Research has uncovered significant ethnic disparities in the treatment of aortic stenosis within the NHS, prompting urgent calls for the expansion of community-based clinics across England. A study from the University of Leicester revealed that black patients are 48% less likely to undergo a procedure to replace their aortic valve compared to white patients, with south Asian patients facing a 27% lower likelihood.
Addressing the Healthcare Gap
To combat this inequality, two rapid access valve assessment clinics have been established in south London through a collaboration between Guy’s and St Thomas’ NHS Foundation Trust and King’s College Hospital. These clinics are strategically located in areas with high populations of ethnic minority backgrounds and historically low treatment rates for valve disease.
Patients identified with heart murmurs by their GPs or at screening events are referred to these clinics for timely diagnosis and treatment. Aortic stenosis, a condition where the aortic valve narrows and restricts blood flow, affects an estimated 300,000 people in England, leading to symptoms like shortness of breath and chest pain.
Pilot Programme Success
The ongoing pilot, which has been operational for six months, has screened 168 patients, with over half (55%) coming from minority ethnic backgrounds. Results show that 57% of those screened had valve disease or other clinically significant findings, while over a third (35%) were diagnosed with at least moderate valve disease requiring further treatment or surveillance.
Professor Ronak Rajani, a consultant cardiologist involved in the initiative, emphasised the importance of this approach. "Despite significant advancements in valve disease treatments over the last 20 years, a lot of heart valve disease still goes undetected," he said. "This is particularly true for people from the global majority and living in economically deprived areas, where there is inequity of diagnosis and treatment."
Calls for Nationwide Expansion
Given the positive outcomes, Professor Rajani and his team are advocating for the scheme to be rolled out across NHS England. "I would advocate for these community rapid access valve clinics to be replicated across the country, where we know the same issues exist, to close the healthcare inequality gap," he stated. "This would be a pioneering approach to deliver heart valve care and tackle a problem in the UK, and globally."
Dr Sonya Babu-Narayan, clinical director at the British Heart Foundation, supported these calls, noting that such projects help break down barriers to essential care. "Cardiovascular disease is a major driver of inequalities in life expectancy across the UK," she said. "It’s not good enough that in 2026, a person’s chance of living a long, healthy life is still shaped by factors such as their postcode or ethnicity."
She added that research has highlighted stark disparities in access to lifesaving aortic valve treatment, affecting women, South Asian and Black individuals, and those in more deprived communities.
NHS England has been approached for comment on the potential expansion of these clinics.
