and Switzerland. France makes it into the leading group through its excellent preventive work, they add.

The impact of financial clout is also clear at the other end of the scale, as all the poor performers are from the Central and Eastern European states.

Luxembourg won none of the categories outright, but excelled across the full range of indicators. It is also the only nation in the group to routinely allow its population to seek care in neighbouring countries.

The UK was placed second in five categories, but the researchers note that heart disease management is actually one of the stronger points of British health care services. “Having the strictest anti-tobacco measures in Europe is a good start. If these were complemented with improved patient choice and more rapid access to relevant care, the results could be even better,” said Arne Björnberg, the Index’s research director.

“To further improve UK cardiac care delivery requires work at both ends of the scale. The introduction of a national screening programme to improve prevention is important but there is also a need for post-hospital rehabilitation and ensuring that quality is measured, not only targeted,” added Health Consumer Powerhouse president Johan Hjertqvist.

Long term health investment
Across Europe, steps such as the introduction of national cardiovascular disease screening programmes, incentivising care providers for preventive measures, smoking cessation assistance and more compulsory exercise in schools should be implemented to ensure long-term health investments, says Dr Björnberg. The European Commission directive on patient rights to cross-border care, which was adopted this week, will contribute to better treatments for many patients, but perhaps of even greater importance is the right to choose of patients to choose their own provider. “All countries face variations in quality of care – patients need to be allowed to pick the provider they trust and knows will deliver best quality of care. In addition, by allowing consumer choice, overall standards will inevitably be improved,” said Mr Hjertqvist.

Data on cardiac care provision around Europe is very patchy and lacking in quality, the researchers conclude. Good specialist care can be found in any European country, although those nations which can afford to allocate “vast” resources to health care perform best, the research shows. However information to patients on where to seek cardiac care and clinic performance is “a disaster area,” with only Denmark, Austria and the UK providing such information.

By category, the winners and losers are:
- information, consumer rights, choice: winner – Denmark; loser – Greece
- access: winners – Belgium, France, Luxembourg, Malta, Switzerland; loser – Portugal
- prevention: winner – France; loser – Czech Republic
- procedures: winners - Norway, UK; losers – Bulgaria, Italy, Poland
- outcomes: winner – Switzerland; losers – Latvia, Romania